7 Activities That Can Make De Quervain’s Feel Worse

De Quervain’s Tenosynovitis is Wrist And Thumb Condition…It’s Common In Caregivers of Small Children and Babies. But what are some things that can aggravate this condition?

If you have nagging wrist pain on the thumb side of your wrist, your doctor may have diagnosed you with De Quervain’s Tenosynovitis.  This is a common injury that may cause shooting pain when you try to complete simple daily activities like picking your baby or lifting a heavy tray. 

If you’re a new mom, you may be overcome with joy, love, and admiration for the new addition… but also overwhelmed trying to navigate your new role – sleepless nights, keeping a consistent feeding schedule, and constant diaper changes may aggravate De Quervain’s and here’s why…

In this blog post we will discuss:

• Causes of De Quervain’s
• 7 Activities That Can Aggravate De Quervain’s
• Treatment Options De Quervain’s Wrist and Thumb Pain
• The role Occupational Therapy can play in your recovery of De Quervain’s

What causes De Quervain’s

What causes it, and more importantly how can you reduce aggravation or completely avoid getting it? 

De Quervain’s, sometimes referred to as “mommy thumb,” is caused by an inflammation of tendon sheaths around our abductor pollicis longus and extensor pollicis brevis tendons (Satteson, 2021), which are responsible in helping our thumb move. If you are currently experiencing or have experienced this pain you know exactly where this occurs in the wrist, but to provide a visual look at one of your hands.  You may feel pain the most where the base of your thumb meets your wrist, also known as the radial styloid. Wrist and thumb movements can make it worse – this is because those tendons glide through the inflamed tendon sheath tunnels in this area when we move our thumb and wrist in a deviated (side-to-side) motion.

Oftentimes De Quervain’s occurs in a person’s dominant hand because it is used more frequently. However, with new moms we often see both hands affected due to the nature of child-care,  “requiring repetitive wrist and thumb movements” (Cavaleri, 2016, p. 3). Lifting and carrying your baby, breastfeeding/bottle-feeding, changing, bathing, and playing with your new bundle (or bundles!) of joy involve those deviations of your wrist and thumb which aggravate symptoms and inflammation. 

Occupational therapists consider these tasks, as well as “self-care (bathing, dressing, personal hygiene) and household [tasks] (cooking, cleaning, laundry, and caring for additional children)” (Fernandes, 2018 p. 3) important occupations that are impacted by this limiting disorder and can cause added frustration as well as psychological stress from feeling as though we are unable to care for our new child/(ren). 

What Activities Can Aggravate De Quervain’s Wrist Pain?

Now that we’ve covered what De Quervain’s is and how it happens, lets discuss some activities that may aggravate symptoms as well as mediation strategies.

Lifting and Carrying Your Child/Children 

The motions involved in picking up a child involve deviation (that side-to-side motion, like waving) of the wrists as you reach down to place your hands around them. Some simple steps to take to help prevent De Quervain’s aggravation include:

• Lifting from underneath the baby in a scooping motion (instead of around the sides, which causes the thumb to be extended away from the palm)
• Keeping wrists in a neutral position when lifting
• Consider using a baby carrier to avoid added strain

Breastfeeding/Bottle-feeding

The time spent feeding our new baby is precious, but it’s important to keep in mind the repetitive motion that feeding can place on the wrist. Here are some suggestions to make sure you’re minimizing inflammation:

• Consider using a breastfeeding pillow, such as the BrestFriend (or Twin Z if you have twins) to help support baby, relieving pressure on your wrist/hand
• If you have a splint (more on this later), wear it while feeding to keep your wrist in a neutral position 

Opening A Jar or Tight Container

This task not only involves wrist deviation, it also forces thumb extension to grasp the jar, which can cause a sudden shooting pain sensation. Here are some tips to avoid this:

• If feasible, purchase a jar opener from Amazon or similar retailer. This device will allow you to keep your wrist in a neutral position while opening the jar
• Ask a loved one for help – we sometimes try to do everything ourselves and don’t want to bother anyone with a seemingly simple task. But keep in mind, the more you can reduce these repetitive straining motions, the better off you will be

Brushing Your Hair

Some new moms opt for the “mom cut” and chop it all off, while others keep their long locks. Either way, the repetitive deviation motion required to complete this activity can be straining. Some tips to help include:

• Keep your wrist in neutral while brushing and try holding the brush closer to the bristles to prevent deviation of the wrist
• Take rest breaks. Especially if you have a lot of hair/thick hair this can be particularly beneficial to give your wrist a break 

Scrolling on Phone/Texting Can Aggravate De Quervain’s

This one can be particularly tough on your thumb as you grasp your phone and scroll with your thumb. This causes repetitive thumb extension that contributes to inflammation. This can be prevented through some simple adjustments:

• Try holding your phone in one hand while you use an index finger with the other hand to text
• Try using voice-command texting to limit thumb/finger overuse
• Take breaks from texting to give your thumb and wrist a break

Writing 

Handwriting may be a part of your job or a leisure activity you enjoy partaking in during your free time. If you’re experiencing pain, here are some strategies to help:

• Use a pencil/pen grip to decrease the force placed on tendons and joints during activity
• Take frequent rest breaks, every 15 minutes if possible 

Doing Laundry 

With a newborn your laundry demands increase exponentially. The added loads of laundry put added strain on your wrist, but some simple adjustments can alleviate this:

