Postpartum Tendonitis & Carpal Tunnel

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Archived Q&A and Reviews

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New mom with postpartum-related tendonitis and carpal tunnel

I am a new mom and have postpartum-related de Quervain tendonitis and carpal tunnel. I wonder if any other new moms have suffered from similar injuries and if anyone has any advice on what worked for them for treatment. Elizabeth

I had a nerve problem in my left hand/arm/shoulder about two years before my daughter was born and had a lot of physical therapy, which helped. But I still have relapses and had one when my daughter hit about 12 pounds. Even though I first experienced the problem in my hand/arm, I found out that my particular problem originates in the neck and shoulder. I'd be happy to talk to you more about specific exercises that have helped me, but here are a few other thoughts: 1. Get your general practitioner to send you to physcial therapy. Mine did. 2. Holding the baby for nursing put a strain on me. Now I either nurse lying on my side or I use the brest friend nursing pillow to support the baby. 3. The one-sided sling makes my shoulder (and hence arm) worse. The more balanced baby bjorn works better for me. 4. Don't carry the baby around in the car seat any more than you have to. When you need arm strength, try to focus on using the muscles between your shoulder blades, in addition to your arm muscles. And be careful not to hunch your shoulders up a lot. That is the crux of my problem. 5. Since the baby is putting a strain on your arm nerves, be very careful about other actiivies that also do so. Limit typing and make sure your work station is ergonomically correct. Try an ergonomically correct keyboard. 6. For treatment, you can make malleable ice packs by putting a mix of 1 part rubbing alcohol to 3 or 4 parts water in a zip lock bag. Then put that in a second zip lock bag and freeze. Ice for 15 to 20 min, as many times a day as you can manage/bear. Advil is the painkiller generally recommended for these problems. Feel free to contact me directly and good luck! Mary

If this is related to breast-feeding and having to constantly support your baby's weight in the same position, I recommend getting a good nursing pillow. I got a Brest friend pillow, with a velcro waist band. This pillow supported my son without slipping out from underneath him. It helped a great deal with neck, shoulder and wrist pain. I also tried strengthening my arms and shoulders through post-partum exercise classes with weights, and this also helped. Good luck. Nancy

I am recovering from wrist problems myself, related to having had an unusually heavy baby. My physicial therapist now thinks it was a sprain rather than tendonitis, which was the original diagnosis, but the treatment has been similar to what you would do for tendonitis/carpal tunnel. Apparently this is a very common first-year-of-life problem. It was a very frustrating experience for me since I'm a writer, and carpal tunnel is pretty much my worst fear (although it was a good excuse to not go back to work during the first year) but I am now feeling about 80 percent improved. Still, it took a long time for me to see much improvement (about 6 months) and I'm not certain which of all the different approaches ended up being the key one, or if it was simply that my son is now 13 months and walking rather than being carried. I do know that it made a big difference to be treated by a hand specialist, rather than a run of the mill PT. My first PT at Healthsouth in Oakland was very nice but completely mystified by my problem and she eventually referred me to the hand specialist in the same office. She, the hand specialist, has been fabulous and has tried various different kinds of treatments including tape, locally-applied anti-inflammatories, ultrasound, stretches and neural glides which are exercises that help the nerves recover. I ended up thinking that the stretches and neural glides were what made a difference, even though it was hard for me to believe that stretching was the answer! Anyway, I'd be happy to talk more about specifics if you're interested. Good luck! Dashka

I had this and was told it is very common. It is very unpleasant and I wished someone had warned me in advance, because it's preventable. I have suggestions, which worked for me but are exactly opposite from what my doctor/Kaiser physical therapists recommended. (The doctor snorted with laughter and told me there was nothing I could do. Not only was this most unhelpful, she turned out to be wrong.) A friend who does trigger point bodywork and is very gifted recommended the plan I followed and it made all the difference.

Many women are fitted with a brace and told to wear it many hours each day and/or all night. This actually makes the problem worse, because everything tightens up. Instead: 1)do gentle hand, wrist, and finger stretches in all directions many times a day (try doing them in the shower); 2)alternate heat (soak in hot water) and ice for short periods a few times each day; 3)practice holding your hands and wrists in neutral. (By neutral I mean hand and wrist in a flat line, not at an angle, and thumb pulled into the palm, not cocked. Do this whenever you hold or carry your baby, push a stroller, etc. It helps a lot!).

