Pain on the thumb side of your wrist after having a baby is de Quervain's tenosynovitis. New mothers are the highest-risk group. Here's how to diagnose it, what a thumb spica splint is, and that a 70%-effective injection exists.
Pain on the thumb side of your wrist after having a baby is extremely common and has a specific name. De Quervain's tenosynovitis affects new mothers at a higher rate than almost any other group — yet almost no new parent knows it exists, what causes it, or that effective treatment is available.
De Quervain's affects the tendons on the thumb side of the wrist — specifically, the two tendons that run along the outside of the wrist into the base of the thumb. The sheath surrounding them thickens and narrows, causing friction and pain when the thumb or wrist moves.
The pain is typically:
• At the base of the thumb / side of the wrist
• Worse when lifting the thumb (giving a thumbs-up, picking something up)
• Worse when gripping — turning a tap, opening a jar, holding a phone, nappy tabs
• Sometimes accompanied by swelling or a grating/clicking sensation
The Finkelstein test: fold your thumb across your palm and wrap your fingers around it. Then bend your wrist towards your little finger. If this causes pain at the thumb side of the wrist, De Quervain's is the likely diagnosis. This test is sensitive enough that most GPs use it to diagnose without any imaging.
Women are 3–6 times more likely to develop De Quervain's than men. Among women, new mothers of small babies are the highest-risk group of all. NHS clinical guidance from multiple trusts notes this explicitly.
Why new mothers are so vulnerable: the combination of hormonal changes postpartum (relaxin and other hormones that affect connective tissue) with a sudden dramatic increase in repetitive thumb-loading activities. Lifting a baby dozens of times a day with the thumbs extended; holding a baby in a nursing hold for hours; carrying car seats; pushing prams; opening and folding baby equipment. The wrist is being used in unaccustomed repetitive patterns at the same time as the connective tissue is already affected by postnatal hormonal change.
This matters because many new parents assume the pain is 'just from lifting' and will resolve if they rest more. It may not resolve on its own, and the longer it goes untreated, the more entrenched it can become.
The first-line treatment is a thumb spica splint — a wrist splint that also immobilises the thumb. This is the wrist brace with the thumb section. A standard wrist splint without the thumb section is not effective for De Quervain's and is what many new parents buy by accident.
Thumb spica splints are available from pharmacies, sports shops, and online. Your GP or physiotherapist can confirm the correct type. NHS guidance suggests wearing it during all activities that provoke pain, or continuously for 4–6 weeks in more severe cases (removing it several times a day to exercise the wrist and thumb gently).
Activity modification alongside splinting: anything that requires pinching, gripping with the thumb, or sideways wrist movement should be modified where possible. Lifting the baby with hands flat (palms up) rather than with thumbs gripping is one practical change. Using baby carriers that don't require sustained wrist flexion can help.
If splinting and activity modification haven't resolved the pain after 4–6 weeks, a corticosteroid injection into the tendon sheath is the next step. This is highly effective: NHS evidence and clinical guidelines consistently report pain relief in around 70% of cases with a single injection.
Your GP can refer you for this. It is done as a brief outpatient procedure, usually by a physiotherapist or GP with a musculoskeletal interest. The injection is briefly uncomfortable but very quick. There may be a temporary worsening for 24–48 hours before improvement. A second injection can be offered if the first provides only partial or temporary relief.
Most cases of De Quervain's resolve within 6–12 months with appropriate management, and many much sooner with intervention. It is a self-limiting condition — it will resolve. The question is whether it resolves over weeks with treatment or drags on for a year without it.
It is safe to use the hand even with pain — the pain from De Quervain's does not represent tissue damage, and using the hand will not make the condition worse in the long term. However, repeated aggravation without any modification slows resolution. The goal is to modify how you use the thumb and wrist enough to reduce the repetitive loading, while keeping the hand functional.
Surgery (decompression of the tendon sheath) is available for the small number of cases that don't respond to conservative treatment and injections. It is a brief, effective procedure but carries a small risk of nerve damage and is genuinely a last resort after other approaches have been tried thoroughly.