'Mommy's Thumb': Surgery, Recovery, and Future Risks

Q: 'Mommy's Thumb': Surgery, Recovery, and Future Risks

Dear readers： The academic term for "mother's hand" is stenosing tenosynovitis, which refers to the inflammation of the tendons near the wrist on the thumb side, specifically the abductor pollicis longus and the extensor pollicis brevis tendons. <br>Inflammation causes the tendon

De Quervain's tenosynovitis

Hello Dr.
Chen: I have been experiencing pain in my right wrist for over a year, and the doctor diagnosed it as De Quervain's tenosynovitis (commonly referred to as "mommy's thumb").
I have previously undergone rehabilitation and received steroid injections, but the pain has returned for the past two to three months, especially in the morning when I wake up.
I feel a sharp pain in my bones and cannot move.
The doctor mentioned that the bones are rubbing against each other and suggested surgery, which would only take about ten minutes.
I have a few questions: 1.
Is surgery necessary? 2.
How long do I need to rest after the surgery before I can do household chores? Is it half a month? I am a homemaker and cannot take too long off.
3.
Will this condition recur in the future? Thank you!

Sharon Wang, 50~59 year old female. Ask Date: 2005/01/03

Dr. Chen Xingyuan reply Orthopedics

Dear readers: The academic term for "mother's hand" is stenosing tenosynovitis, which refers to the inflammation of the tendons near the wrist on the thumb side, specifically the abductor pollicis longus and the extensor pollicis brevis tendons.
Inflammation causes the tendon sheath to thicken, leading to obstruction or sudden locking of the tendons as they glide within the sheath, resulting in pain.
Mother's hand is commonly seen in healthy women in their fifties or in postpartum women, often due to abnormal or repetitive strain.
Activities such as carrying children, doing laundry, twisting objects, and typing can contribute to this condition.
Many patients may also experience trigger finger, and about thirty percent of patients may have symptoms in both wrists simultaneously.
Initial treatment includes rest, splinting, and medication (non-steroidal anti-inflammatory drugs).
If symptoms do not improve, corticosteroid injections may be considered.
Generally, it is quite safe to have no more than three injections.
In rare cases that do not improve, surgical intervention may be considered.
The surgical technique is not difficult and can be performed under local anesthesia, taking about ten minutes with a small incision and minimal pain, allowing for outpatient treatment without the need for hospitalization.
Stitches are typically removed about ten days to two weeks post-surgery, during which time it is important to keep the wound clean and dry while providing some protection to the wrist.
Daily activities are usually not significantly affected.
Post-surgery, the original wrist pain can be greatly improved, allowing for a quick return to work.
In summary, mother's hand is caused by improper or excessive use of the tendon sheath leading to inflammation.
Preventing its occurrence is always more important than treatment.
If conservative treatments (rest, splinting, medication, corticosteroid injections) are ineffective, surgical treatment should be considered.
Wishing you peace and health! Sincerely, Dr.
Chen

Reply Date: 2005/01/03

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding your diagnosis of "Mommy's Thumb," also known as De Quervain's tenosynovitis. This condition is characterized by pain and swelling in the wrist and thumb, often caused by repetitive movements or overuse. I understand that you have been experiencing pain for over a year and have undergone rehabilitation and steroid injections without lasting relief. Let’s address your questions one by one.

1. Is surgery necessary?
Surgery is generally considered when conservative treatments, such as physical therapy and steroid injections, have failed to provide relief. In your case, since you have been experiencing persistent pain and functional limitations, surgical intervention may be warranted. The procedure typically involves releasing the tendon sheath that is causing the pain, which can provide significant relief. However, the decision should ultimately be made in consultation with your orthopedic surgeon, who can assess your specific situation and the severity of your symptoms.

2. How long is the recovery period post-surgery?
The recovery time after surgery for De Quervain's tenosynovitis can vary depending on the individual and the extent of the procedure. Generally, patients can expect to rest for about one to two weeks post-surgery, during which you may need to limit the use of your hand. After this initial period, many patients can gradually resume light activities, but it is advisable to avoid heavy lifting or strenuous tasks for at least four to six weeks. Since you are a homemaker and concerned about the duration of your recovery, it’s essential to discuss your specific needs with your surgeon, who can provide a tailored recovery plan that considers your lifestyle.

3. Will the condition recur?
While surgery can provide significant relief, there is always a possibility of recurrence, especially if the underlying causes, such as repetitive strain or overuse, are not addressed. To minimize the risk of recurrence, it is crucial to incorporate ergonomic practices into your daily activities and to engage in preventive exercises that strengthen the wrist and thumb. Your physical therapist can guide you on exercises that can help maintain flexibility and strength in your hand.

In summary, surgery may be a necessary step for you given the persistence of your symptoms. Recovery typically requires a few weeks of rest, and while there is a chance of recurrence, adopting preventive measures can help mitigate this risk. It’s essential to maintain open communication with your healthcare provider throughout this process to ensure the best possible outcome.

Please feel free to reach out if you have any further questions or concerns. Wishing you a smooth recovery!
Best regards,
Doctor Q&A Teams

Similar Q&A

Post-Surgery Health Issues in Mothers: Seeking Solutions and Advice

Hello Doctor: Since my mother underwent arthroscopic surgery on her right knee two years ago, her health has changed significantly. For example, the palms of her hands have become inexplicably hardened, resembling dehydrated meat; she has also experienced hair loss, possibly due ...

Dr. Chen Bozhang reply Family Medicine
Hello: In response to your question. You are very filial, and your mother has your concern, so her condition should improve quickly! As for your question, I personally recommend seeking a consultation with another orthopedic surgeon, as I believe this can resolve your issue! Wish...

Understanding Thumb Surgery: Insights from Recent Orthopedic Cases

Two months ago, we saw in the Liberty Times that a doctor performed surgery on a thumb in collaboration with National Cheng Kung University Hospital, as my mother hopes for a similar procedure.

Dr. Hong Ximing reply Orthopedics
Hello! Trigger thumb is caused by inflammation of the tendon sheath, which can lead to symptoms of locking and pain. Generally, physical therapy or local corticosteroid injections are effective for treatment. If these methods are ineffective, surgical intervention may be consider...

Understanding Trigger Finger in Children: When to Consider Surgery

Hello doctor, my son is two years old and has trigger finger in his right thumb. The orthopedic surgeon said it is congenital and requires surgery. I would like to ask if we can wait until he is older to have the surgery, and will it cause any complications? Thank you.

Dr. Li Wenlin reply Orthopedics
Hello: For a two-year-old child with trigger finger, surgery is not always necessary. According to the literature, the chances of spontaneous improvement decrease with age. Generally, physicians recommend trying splinting and rehabilitation (to be done by parents) before the chil...

Understanding Thumb Swelling: Surgical Risks and Alternative Treatments

Hello Doctor: My mother is 70 years old. Last year, her left thumb swelled up for no apparent reason. She is right-handed and primarily uses her right hand, but the swelling is only in her left hand, and we cannot find the cause. Last year, she received an anti-inflammatory injec...

Dr. You Dianqi reply Orthopedics
It is difficult to assess the patient's actual condition based solely on text. If there are any concerns, it is recommended to discuss them with the patient's attending physician or to take the patient for a medical consultation and seek opinions from other doctors in p...