Last updated: 2026-08-20
What Is the Treatment Sequence at The Wells?
First, we reduce the strain placed on the wrist when lifting the baby or holding a bottle. After checking for tenderness and swelling along the tendon sheath on the thumb side of the wrist, as well as the condition of the skin, we begin with WINBACK treatment to calm inflammation and nerve irritation during the swollen and sensitive stage. We do not rush into forceful thumb stretches or strong gripping exercises at this stage.
Once the swelling has subsided and the skin condition has stabilized, we reassess tenderness to pressure and movements used in daily life. If tendon damage remains, we use REPToN extracorporeal shock wave therapy to support the recovery of the damaged tendon and adjust the intensity and intervals according to the response.
If numbness is also present, we add nerve-gliding exercises. While checking that changing the wrist angle does not worsen the numbness, we gradually increase the range through which the thumb and fingers open and close.
Finally, we use SpineCor stabilization treatment to correct posture in which the elbow flares outward and the shoulder rolls forward, concentrating strain on the wrist. We practice lifting objects close to the torso and balance the movement and grip strength of both arms to distribute repetitive strain. During periods of childcare that place a heavy load on the wrist, a brace is used as an assistive measure to support the thumb and wrist together.
When lifting the baby, do not spread the thumb and index finger around the baby's armpits as if pinching; instead, support the baby's weight with a broad area of the palm and forearm. Keeping the baby close to the torso with a nursing pillow or baby carrier and supporting the elbow can also reduce the angle at which the wrist bends toward the little-finger side. In caregiving situations where complete rest is difficult, the first priority is to reduce the amount of force placed on the wrist at one time.
Did the Thumb Side of Your Wrist Start Hurting After You Began Carrying Your Baby?
Some people experience an aching sensation from the base of the thumb to the outer side of the wrist when lifting their baby or supporting a bottle. This initially raises suspicion of wrist tenosynovitis, particularly de Quervain's disease. It occurs when the passageway for the thumb tendons becomes narrowed. The pattern of pain differs from carpal tunnel syndrome, which causes numbness in the fingers.
You may feel a stabbing pain when supporting your baby's bottom to change a diaper or lifting your baby from the bed. If pressing one spot on the thumb side of your wrist produces distinct pain even during everyday activities, the problem is more likely related to the tendon passageway. In contrast, if your thumb, index finger, and middle finger are numb and you have to shake your hand every night before you can finally fall asleep, carpal tunnel syndrome caused by compression of the median nerve should be ruled out first.
The two conditions may also occur together. After childbirth, the hands tend to swell, and feeding and caregiving require you to hold the same positions for long periods. Checking separately whether one spot on the thumb side of the wrist hurts and whether the fingers are numb can help prevent confusion between the two conditions.
A 2024 study of infant caregivers also identified symptoms consistent with de Quervain's disease in a considerable number of participants, and these symptoms were associated with the length of time spent caring for an infant.(Manzoor A et al., 2024) Do not dismiss postpartum pain as fatigue. Check which fingers are numb, whether one spot on the thumb side of the wrist hurts, and whether the pain worsens when lifting your baby.
Why Does It Affect the Thumb Side?
The abductor pollicis longus tendon, which moves the thumb away from the hand, and the extensor pollicis brevis tendon, which straightens the thumb, pass together through the first extensor tendon compartment on the outer side of the wrist. Tendons move like slender cords. The tendon sheath, a thin membrane surrounding a tendon, reduces friction and helps the tendon glide smoothly.
When you place your hands under a baby’s armpits and lift, your thumbs spread wide and your wrists bend toward the little-finger side. Repeating the same movement dozens of times a day causes the passage surrounding the tendons to thicken, making their movement stiff. In this state, picking up a baby bottle or supporting the baby’s head can cause the tendons to catch, often resulting in sharp pain.
Shortly after giving birth, many people experience swelling in the backs of their hands and fingers, making their rings feel tight. When fluid changes around pregnancy and childbirth coincide with repetitive wrist use, the first extensor tendon compartment, which already has limited space, bears increased strain.
Viewing this only as a problem caused by overusing the thumb overlooks how you hold the baby. If you hold your elbows away from your body and support the baby’s weight by bending only your wrists, the force becomes concentrated in a small area. Holding the baby close with both arms and your torso reduces the weight that one wrist must bear. This is why treatment also includes changing how you hold the baby.
How Can I Tell If It’s De Quervain’s or Carpal Tunnel Syndrome?
If you tuck your thumb into your palm, make a fist, and slowly tilt your wrist toward your little finger, pain on the thumb side of the wrist may suggest de Quervain’s disease. However, bending the wrist forcefully can also hurt normal tissue, so this maneuver alone is not used for diagnosis.
