How to deal with postnatal wrist & thumb pain (DeQuervain's Tenosynovitis)

What Is DeQuervain's Tenosynovitis?
DeQuervain's Tenosynovitis is an inflammatory condition affecting the 'Extensor Pollicis Longus and Brevis tendons of your thumb. It's that nagging pain at the side of your wrist, and it can feel very sore indeed. DeQuervain's is also known as "Mummy Thumb" because it's common during the postnatal period. 

​New mums are particularly susceptible to DeQuervain's because their hands have to work extra hard while caring for a newborn and rarely have an opportunity to rest. Furthermore, the hormone' Relaxin' is still present during the postpartum months, causing soft tissues to be weaker than usual. These factors combined can result in the thumb tendons getting very overworked and inflamed.  ​

Fortunately, 'Mummy Thumb' is only a temporary problem. As your baby grows, the demand on your hands eases which allows the tendons to recuperate, and it will eventually go away. But, whilst you are suffering in the most difficult phase of this condition, here are some tips to help you recover faster and deal with the pain more effectively. ​

​1. Apply Ice
​DeQuervain's is characterised by inflammation; so you can make yourself feel more comfortable by addressing this component directly. Here is where ice will be your best friend! You can make a cool pack by wrapping a bag of frozen peas in a damp towel. Then, apply it to your wrist and thumb for 10 to 15 minutes, as many times a day as you need to find relief

2. NSAIDs
Non-steroidal anti-inflammatory pain medications (NSAIDs) can be beneficial if the pain is very debilitating. They are not suitable for everyone, so you must consult with your GP before using them or any other medication, especially if you're breastfeeding. Your doctor may advise you to take a course to address the rogue inflammation more effectively instead of using them solely for pain relief. If you are not keen on or cant take oral medication then you could consider a topical NSAID or to be super natural rub Arnica gel on the area instead.  

3. Modify Activities
When you have a newborn, it isn't easy to rest, but you can modify the most common activities. For example, instead of carrying bags, you can use a backpack to avoid putting your thumb to work. When breast or bottle feeding, you can use a nursing pillow to give your hands a break. You can easily modify most daily activities; remember the goal is to rest your thumb!

4. Change Your Grip
We use the 'L' shaped grip all day long for activities such as holding a phone, lifting our baby, picking up toys, etc. Although it's a useful and instinctive way to hold things, this particular grip causes increased strain on the already suffering tendons. 
​This position will cause even more stress if you're handling weight. It would help if you closed that thumb to rest next to your other fingers when holding things and doing things with your hands. This ergonomic adaptation can be a real game-changer when it comes to speeding up your recovery.

5. Limit Your Tablet and Smartphone Use
​Repetitive actions such as texting, swiping, and simply holding a device will worsen your symptoms. I'm not suggesting you stop using smartphone entirely, but you should limit your sessions whilst you have this condition. Only use your mobile devices when you need to! You can also avoid using your hands by resting it on a surface instead and avoid using your thumb as much as possible. 

6. Use a Soft Splint
​If your pain is making things very difficult, a splint can be helpful. It is not a long term solution, but it will force you to rest the affected area because you won't be able to load or repetitively move your thumb inadvertently. If you use a splint, you should remove it every few hours to do rehabilitation exercises, apply ice, and allow your wrist some gentle movement, so it doesn't become stiff.

7. Isometric Exercises
​Isometrics are done by activating the muscle without actually moving. This type of exercise gently loads the tendon to help it get more resilient. There are several benefits to isometric exercise for an irritable condition like DeQuervain's: First, it will allow you to exercise your thumb in a non-aggravating way. Second, Isometrics create a lot of muscle action, meaning your tendons will get stronger over time. Third, it stimulates 'mechanoreceptors' in the tendon, triggering an analgesic effect. Simply put, isometric exercises don't only make you stronger, they can reduce your pain right away. ​

​8. Use Nutrition to Optimise Your Recovery
​What you put in your body can have a significant effect on your recovery. You should include foods rich in protein and zinc to provide the building blocks of repair, and omega 3 to reduce inflammation. Hydration is also essential; water helps improve circulation, which is essential in delivering nutrients and oxygen to the injured area. 
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You should take care to avoid processed foods, sugar, alcohol and caffeine. These put stress on your body, drive inflammation, and can slow down your healing.

Final Words
​Although DeQuervain's is the last thing you need when you are a busy new mum, you are not alone, and there are lots of things you can do to ease your symptoms now and promote recovery. With rest, ice, ergonomic adaptions, good food, and some targeted exercises, you will get better and beat this troublesome condition!