• Instead of holding a laundry basket try using an over-shoulder or cross-body bag to transport laundry 
• Try using laundry pods or powder that you can scoop instead of large containers of laundry detergent
• If both hands aren’t affected move laundry from washer to dryer with unaffected hand 

Hammering And Using tools

You might be accumulating photos of your precious new addition and can’t wait to print them out and hang them on your wall. Or maybe you have a crib or other nursery furniture to assemble. Before you run to grab your tools, it’s important to keep in mind that tasks like hammering can contribute to aggravation of your symptoms. Here are some tips to help prevent worsening of pain:

• Try holding the hammer closer to the top to help keep your wrist in neutral while hammering. When holding further down on the handle it forces the wrist to deviate more
• Ask for help. If there is someone who is not experiencing De Quervain’s who is willing and able to assist, then take them up on it
• Take breaks – no need to hang all those photos in one sitting 

Wrist Pain Relief: Treatment Options for De Quervain’s 

De Quervain’s Wrist Pain Treatment At Home

If you start to notice symptoms of De Quervain’s (or have already been experiencing symptoms for some time) you should schedule a visit with your doctor. While you wait for that appointment there are some at-home strategies you can try to help alleviate pain:

R-I-C-E – which stands for rest, ice, compress, elevate. These techniques combined assist in reducing inflammation and pain. 

Rest: When completing an activity that requires repetitive wrist/thumb motion and/or gripping for extended periods of time, try to take a rest break. Ideally, if you start to feel pain, stop the activity and rest until the pain subsides. If you’re not able to stop the activity completely, try taking 15-minute rest breaks for every hour of work (for example, when typing or handwriting). 

Ice: Occupational therapists in hand therapy use ice often to help reduce/prevent inflammation and pain. Be sure to wrap your ice pack in a hand towel or washcloth and don’t leave the ice on for more than 5 minutes at a time. You can use ice throughout the day in 10-15 minute increments every 2-3 hours as needed.

Compression: Compression assists in preventing inflammation and helps provide stability to your wrist. You can purchase an ace bandage from any local drugstore as well as online. Be sure to not wrap too tightly to prevent cutting off circulation.

Elevation: Finally, keep your affected hand elevated above the level of your heart. This aids in reducing inflammation. While you sleep, try to prop your hand on a pillow next to you, or keep it on your chest. 

Gentle massage over the affected area: We recommend using a small amount of lotion to help prevent friction. Don’t press too hard to prevent aggravation of inflammation. 15-20 minutes, you can do this while you watch tv or before bedtime.

Epsom salt soak: If you don’t have time for a full-on bath, you can still soak your hand in warm water with Epsom salt to help reduce pain and inflammation. If possible, keep your affected hand submerged for 20-30 minutes.

Try to remember to keep your wrist in neutral during daily activities. Try out some of the adaptations and modifications mentioned above.

Make An Appointment With Your Doctor

Hopefully some of the home strategies help alleviate some pain while you wait for your doctor’s appointment, and it’s important to keep in mind that the advice given in this post is not medical advice and it’s important to follow your doctors’ instructions and recommendations. Once you see your doctor, they can advise you on next steps. They may suggest wearing a splint you can purchase from online retailers such as Amazon, provide injections that target inflammation, or, in severe cases, recommend surgery. Remember to ask questions about outcomes and scenarios for each case. 

Ask Your Doctor If Occupational Therapy Is Right For You

Your doctor may also recommend outpatient hand therapy, but if not, ask them if they feel it could work for you.  Occupational therapists “can contribute to preventing pain, increasing function, and promoting meaningful occupations during pregnancy and the postpartum period (Fernandes, 2018, p.1)”. Outpatient clinics provide specialty services and treatment modalities as well as provide you with wrist pain exercises, gentle stretches, custom splinting if indicated, and patient education about your diagnosis. Oftentimes, hand therapists will utilize massage techniques to target and reduce inflammation and provide strengthening exercises using theraputty to strengthen muscles around your thumb/wrist to help alleviate pain. 

Occupational Therapy at Home for Busy Parents

If getting to an outpatient clinic is not possible, but you still wish to seek the advice/expertise of an experienced occupational therapist, concierge OT may be for you. Interested? You can find information on our services here, and learn more about Susanne Corrales, OTR/L, Owner of Hand Wellness OT.

The Importance of Rest, Mental Health, Self-Care 

We want to emphasize that to care for others you must first take care of yourself. Easier said than done as a new mom, but an important thing to remember. If you can find balance and little ways of relieving some pressure and stress, you will likely find that you’re more satisfied and happier overall. Don’t feel guilty about asking for help, hiring a sitter for a few hours, or taking that much needed hot bath. You deserve it, and you are worth it.

Conclusion

In this post we discussed De Quervain’s including what it is and what tendons/body parts are affected. We went into a little more detail about some specific activities that aggravate pain and inflammation and provided some adaptive/compensatory strategies for each of those activities. We provided guidance on home remedies until you’re able to meet with your doctor and gave some insight as to what outpatient hand therapy might look like for you. In addition, we noted that attending an outpatient hand clinic might not be feasible for everyone and provided an alternative solution with concierge OT. We concluded with the importance of rest and self-care. 

Remember to always follow your doctor’s medical advice and instructions before initiating any treatment. Follow our blog to learn more about 

• De Quervain’s
• Carpal Tunnel Syndrome
• Arthritis in Wrist and Thumb
• Tendinitis of The Hand 
• Hand Wellness 
• Joint Protection Strategies