UNC Health Care
Mother holds infant son

Find Relief from the Pain of ‘Mommy Wrist’

A newborn is small and light and a cinch to pick up. But after a few months, that tiny bundle blossoms into a chubby baby with rolls and heft. Before you know it you’re lifting a toddler. And you do this dozens of times a day—and sometimes night—month after month.

This repetitive movement can lead to a condition called de Quervain’s tenosynovitis, also known as first dorsal compartment tendinitis or, colloquially, as “mother’s wrist” or “mommy wrist.”

The problematic motion is one that “requires your wrist to go pinky side to thumb side, back and forth, back and forth,” which is what happens when you lift a baby under the armpits, says UNC Health orthopedic surgeon J. Megan M. Patterson, MD. “When you’re lifting 15 pounds of weight, or more, over and over, you can get this problem.”

What Is Mommy Wrist?

Mommy wrist doesn’t just happen to moms; this type of tendinitis can happen to dads, nannies, day care workers and other caregivers, as well as people who swing hammers or tennis rackets repeatedly. To be more inclusive, Dr. Patterson calls it “caregiver’s thumb.” (The pain is located on the thumb side of the wrist.)

Tendons are tissue that attach muscle to bone, and tendinitis is the inflammation of this tissue. In this condition, the affected tendons are the two that help extend the thumb, the extensor pollicis brevis (EPB) tendon and the abductor pollicis longus (APL) tendon.

These two tendons travel through a compartment in the wrist, akin to a tight tunnel along the thumb side. This tunnel keeps the tendons in place, but if they are overused, they can become inflamed and rub against that tunnel, causing pain. The more inflamed the tendons get, the tighter the tunnel gets and the more they rub, making the problem worse.

“It’s hard to get it to go away because it just keeps feeding on itself,” Dr. Patterson says.

Symptoms of Mommy Wrist

De Quervain’s tenosynovitis causes the following symptoms:

  • Pain on the thumb side of the wrist that worsens with motions that involve gripping or twisting with the thumb, such as turning a doorknob or opening a jar
  • Swelling in the wrist, potentially with a bump (a cyst with fluid can develop)
  • Clicking or popping in the wrist

How Mommy Wrist Is Treated

For some people, this type of tendinitis can be remedied with conservative at-home treatments, following the RICE method: rest, ice, compression and elevation. That means rest the wrist (which can be difficult for caregivers), ice it, compress it with a bandage and elevate it at or above your heart level. These four steps should help reduce pain and swelling.

Wearing a splint can help too, but Dr. Patterson stresses that it must immobilize both the thumb and the wrist to be effective. This type of splint is called a wrist thumb spica splint. If you’re wearing a splint but the thumb is free, it won’t be nearly as helpful, she says. Anti-inflammatory medications such as ibuprofen can lessen pain, and an occupational therapist can help you figure out how to perform daily activities such as lifting your child in a manner that is less harmful to your wrist.

But the most effective nonsurgical treatment is a cortisone injection into the compartment. At least 60 percent of the time, one shot will fix the problem, Dr. Patterson says. “The goal of the shot is to cure the problem so it goes away and doesn’t come back again.”

In a minority of cases, a second shot is needed. If two shots don’t work, it’s usually best to move on to surgery, which involves opening the tunnel to take pressure off the tendons, Dr. Patterson says.

Either way, you don’t have to wince when lifting your not-so-little one, Dr. Patterson says. “What’s important is that it’s totally treatable.”


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