Finally, I was sleeping with my baby during this time, spending much of the night with my arm around or under him. My symptoms improved a lot as he transitioned to his own bed (or at least to sleeping in my bed without me holding him all night). Your wrists and hands need a break and the blood needs to flow unimpeded! Karin

I have gotten help beyond any expectations for both tendonitis in my elbow from endlessly lifting my babies and with chronic shoulder problems from car accident injuries years ago, from Feldenkrais work with Richard Adelman in Berkeley. He's reasonable and very effective, also honest about when he may not be able to do any more to help. I don't have his number handy but he's in the book. Good luck. Carrie

I don't know the technical term for it, but for 4 or 5 months after my daughter was born I had extreme pain in the tendons leading from my thumbs to my wrist. When I went to see my doctor, she looked at the baby (who was with me) and at my wrists and said oh yes, I see this often in new mothers. She said there wasn't much she could do for me, and that it would go away, which it did. The best solution I found in the interim was a stretch. You put your hands out in front of you, palms facing each other. Then you make a fist with each hand. Then tuck your thumbs inside your fists. Then you just gently tilt your fists down. This absolutely stretches that tendon. You can also circle the wrists in this position. Also, talk with your doctor about whether you can take some ibuprofen if the pain is bad enough (I know they don't recommend it if you're breast feeding, but if you're in agony, a little might be okay). And hang in there, it really will go away, although it's hard to believe. It's all those snaps and diapers! Jody

I had this type of tendonitis so badly that I could not use my hands after my first was born. (They called it new-Moms syndrome in Physical Therapy and said it's very common.) Here's how I cleared it up in short order (once I figured out what to do- thanks to the hand specialist in the Kaiser Oakland physical therapy office).

Several times per day, do the following. First put your hands and wrists into warm water (as hot as you can comfortably stand) for 2-3 minutes. This increases blood flow and brings nutrients to the inflamed area. Then put hands/ wrists into a bowl or sink or whatever of ice water for a minute. This reduces inflammation. Then alternate putting them into the hot water and then ice water for 1 minute each a couple of more times, always ending with the ice water. Made the tendonitis go away within a week or two of starting this after nothing else had helped for months. Good luck. Andrea

It is believed that carpal tunnel during and after pregnancy is due in part to the increase in blood volume, which dilates arteries and can cause swelling. In most areas of the body, a little bit of swelling is easily accommodated, but in some women it can be enough to cause problems in the wrist area.

For most women, symptoms will resolve on their own as the body gradually returns to it's pre-pregnant condition but a small number will go on to have chronic problems. Because of this, it is very important that you do not ignore any symptoms or pain. Don't try to work through the pain. Pain and swelling are the body's way of immobilizing the area to prevent further injury.

Because you are probably breast feeding, prescription anti-inflammitories are probably not an option. Many of them are really hard on the stomach. Consult your doctor. The healing process for both tendinitus and carpal tunnel is speeded up by reducing and/or eliminating swelling.

When dealing with any injury in the acute phase, think R.I.C.E. Rest, ice, compression and elevation.

Rest: if picking up your baby and diapering etc. cause your wrists to flare up, get help with the baby care and other household chores! Wrist supports are also available at stores like Longs Drugs and can be used when your wrists are bothering you. Because of post-partum ligament laxity, your joints, including your wrists are structurally weaker and more vulnerable to injury. Do not bear weight on the hands. You really need to baby your wrists.

Ice: is the most effective anti-inflammatory there is. It's free and if you use it correctly, has no adverse side effects. You can use crushed ice (zip-lock bagged) or even a bag of frozen peas or corn. Protect your skin from burning by wrapping the ice in a thin hand towel or other cloth. Ace bandages work great for holding the ice in place so that you can have use of the other hand and go about your business as you ice. Ice the effected area for 15 to 20 minutes, or less if the area begins to get uncomfortably cold.

Compression: in this case not advisable.

Elevation: helps the body drain excess fluids. This is easily done at the wrists by supporting the elbow on a table or chair arm rest and reaching the fingers to the ceiling.

Controlling symptoms and preventing future flare-ups should be your primary goals. Good luck. Helene

About six years ago when I nursed my daughter I also suffered from post-partum tendonitis. Normally I am a western medicine kind of person. My dilemma was that my orthopod's primary advice was medication which would interfere with nursing. I took him up on his secondary advice, What worked for me was going to an acupuncturist (Nancy Rakaela on 10th Street in Berkeley) once a week. It eased the pain (it also had an added benefit of having at least a quiet 1/2 hour for myself). When I stopped nursing fulltime, the symptoms went away on its own.

