Mommy Thumb is the current nickname given to De Quervain’s tendonitis. Almost 50% of new mothers experience this condition, as described below. However, it is a condition common to many people who engage in repetitive hand or wrist movement, such as gardening, knitting, cooking, playing a musical instrument, carpentry, walking a pet on a leash, lifting a baby, and the like.
De Quervain’s tendonitis is not carpal tunnel syndrome, a pain that is usually centered on the inside of the wrist where nerves and tendons pass through a narrow tunnel-like space. De Quervain’s tendonitis involves just the thumb tendon, which runs through a canal at the base of the thumb at the back of the hand. Specifically, the protective synovium sheath of the tendon becomes inflamed. In most cases, the condition is not serious and can be easily treated. This article will help you identify De Quervain’s tendonitis and its causes, and suggest treatment strategies including the use of Solomon’s Seal tincture and salve.
What Causes De Quervain’s Tendonitis?
When you grip, grasp, clench, pinch or wring anything in your hand, you use two major tendons in your wrist and lower thumb. These tendons run side-by-side from your forearm through the thumb side of your wrist. They normally glide unhampered through the small tunnel that connects them to the base of the thumb. In De Quervain’s tendonitis (the term tenosynovitis is also used), the tendons’ slippery covering becomes inflamed, restricting movement of the tendons. It is the inflammation of the tendon sheath that must be treated. See the accompanying illustrations.
In short, Mommy Thumb is simply overuse of the wrist and thumb, i.e. repetitive motion, while performing activities of daily living (ADL). Because up to 50% of the hand’s function relates to the thumb, overuse can significantly hamper everyday functions. Here are ways such overuse happens:
- Gardening: Repetitive hand weeding (grasping/pinching and pulling), hand-troweling, and pruning with small hand clippers
- Playing a musical instrument: Repetitive practice and performance by pianists, guitarists, harpists and string players who rely heavily on thumb and wrist movement
- Knitting & crocheting: Repeated wrist and thumb motions for hours at a time
- Cooking: Constant chopping with a knife and lifting cookware
- Carpentry: Hammering, sawing, using tools, lifting quantities of wood and materials
- Walking a Pet on a Leash: Continuous yanking and pulling at the wrist while holding the leash
- Office work: Repetitive work tasks such as typing, lifting, organizing files, etc.
- Hobbies: Any hobby or craft that relies on constant use of the thumb and wrist
- House Cleaning, Maid work: Constant gripping, wrist bending and wringing out of a cloth or sponge from day-to-day
- Sports: Tennis, golfing, bowling, baseball, archery, hockey, etc. that involves gripping
Why Mother (& Fathers) are Affected
It has been determined that Mommy Thumb occurs when infants are lifted improperly. A mother may describe it as a sharp, shooting pain starting at the thumb, through the wrist, and darting up the forearm.
This improper lifting affects up to 50% of new mothers, the primary caregiver of an infant.
How it happens: Many mothers reach down and place their thumbs in their child’s armpits to lift them. This causes extra strain on the thumb and tendons. The heavier the child is, the more likely this condition will occur. The same goes for the lower down a child is lifted from (say, from the ground or a low crib). The repetitive motion of placing the thumb and index finger in the shape of an “L” to lift young children causes the pain and inflammation. Similarly, cradling the child with the L-shaped thumb and index finger beneath its head can also cause discomfort, as can other awkward hand positioning when carrying a baby.
Although this condition can affect any mother, research shows mothers over the age of 40 have an increased risk for developing Mommy Thumb. Several reasons are cited: women are having children at later ages, newborn babies weigh up to 10% more than 30 years ago, crib heights are lower (causing undo leaning over to awkwardly lift the child up), and many new mothers use PDAs for message texting. Lastly, hormonal changes associated with nursing and pregnancy can contribute to weaker thumb and wrist functions.
The proper way to lift a child: Mommy thumb can be avoided by changing a few of your habits. When picking up your child, do not use your thumb and fingers. Instead, place your hands on both sides of their rib cage and gently squeeze the child to lift. Or, place one hand under the child’s bottom and one behind their head to lift the child. Make sure you aren’t bending down farther than necessary. Remember to use your legs to lift heavier children and avoid bending the back or stooping while lifting your child.
