Mother's thumb

You lift your child under the arms for the hundredth time that day, support their head while feeding, or scroll on your phone with your thumb for an hour, and suddenly feel a sharp pain at the base of your thumb where it meets the wrist.

de Quervain’s syndrome / inflammation of the first dorsal extensor compartment of the hand

It hurts with every grip, when turning a tap or clenching your fist. This is not an ‘overtrained thumb’ that will pass after a day’s rest. It is de Quervain’s syndrome, inflammation of the first extensor compartment, commonly called mother’s thumb.

What is actually happening?

At the base of the thumb, where the wrist becomes the thumb, two tendons responsible for extending and abducting the thumb run together through a shared narrow tunnel, surrounded by a sheath that acts like a lubricated bicycle-brake cable housing: it lets the tendon glide smoothly without rubbing against bone. When the movement is repeated too often, the sheath becomes irritated, swollen and thickened, leaving the tendons too little room. Each subsequent thumb movement then resembles pulling a cable through an overly narrow, swollen housing.

It is most often caused by repetitive movements combining thumb abduction with wrist flexion: lifting and carrying a child, prolonged phone use and thumb scrolling, or work requiring gripping and twisting the wrist. The risk increases during pregnancy and breastfeeding: hormonal changes, daily strain on the hand and the sustained position while feeding place additional tension on the irritated tendons.

How can you recognize it?

  • pain and swelling on the thumb side of the wrist, exactly where the thumb joins it,
  • pain worsening when turning a tap, opening a jar or pressing a door handle,
  • difficulty gripping something with the thumb and index finger, for example turning the pages of a book,
  • sharp pain when you tuck your thumb into your fist and bend your wrist toward the little finger.

Why you should not wait

A chronically irritated sheath becomes increasingly thickened, leaving the tendons even less room. It is a vicious circle: the more it hurts, the less naturally you move the thumb, further worsening stiffness.

The prognosis is good, but breaking the overload cycle is necessary. The longer you wait, the longer conservative treatment takes and the greater the risk that surgery will be needed.

How we help

We begin with a consultation and ultrasound, which confirms thickening of the tendon sheath of the first extensor compartment and rules out other causes of wrist pain, such as degenerative changes in the thumb joint.

The vast majority of cases resolve with conservative treatment: an orthosis immobilizing the thumb and wrist, limiting movements that cause pain and sometimes an anti-inflammatory injection directly into the sheath, reducing swelling and improving tendon glide.

If this does not help after several months, we decompress the tendons surgically: through a small incision, we open the overly tight sheath and cut the retinaculum compressing it, giving the tendons room to move freely again.

There is one goal: a thumb that grips without pain again.

Book a consultation

If you recognize these symptoms, do not wait until the pain prevents you from functioning normally. Book a consultation. We will check whether it really is de Quervain’s syndrome and tell you how to treat it effectively.