I've been helped tremendously by a homeopathic ointment called Triflora, which you can get at Whole Foods and probably other health food stores. After two years of pain from tendonitis, I now only have occasional pain which usually goes away after one application of Triflora at bedtime. This ointment also helped my sister with arthritis pain, and helps sore muscles and sprains. Also helpful were relaxation tapes, especially anything that warmed my arms -- my doctor claimed that thin women have a greater likelihood of getting tendonitis because their arms are too cold (not enough blood flow). Inbal

Tendonitis from carrying around 20-pound baby

Does anyone have experience with/advice about tendinitis? The combination of picking up/carrying our 20 lb daughter and using my wrists for other things seems to have given me this trouble. (It's not related to Carpal Tunnel syndrome, but is something caused by repetitive use.) The orthopedic Dr. I went to seemed very eager to just prescribe anti-inflammatory medicine (something called Piroxicam) and be done with it... The list of possible side effects for this medicine is quite long, so I thought I'd check with others first. Sarah

I have had tendonitis in many forms (including carpal tunnel) prior to being pregnant. However, shortly after I started breastfeeding, the tendonitis became unbearable. The act of holding my hands in one position for an extended period of time put too much stress on my tendons. Since I intended to nurse my daughter until she was one year old I was in a real dilemna. Anything stronger that tylenol was out of the question for me. Just so you know, I tend to use traditional western medicinal advise before trying alternative measures. After meeting with my orthopod at Kaiser, he suggested accupuncture. It helped immediately and allowed me to finish nursing. I would go once a week until I stopped nursing fulltime. Fortunately, when I stopped breastfeeding, the tendonitis disappeared. I have not seen this person in five years but I would wholeheartedly recommend Nancy Rakela, O.M.D., L.Ac. Her office was then at 1802 Tenth Street, Berkeley, (510) 540-6267. Good luck!. Jeanne Jeanne

I was struck by a bout of pregnancy tendinitis, which affects the use of the thumbs (and the ability to grab). I tried not using my wrists to let the swelling go down, but that is almost impossible with a baby, even with one in the 5th percentile. My PCP injected a small amount of cortisone which provided much relief, but it returned within a few months. So I ended up going to see a orthopedic specialist who first prescribed an anti-inflammatory, which didn't help enough. So after not being able to carry or pick up much of anything I went back and received an injection of cortisone. After this I was able to recover and function again. I don't know if it would have gone away on its own, but after being uncomfortable and handicapped for all those months, I would have gone to the orthopedic doctor and asked for the cortisone much earlier. Denise

Shortly after my son was born, I developed DeQuervain's syndrome, which is tendinitis in the tendon running from my thumb through to my wrist. I assume your problem is similar. I did not want to take any medication other than ibuprofen because I was nursing. I wore a splint for most of the day, and did 6 weeks of physical therapy (3x/week) which both cured my problem then, and taught me what to do to prevent and treat flare-ups. I was told to rest my wrist and keep my thumbs tucked up next to my other fingers and my hands in line with my arms when lifting my son. To reduce swelling, I took a lot of ibuprofen and performed the following ritual 3x/day as long as I was in pain: for 15 minutes, alternate dunking my wrist in a cool bath (cool as in as cold as your tap will give you) for one minute and a warm bath (comfortable bath temperature) for another minute, etc. This really helps treat flare-ups and prevents them from getting worse. However, they do more things to you at physical therapy (I couldn't believe I was being hooked up to a current), and can apply very strong anti-inflammatories in a localized fashion (which I opted not to do). Pia

In my experience, the two things that have helped the most are cold packs and relief from stress, but I can't say which of those two helped more (I suspect the latter, but that's not something you can keep in the freezer and take out when you need it!). Twenty minutes of cooling my wrists with a cold compress in the evenings gave pretty quick relief. Aspirin and ibuprofen are good anti-inflammatories that enhance the effects of the cold compresses, with few side effects for most people. Be careful not to overdo the cold--you can get a rebound effect that's worse than the original tendinitis.

I would advise treating it agressively. I think tendinitis is like crabgrass--you want to get in quickly and get rid of it before it gets too well established, or it will definitely get worse and be harder to get rid of.

I too developed very painful, debilitating tendonitus in my wrists from picking up my new baby- a repetitive stress injury, and have been told that it is one of the most frequent problems seen in physical therapy these days - they called it something like new Moms syndrome.

It is now almost gone without my taking cortisone or other drugs for it. I could have prevented it or had it under control months ago if I'd known what to do. Here's the relatively easy solution that worked for me. (By the way, this is so common, I believe it should be addressed in all birth prep classes - it would be so easy to prevent the problem from developing in th first place.)

1) Soak the wrist(s) in first hot water (2-3 minutes) [to increase blood flow which brings nutrients to the area and promotes healing] then ice water for say 20 seconds (to reduce inflammation), then alternating hot and ice water 2 or 3 times ( a minute or so in each temperature), ending with ice water (total time required= say 6-8 minutes each time, 3-4 x/day)

2) I wore wrist splints at night to keep my wrists from bending out of the neutral position when I wasn't conscious (I started with drugstore purchased splints then the hand specialist Elizabeth at Kaiser Oakland made me custom wrist splints - MUCH more comfortable and effective)

3) Taking the repetitve strain injury class at Kaiser and learning how to use my wrists correctly - both with the computer and picking up my ever-heavier baby - so I prevent further problems... learned about lifting in the neutral position, hand/wrist mechanics, etc.

