New Moms: Welcome Relief from Hand Pain
Last reviewed by Faculty of Harvard Medical School on January 14, 2013
By Alice Y. Chang, M.D.
When my right wrist began to hurt, I assumed it was carpal tunnel syndrome, a condition caused by inflammation of the tendons that pass through the wrist. Since new mothers like me are often prone to this condition, it was a natural but wrong self-diagnosis.
Doctors often neglect or dismiss their own health problems, and I'm no exception. As a busy working mom, I depend on caring and observant family, friends and co-workers to remind me when I'm neglecting myself. Even when colleagues told me to see a doctor, I kept saying, "I am a doctor." I figured ice, ibuprofen and a brace were the only remedies available. But the pain continued to interfere with many of my activities at home and work. Most of all, it broke my heart when I couldn't pick up my son after a long day at work. Now I want more women and physicians to know about this potentially overlooked diagnosis and how to fix it.
A wise physician and mentor, who is also an experienced father and grandfather, made the right diagnosis after one quick glance at my wrist brace. "You know what that is, don't you?" he asked. I quickly said, "Yes, carpal tunnel syndrome." He patiently replied, "No, it's de Quervain's tendonitis. They say new mothers and grandmothers often get it from repeatedly picking up a baby or child. My wife had it. But an injection fixed it."
That last comment got my attention. There was something more that could be done! I made an appointment with a doctor and within a week, I was rescued from pain. It was a miracle. I now put this rheumatologist on a pedestal next to the anesthesiologist who gave me my epidural when my son was born!
The inflammation and pain caused by de Quervain's tendonitis is similar to other types of tendonitis caused by overuse. But two things make it unique: its location (the base of the thumb) and who it affects (new mothers). In carpal tunnel syndrome, pain is usually centered on the inside of your wrist where nerves and tendons pass through a narrow tunnel-like space. De Quervain's tendonitis, however, involves just the thumb tendon, which runs through a canal at the base of the thumb at the back of the hand.
The common teaching is that people who do a lot of work with their hands, particularly those who do needle and computer work, are susceptible because of the repetitive movements of their hands and thumbs. But what medical textbooks never told me is that it commonly occurs in new mothers or grandmothers who are more likely to repeatedly pick up their first child or grandchild.
Signs you may have de Quervain's tendonitis:
How de Quervain's tendonitis is diagnosed:
A health care professional might want to check an X-ray of your wrist to make sure it isn't a fracture.
What you can do:
How a health care professional can help:
Busy moms can't afford to be sidelined by hand pain. If you notice a new mother or grandmother favoring one wrist, ask her to touch the area at the back of her wrist, just below the base of the thumb. If it's tender, chances are she has de Quervain's tendonitis. When home treatments fail, see a health care professional. A corticosteroid injection can quickly relieve the pain and accelerate the healing process.
Alice Y. Chang, M.D. is a former instructor in medicine at Harvard Medical School. She is currently associated with University of Texas Southwestern Medical Center. Her clinical interests and experience are in the fields of primary care, women's health, hospital-based medicine and patient education.