Carpal tunnel syndrome commonly causes tingling or burning in the thumb, index finger, and middle finger, and often wakes people from sleep because of abnormal sensations in the hand. De Quervain’s disease is more likely to cause tenderness at a specific point on the outer wrist than tingling. It is especially painful when spreading the thumb to grasp an object or lifting a child.
Arthritis at the base of the thumb causes pain in a slightly different location. Twisting a bottle cap or key or pinching an object between the thumb and index finger causes aching in the joint at the base of the thumb near the palm. Pressing or rotating that joint may also reproduce the symptoms.
First, the clinician identifies the spot the patient points to with one finger. The clinician checks whether pressing on the first extensor tendon compartment causes pain and whether moving the thumb causes pain to spread along the tendon. Finger sensation and thumb strength are tested to determine whether the tendon or nerve should be treated.
If arthritis or bone damage is suspected, X-rays are used to examine the joint at the base of the thumb and the wrist bones. However, the physical examination comes before imaging. If necessary, ultrasound is used to check whether the tendon sheath is swollen, the compartment wall has thickened, or the tendon catches during movement. The clinician then decides which treatment to start based on pain severity, activities the patient can no longer perform in daily life, swelling, and imaging findings.
Do Not Delay Seeking Care in These Situations
When the tendon sheath thickens, the tendon cannot glide smoothly as you straighten and bend your thumb, which may cause a clicking sound or a sensation of catching and then releasing. The outer side of the wrist may also become visibly swollen, and at this point, rest alone will not make it subside.
If your grip has become so weak that you keep dropping a baby bottle or cup, you should be evaluated to determine whether pain is preventing you from gripping or whether nerve function has also declined. If the pain wakes you at night or numbness spreads across your fingers, you will also be evaluated for wrist tenosynovitis, carpal tunnel syndrome, and nerve problems originating in the neck. The next step is to decide which treatment to pursue.
You should come to the hospital if the pain improves after a few days of rest but returns in the same spot as soon as you hold your child again, or if it remains unchanged even after using your hand less for several weeks. You should also seek prompt medical attention if the area suddenly becomes red, hot, and swollen, if you have severe pain immediately after an injury, or if you cannot move your thumb properly.
Telling someone caring for a child not to use their hands at all is not realistic. Family members should share tasks such as bathing the child and holding the child for long periods to help them fall asleep, and you should use a nursing pillow or baby carrier to support the weight. You and your healthcare provider should also identify and correct positions that cause your wrist to bend. If taking long breaks is difficult, take frequent short breaks and distribute your child’s weight across both hands and forearms.
References
- Manzoor A, Syed S, Nadeem M (2024). Prevalence of De Quervain disease in infant caregivers and its association with caregiving duration. Cross-sectional study. PMID: 39028065
- Challoumas D, Ramasubbu R, Rooney E (2023). Management of de Quervain Tenosynovitis: A Systematic Review and Network Meta-Analysis. JAMA Netw Open. PMID: 37889490
- Huisstede B M, Gladdines S, Randsdorp M S (2018). Effectiveness of Conservative, Surgical, and Postsurgical Interventions for Trigger Finger, Dupuytren Disease, and De Quervain Disease: A Systematic Review. Arch Phys Med Rehabil. PMID: 28860097
Frequently Asked Questions
Q. Could It Be Wrist Tenosynovitis Even If It Hurts Only When I Move My Thumb?
Early-stage wrist tenosynovitis may cause pain only when you move your thumb away from your hand or straighten it. However, the location of the pain, tenderness, and tendon movement must be assessed to rule out other possible injuries.
Q. Can wrist tenosynovitis and carpal tunnel syndrome occur at the same time?
Swelling around childbirth and repetitive caregiving movements can cause both conditions to occur together. If pain on the thumb side of the wrist and tingling in the fingers persist at the same time, the condition of the tendons and nerves should be evaluated separately.
Q. Can postpartum wrist tenosynovitis improve with rest and a brace alone?
In the early stages, when symptoms are mild, reducing aggravating movements and using a brace that supports both the thumb and wrist may relieve pain. However, prolonged immobilization may cause joint stiffness, so brace wear time and activity levels should be adjusted based on the condition.(Huisstede B M et al., 2018)
Q. If wrist tenosynovitis persists for a long time, is surgery always necessary?
Surgery is not performed immediately solely because the pain has lasted a long time. Surgery may be considered if severe pain and catching persist after treatment with activity modification, a brace, medication, or injections.(Challoumas D et al., 2023)
Jumin Kim · Medical Director · The Wells Clinic, Jamsil Main Branch
This content is provided for medical information purposes and may vary depending on individual circumstances. It is important to consult a specialist for an accurate diagnosis and appropriate treatment.