Mummy Thumb: Why the Base of Your Thumb and Wrist Hurts
Updated: Sep 15
Sharp pain at the base of your thumb when you pick up your baby, lift a car seat, use your phone or twist a jar lid? You may be experiencing De Quervain's tenosynovitis, commonly known as "mummy thumb" or "mummy wrist."
The name comes from the repetitive lifting, carrying and feeding involved in caring for a baby.
But De Quervain's isn't just a new-mum problem. It can affect anyone who repeatedly loads the thumb and wrist through work, sport, hobbies or everyday activities such as texting, gaming, gardening or using tools.
What is De Quervain's tenosynovitis ("mummy thumb")?
Two tendons that move your thumb — the abductor pollicis longus (APL) and extensor pollicis brevis
(EPB) — pass through a narrow compartment on the thumb side of your wrist.
With De Quervain's, the tissues around these tendons become irritated and thickened, making it harder for them to glide comfortably. This can cause pain, tenderness and sometimes swelling or a catching sensation with thumb movement.
For new parents, repeatedly lifting and carrying a baby can place considerable load through this area, particularly when the wrist is bent and the thumb is held away from the hand.
What does De Quervain's feel like?
Common symptoms include:
Pain at the base of the thumb, where the thumb meets the wrist
Pain when lifting or carrying your baby, a car seat or other objects
Pain with gripping, pinching or twisting, such as opening a jar or turning a key
Tenderness or swelling on the thumb side of the wrist
Clicking, catching or snapping with thumb movement
Pain that may travel up the thumb side of the forearm
Reduced grip or pinch strength because of pain
Symptoms can affect one or both hands.
How is De Quervain's diagnosed?
De Quervain's is usually diagnosed through your symptoms and a physical examination. Your hand therapist or doctor will assess the location of your pain, your thumb and wrist movement, and which activities reproduce your symptoms.
Tests such as the Finkelstein test may be used as part of the assessment, but no single test should be relied on in isolation.
Imaging is not usually necessary, although it may be recommended if the diagnosis is unclear or another condition needs to be ruled out.
What causes it?
The exact cause isn't always clear, but repetitive loading of the thumb and wrist can contribute.
This may include:
Repeated gripping, pinching or lifting
Frequent thumb and wrist movements
Lifting and carrying a baby many times throughout the day
Holding or feeding a baby with the wrist in an awkward or bent position
Repetitive work, sport or hobbies
Not having enough time for rest and recovery between activities
The important point is that anyone can develop De Quervain's when the thumb and wrist are repeatedly stressed.
How is De Quervain's treated?
Most cases can be managed without surgery. A hand therapist can assess your symptoms and tailor treatment to your needs and daily activities.
Splinting
A splint that supports the thumb and wrist can reduce movement and load through the irritated tendons, helping symptoms settle. Your hand therapist can recommend the most appropriate splint and advise when to wear it.
Activity and technique modification
Small changes to how you use your hand can significantly reduce strain.
When caring for a baby, for example:
Keep your wrist as straight as possible when lifting
Use both hands where you can
Bring your baby close to your body before lifting
Avoid repeatedly lifting with your thumb held wide and your wrist bent
Use your whole hand and forearm to support your baby's weight
Change feeding and carrying positions regularly
The same principle applies to work, sport and hobbies — identifying and modifying the movements that repeatedly aggravate your symptoms is an important part of recovery.
Graded exercise
Once symptoms are settling, a graded exercise program can help restore thumb and wrist movement, strength and tolerance for everyday activities. Your hand therapist can guide you on the right exercises and when to introduce them.
Pain and swelling management
Ice, relative rest and appropriate pain-relieving or anti-inflammatory medication may help in some cases. If you're pregnant or breastfeeding, speak with your doctor or pharmacist before taking medication.
Corticosteroid injection
For persistent or more severe symptoms, a corticosteroid injection may be considered. Your doctor can discuss whether this is appropriate for you and explain the potential benefits and risks.
Surgery
Surgery is rarely needed. If symptoms don't improve with appropriate non-surgical treatment, a hand surgeon may recommend releasing the tendon compartment to allow the tendons to move more freely.
How long does it take to get better?
Recovery varies from person to person. Some people improve within a few weeks with appropriate
treatment, while others take longer, particularly if the hand and wrist continue to be heavily loaded.
Getting the condition assessed early can help identify what is aggravating your symptoms and put the right treatment in place.
When should I get it checked?
It's worth having your thumb or wrist assessed if:
Pain is interfering with caring for your baby or everyday activities
Symptoms are getting worse or aren't improving
You have persistent swelling or tenderness
Your grip or pinch feels significantly weaker
You have ongoing clicking or catching
Not all thumb and wrist pain is De Quervain's, so an assessment can help confirm the diagnosis and rule out other causes.
Book a hand therapy appointment
Whether your thumb pain has developed from caring for a baby, work, sport, hobbies or repetitive everyday activities, our experienced hand therapists can assess your symptoms and develop a practical treatment plan.
Not sure whether hand therapy is right for you? Contact us and we can help you understand the
next step.
Important Information
This article provides general information only and is not a substitute for individual clinical assessment or medical advice. If you're experiencing persistent or significant thumb or wrist pain, speak with your GP, hand therapist or other appropriate healthcare professional.
Comments