4) I also had several physical therapy appointments where I had hot wax treatments, reevaluation of progress, etc. I suspect that I might have been able to get it under control myself if I'd known what to do earlier.

Good luck, and feel free to contact me if you have further questions. Andrea

I didn't exactly have tendinitis, but I had some really nasty wrist problems. It's a rather long story (luckily with a happy ending) but I would like to share it with you.

As you probably know, when you are pregnant your body emits a special chemical called elastin (or something similar) that loosens up your joints and makes them more flexible. (And also more susceptible to injury). This is in preparation in case your hips need to widen a little for the birth. This chemical doesn't immediately go away after birth. I never really thought much about it at the time. But I would often hold my baby mostly with my right hand, with my wrist at an odd angle (sideways) while nursing. She was born in June. By the end of August I was getting symptoms very like tendinitis or carpal tunnel syndrome in my right wrist. Since the symptoms did not go away, I went to the Tang center (since I'm a student). The first prognosis was that I had strained something, and they sent me to see a physical therapist. I had two or three appointments with the physical therapist (who in retrospect was GROSSLY incompetent). We tried a few simple manipulations, some mild shock therapy, and I don't remember what else. Nothing seemed to really help. So after the last (and most traumatic visit) the physical therapist basically said Don't come back; there's nothing more I can do. Well about 2-3 HOURS after that last visit I suddenly lost 2/3 of the lateral (side-to-side) motion of my wrist. Every time I tried to move my wrist sideways it felt like there was something blocking the motion; like my wrist was hitting a doorstop or something. To make a long store short, I saw a myriad of doctors at the Tang center, none of whom listened to me when I tried to tell them what *I* thought was wrong (namely that because of the elastin and the odd nursing angle, something in my wrist had gotten slightly out of alignment), and who insisted on stupid things such as (well obviously your tendon has atrophied, and just needs to be gently stretched... as if a tendon could possibly atrophy in the course of hours!).

Luckily, my mother is a physician (who lives on the East Coast). She came out to visit in March. She looked at my wrist, *listened* to me, and came to pretty much the same conclusion I had. In addition to her M.D. she also had training in Osteopathic Medicine, which includes a fair amount of manipulation training (sort of like chiropractors, but Osteopaths go through complete medical school training). She showed me some manipulations and exercises I could perform regularly on my wrist. 3 months later my wrist was almost all better, and today it *is* all better.

Based on my experience, my recommendation would be to find a good Osteopathic doctor in the area and get him or her to look at your wrist before you write it off as tendinitis. Caroline

I had a problem similar to Caroline's after the birth of my son: my pelvis (which stretches apart due to the elastin) went out of alignment during the birth and stayed there. An osteopath diagnosed and fixed the problem. As Caroline said, osteopaths are trained as MD's, but they specialize in the nervous and muscular system. So even if you did have tendonitis, an osteopath would be very appropriate. After my experience, I would be willing to pay out of my pocket to see an osteopath before I would even bother to see my regular MD about a nerve/joint/muscle problem. Some medical plans have osteopaths in their roster; I never asked, but you might be allowed to choose one as your primary physician. Fran

To the person who got tendonitis from picking up a child: When I got this from picking up a 6 month old baby I was referred to Dr. Reiley of the Berkeley Orthopaedic Medical Group who said this was caused by overuse of one set of muscles and he prescribed an exercise to develop the other set. Bend the wrist up as far as it will go, and stretch your thumb and pinky in opposite directions, separating fingers as far as possible, and hold. Repeat frequently. He didn't rule out injections if the problem didn't go away, but this exercise took care of it for me. Xanthippe

I have just read your letters from Mums suffering from tendon pain and their advice and would like to share my experience. i had a similar problem with dequervains in my left wrist. I saw a hand specialist who gave me a cortisone injection which will last around 3 months. he told me this problem is common amongst mother's because of BREASTFEEDING! the hormone in your body producing milk can cause a build up of fluid in other areas of your body, most commonly in wrists (same hormone that swells akles when pregnant) if Icontinue to feed it is going to return. My baby is 1 and I am having to wean him because ot this. apparantly it usually occurs around 3 months I just wanted to tell you yhis as no-one seems to be making the conection between stopping the feeding and the dissappearance of thge problem. hope this helps Kirsty

Hand pain from lifting 6-month-old

Oct 1999

Help! I'm suffering from very painful hands (top and side of hands near thumb/wrist intersection) due to lifting my 20-lb. six-month old baby. Now it even hurts to lift a stack of papers at work. I would appreciate any suggestions or advice. I got past the back pain by doing exercises I found on a great website from the University of Illinois at Champaign-Urbana, but don't know what to do for hands.