Mommy Thumb

Mommy thumb, also called de Quervain’s tenosynovitis, is one of the more common conditions seen in hand clinics. While it is especially common in new mothers, most people affected by the condition are not new parents. One theory of why new mothers are affected is from the repetitive action of lifting a small child by the armpits with the thumbs extended. However, the more recently accepted line of thought is that hormonal changes are the real culprit. Regardless of the cause, the result is moderate to severe pain at the base of the thumb particularly when giving the thumbs up sign.

Physiologically, the problem is inflammation around the tendons that extend the thumb where they are stabilized in a tunnel at the wrist bone. Friction between the inflamed tendon and tunnel can cause significant pain. Most new parents are so busy that they put off coming to the doctor for this discomfort until it is quite severe. However, there are several treatments available. The mainstay of treatment is a cortisone injection. An injection is safe even in nursing mothers and will generally cure or at least greatly reduce the symptoms. For those who do not want an injection, a brace along with over the counter anti-inflammatory medications is another option. In severe cases that do not respond to more conservative treatments, there is a surgical treatment, but in my experience this is rarely necessary given the effectiveness of the injections.

More information is available is available at the ASSH (American Society for Surgery of the Hand) website here. I commonly treat deQuervain’s tenosynovitis and feel strongly that the majority of patients will have an excellent outcome without surgery. If you are a new mother, or just having pain at the base of the thumb, relief is readily available with an appropriate diagnosis and treatment.

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