Mommy thumb is a common term for “stenosing tenosynovitis" or "de Quervain's disease", which is a prevalent urban disease in Hong Kong. We have invited registered chiropractor Dr Steve Yun to share with everyone the causes, symptoms and prevention of mommy thumb.

What are the causes and affected areas of mommy thumb?

The medical field is unsure about its exact causes, but most cases are caused by long-term overuse of the wrist and repeated wrist motion involving the radius and ulna. This triggers swollen tendon sheath on the radius side (the thumb side) of the back of the hand, compressing the tendons and synovium of the extensor pollicis brevis and abductor pollicis longus. The tunnel where the tendon slides becomes narrowed with inflamed and swollen tendons and synovium, causing pain in the thumb side of the wrist. In severe cases, tendon adhesion can occur, limiting the movement of the thumb and wrist.

What are the common symptoms of mommy thumb?

Patients will feel pain in the thumb side of the wrist, and the pain will intensify when the tendons are tightened while bending the thumb, rotating the wrist, making a fist, or gripping something. There may also be swelling on the thumb side of the wrist. If left untreated or not properly treated, the pain may spread to the entire thumb or the forearm. The pain can interfere with daily activities and work that require wrist motion, such as twisting a towel, using a mobile phone with one hand, typing, using a mouse, or even carrying shopping bags. Generally, the symptoms are most noticeable in the morning, and the pain will decrease after some activity. However, the pain will intensify again with repetitive movements of the thumb/wrist.

Does it only affect moms?

Although the condition is commonly referred to as mommy thumb, it does not only affect mothers or housewives. The high-risk groups for mommy thumb are not limited to women or housewives, but also include new parents, individuals who use mobile phones or tablets for a long time, people who knit or sew for a long time, waiters, hairdressers, plumbers, office workers who use the mouse and keyboard for a long time, golfers, etc.

How can we treat mommy thumb? Does it recur easily?

When you experience pain, you should seek professional medical attention as soon as possible for examination and treatment. Try to avoid repetitive wrist/thumb movements to allow the inflamed area to rest. If there is swelling, apply an ice compress to the affected site. Anti-inflammatory and pain-relieving medications can be used to alleviate the symptoms, while steroid injections may be used to reduce serious inflammation and pain. For severe cases, surgical intervention may be necessary.

In chiropractic care, a detailed examination is usually performed to rule out other conditions. Then, chiropractors will utilize manual therapy to correct misaligned joints and relax nearby muscles and soft tissues. Depending on individual conditions, cold/hot compresses, therapeutic ultrasound, radiotherapy, or shockwave therapy may also be used. Generally, with proper treatment and sufficient rest, the condition can greatly improve or recover within 1 to 3 months. However, if the patient does not rest properly, the condition can fail to improve and even recur later on.

2 exercises to prevent mommy thumb

Prevention is better than cure. Apart from avoiding excessive and repetitive use of the thumb, you can also stretch the relevant tendons from time to time.

Exercise 1

Place your hand on a table with the palm facing up.

Lift the thumb and little finger, and gently press the tip of the thumb against the tip of the little finger, creating a stretching sensation in the base of the thumb and wrist.

Hold for 6 seconds, then relax. Repeat 10 times.

Exercise 2

Extend your arm and make a fist. Bend the thumb into the palm of your hand.

Gently use the other hand to stretch the thumb and wrist downward, creating a stretching sensation in the thumb side of the wrist.

Hold for 15 to 30 seconds, then relax. Repeat 2 to 4 times.