Tendonitis & Carpal Tunnel with new baby
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Tendonitis & Carpal Tunnel with new baby
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
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
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.
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