Although the primary cause of De Quervain’s tendonitis is overuse, there are other possible causes associated with aging, disease, or direct injury:
- Direct injury to the wrist (such as a fracture) or tendon that causes scar tissue to build-up and restrict movement of the tendons
- Inflammatory arthritis, such as rheumatoid arthritis
- Metabolic conditions such as diabetes, hyperuricemia, hypothyroidism
The common complaint of de Quervain’s tenosynovitis is a pain and swelling near the base of, or over the thumb. The pain may appear suddenly or may increase over time, spreading farther into the thumb and wrist, and up the forearm. Pinching, grasping, lifting and other movements of the thumb and wrist aggravate the pain. Look for these potential signs of discomfort:
- Pain near the base of your thumb
- Swelling near the base of your thumb
- A fluid-filled cyst in the same region as the swelling and pain
- Difficulty moving your thumb and wrist when you’re doing activities that involve grasping or pinching
- A “sticking” or “stop-and-go” sensation in your thumb when trying to move it
- A squeaking sound as the tendons try to move back and forth through the inflamed sheaths
- Pain and/or swelling on the wrist’s thumb side at the back of the wrist
- Increased pain while forming a fist, grasping or holding objects, or turning the wrist
- A snapping or catching feeling when moving the thumb, much like a trigger finger.
The most common diagnostic procedure (besides review of day-to-day activities) is the Finkelstein maneuver. This simple test can also be self-administered. Make a fist with the fingers placed over the thumb (the thumb is tucked in and bent towards the little finger; see photograph). You may feel tenderness at the base of, or over the thumb, or even a swelling or thickening. As Figure 2 shows, you may also bend your fist downward for further testing of discomfort. The common finding in this test is the tenderness felt over the thumb, which confirms tendonitis, and perhaps shooting pain up the forearm.
Remember, De Quervain’s tendonitis is an irritation and swelling of the sheath or tunnel which surrounds the thumb tendons as they pass from the wrist to the thumb. This inflammation is causing the discomfort around the thumb and up the forearm.
Surgery is always the last resort for treatment of De Quervain’s tendonitis. The primary goal is to relieve the ache that is caused by the inflammation of the nerve sheath that the tendons pass through. Oftentimes return to normal functioning can occur within 2-4 weeks. The following treatment approaches are optimal.
- Limit and avoid activities that may directly aggravate thumb and wrist discomfort
- Wear a wrist brace or splint
- Apply ice or cold packs for 5-15 minutes to affected hand several times a day
- Modify lifting activities of an infant
- Use ergonomically designed tools: kitchen, gardening or handyman tools
- Do rehabilitation exercises such as wrist extension and flexion stretch, and supination and pronation of the affected forearm only if these do not cause further discomfort or pain
- For pain relief, take nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin, others) or naproxen sodium (Aleve, Anaprox). Use as directed or in consultation with your medical advisor. Prolonged use can cause gastrointestinal problems, ulcers, heartburn, etc.
- Use an herbal intervention such as a tincture, salve and/or liniment (see below)
HOW SOLOMON’S SEAL HELPS HEAL DEQUERVAIN’S TENDONITIS
The body has what is called a plastic regeneration response to injuries, that is, the ability of the body to create a healing response that attempts to repair tissues, tendons, joints, etc as a result of strain or injury. Solomon’s Seal is useful to fight and correct joint inflammation, tumors, as well as the acute and chronic swelling and edema that occur in the surrounding tissues following injury or strain.
Effect on Soft Connective Tissues
The soft connective tissues surrounding muscles, tendons and ligaments that are damaged/injured often results in inflammation, swelling and edema. These types of problems are usually the result of excessive out-of-balance tensions on the muscles, tendons, and ligaments. Solomon’s Seal appears to “read” and correct these tension inbalances. Because of the natural presence of allantoin, Solomon’s Seal also acts as an anti-inflammatory on almost all of the connective tissues. This is achieved by restoring proper lubrication (synovial fluids) that both supplements the deficiency and acts protectively to reduce friction on the tissues.
Enhancing Solomon’s Seal’s Effectiveness with other Herbs
In our intense study and observation of Solomon’s Seal’s palliative effects on various conditions, we have been inspired to integrate its use with other esteemed healing herbs. In our Cortesia Solomon’s Seal Tincture, Formula #1 – Arthritis & Joint Repair, we have combined it with Gravel Root and Pleurisy Root. Gravel Root is specifically indicated for arthritis for it brings minerals into and out of solution, hence its use as a remedy to dissolve and remove deposits in joints. Pleurisy Root is indicated in cases of acute inflammation, arthritis, bursitis, lack of lubrication, or clicking in the joints.
Our Cortesia Solomon’s Seal Tincture, Formula #3 – Cartilage & Tissue Repair is integrated with the highly respected Horsetail plant. Horsetail’s high silica content helps to rebuild damaged cartilage and structures. It strengthens connective tissue, bones, cartilage, mucous membranes, arteries, skin, and other tissue.
Of course, Solomon’s Seal by itself works to harmonize, feed, lubricate, and tighten or loosen (as needed) tendons, ligaments, attachments, and joints. It is also a valuable connective tissue anti-inflammatory, and is known to help moderate the symptoms of osteoarthritis. It has many other benefits described in other articles on our website and blog.
The Use of Solomon’s Seal Salve to Reduce Inflammation & Pain
Reducing inflammation and soothing the pain of tendonitis can be done topically if a pain reliever has the ability to penetrate the skin barrier and contains anti-inflammatory agents. A topical formula will not only relieve pain or inflammation, but also dilate the blood vessels (if it contains natural menthol). This allows for relief of tendonitis, without causing any stiffening of the tissue.
Our Cortesia Solomon’s Seal Acute & Chronic Injury Salve is a very effective topical salve, especially when used with our Solomon’s Seal Tincture, or any of the above mentioned Solomon’s Seal formulas. The salve contains Arnica, Calendula, Comfrey, Horsetail, Mullein, St. John’s Wort and Solomon’s Seal root. Unlike most topicals, however, the herbal properties in our salve permeate deeply through the skin layers into the cellular level of affected tissues.
THE 3-STEP METHOD:
COMBINING A LINIMENT, SALVE & TINCTURE FOR DEEP HEALING
When using herbal interventions or products such as a tincture, salve or liniment, we believe that a 3-Step Method is the best way to address many of the types of acute and chronic injuries mentioned above. (Note: This approach should never take the place of other practical strategies such as rest, support or elevation of injury, increasing water intake, adjustment of diet and nutrition, etc.)
Apply Cortesia Quick-Relief Liniment topically several times daily, as needed, in area(s) where pain or discomfort is occurring. Apply morning, afternoon, and evening OR before and after periods of activity and again before bed. This will provide short-term relief so that certain activities are less painful or so that you can get to sleep. It is important to firmly rub the liniment for several minutes to stimulate blood circulation in the effected tissue or joint area. This works very well for arthritic conditions or joint issues to increase flexibility. Of course, use lighter pressure for a sprain, bruise, very sore muscle, or painful area. For detailed information about the effectiveness of liniments, see our two articles on this Blog and our website: www.solomonsseal.net.
Apply Cortesia Acute and Chronic Injury Salve externally to injured area twice daily, morning and evening (apply after the liniment). Wrap or bandage as needed to protect clothing. This is an important long-term method of healing for strains, sprains, aches, symptoms of arthritis, damaged muscles, tendons, ligaments, joints, etc. It perfectly compliments the liniment.
Note: After applying a liniment or salve, it is very useful to simply lay your hand(s) lightly over the affected area for a few minutes. This form of “touch healing therapy” is therapeutic (see our article Solomon’s Seal and the Healing Effects of Touch to understand more). You can feel the warm or cooling sensation of your injury; you can also mentally visualize healing currents.
Consider taking Cortesia Solomon’s Seal Tincture internally several times daily. Solomon’s Seal works to harmonize, feed, lubricate, and tighten or loosen (as needed) tendons, ligaments, muscles, attachments, and joints. It is a valuable connective tissue anti-inflammatory, and is known to help moderate the symptoms of osteoarthritis, repetitive use injuries, and connective tissue damage. Depending on your injury or condition, one of our Solomon’s Seal Formulas (described elsewhere on this site) may be appropriate — for example, the #1 Arthritis & Joint Repair, the #2 Bone-Building & Bone Repair, the #3 Cartilage & Tissue Repair, the #4 Pain & Tension Relief, or the #6 All-in-One Deep Healing Formula.
You can review these products and their ingredients, and order, at our website http://www.solomonsseal.net