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Therapy: The Physical Kind.

Photo credit:  www.spineandsportsmed.comBack in February 2009, I was diagnosed with tendinitis, in large part thanks to the mass amounts of computer work I was doing.  All that mousing took a toll on my wrist, leaving my tendons swollen and all -itis'ed.  I made some changes in efforts to alleviate the pain, but eventually I caved and received a cortisone injection.

And then some things happened.  Like a pregnancy.  And leaving my old job in pursuit of being a work-from-home pregnant lady and now a work-from-home mom. 

My hands?  Never got that break they needed.  And now the tendinitis has moved from the outside of my wrists to the interior.  It started just after BSparl was born, when I was breastfeeding.  The hand positions required to keep the baby latched on properly weakened the tendons in my hand.  And as BSparl got bigger and bigger, the stress of putting the baby in her carseat and into her crib made the tendons in my hands swell to epic proportions.  Even stopping breastfeeding didn't give me any relief in the hand department. 

I was permanently in pain.

After much prodding from Chris ("Baby, call the physical therapist."  "Call them today?"  "If you don't call them, I'm calling them for you."), I finally made an appointment with the physical therapist.  

"Hi.  I'm K.  I'm going to help ease this pain for you, okay?"  said the physical therapist as she met me in the waiting room.  (Already a 180 degree difference from my interview with the primary care physician.)

"Yes, please.  I've had this pain since before I had my daughter, but since her birth, it's shifted from the outside of my wrist to the inside.  I'm having trouble picking her up, putting her in the carseat, and getting her up from her crib.  Oh, and opening jars.  And turning doorknob."  I shrugged.  "Anything that requires my hands."

"Let's figure out what's going on."

I'd never been to a physical therapist before, and I resisted it because I felt like I should be able to get rid of this pain on my own.  It's not like I can't walk - it's just wrist pain. 

"I'm going to measure the mobility you have in your wrists now, okay?"  the PT asked, and I nodded.  We then went through a series of wrist mobility exercises which she measured with what looked like a plastic protractor.   And it was then that I realized how little comfortable movement I had in my hands.

"You are in a lot of pain throughout the day?  Okay, we need to take some of the stress away from your wrists.  What do you do for work?"

I laughed.  "I am a writer.  I work on the computer for several hours a day."

She laughed, too.  "That doesn't help.  How about when you aren't working?"

"I have a six and a half month old daughter.  And I work from home so I can take care of her, so I'm either typing or toting her around."

"I'm not surprised.  I've examined the inflammation in your hands and did you know there's actually a tendinitis called De Quervain's tenosynovitis that occurs in new moms a lot.  It's exacerbated by the motion of picking up the baby."

"Wow.  So is that what I'm dealing with?  This decoupage syndome?"  (I am clueless.)

"De Quervain's.  And yes.  You also have the very beginning of carpal tunnel, but we're catching it early.  I'm hopeful that eight weeks of physical therapy twice a week, in conjunction with hand exercises done every day at home, that you'll have marked relief.  I don't want to make any promises, but I know we can help you out."

For the rest of the appointment, we spent time reviewing the exercises I was to complete twice a day at home.  (These exercises make it look like I'm painstakingly waving at someone, in slow motion.  Chris is confused by this.  "Are you waving at me?"  "No, I'm gliding my tendons.  What, that's not cool?")  And the PT also used an ultrasound machine to pulse heat and vibrations into my tendons to help ease the swelling.  (It was kind of neat to have an ultrasound that didn't show a baby bouncing around in there.  New experience for me.)  And I've also been prescribed two wrist braces to wear while I sleep to help keep my hands in a "neutral" position.  (And I've tried wearing the braces to bed for the last three nights, but somehow, in the middle of the night, I end up taking them off.  While I'm sleeping.  Very odd.)  I'm trying out everything I can in efforts to rid my wrists of this pain. 

I'm hoping to see some relief in the next eight weeks, and I'm cautiously optimistic that I'll feel close to 90% once the physical therapy sessions are over. 

(And, for the record, this is the way a doctor's office should be run.  Attentive staff, clean environment, medical professionals who make eye contact with their patients, and a discussion about payment after they learned my name, not before.  These small things make a big difference in patient experience, and I'd give this PT office a referral any time.)

Comments

I've struggled with carpal tunnel in one hand, and trigger finger in the other - the braces help alot for sleeping. Ice packs are also your friend - they have some that velcro on around your wrist for people like me who can't sit still long enough to hold pack on there :)

I hope you find some relief soon Kerri. I cannot even imagine the pain while caring for 6 month old on top of the writing you do.

P.S. Glad this was a better experience than the doctor's office.

The wrist braces at night might help a lot. If you continue to wear them, one morning you will wake up and they will still be on. Eventually they become easier to tolerate. If you swing your arms while sleeping though, tell Chris to watch out. Most of these braces have a metal bar in the bottom and it can hurt if smacked with it!

Aha! So it is DeQuervain's. Having had it, I feel for you. The pain of it, for me, was excruciating. I'm glad you've got a good physical therapist. The shot of cortisone cured me, and I hope I never get that pain back. Did your endo. not tell you, though, that we diabetics are prone to connective tissue disorders, of which DeQuervain's is one?

ugh! i'm so sorry! I just went through this last year after my twins were born. I literally held a baby all day long-no kidding! i held one while the other slept so the one awake wouldn't wake the other and back and forth. It got so bad that between my babies being 4 months old and 8 months old I couldn't move my hands at all until I ran them under hot water. My tendonitis got so bad the inside of my wrists would click all the time-the bone was moving! I didn't have a way of going to physical therapy so I had to just deal with it. I'm so glad you're able to get help! Eventually what helped me get better was to do two things: First, I taught my kids to walk by the time they were 10 months old so that they would have fun walking around and mom wouldn't be holding them all day. And the other thing was yoga. Holding a baby and typing on a keyboard tends to tighten up muscles in an unnatural way so I got to the point where I got super strong shoulders but couldn't rotate my arm like before. My muscles tightened up in certain places and restricted mobility. Simple yoga over time completely fixed me :) And helped tighten up everything, too! Oh and I must say, I suffered 15 years of carpel tunnel unti one day I biked 26 miles and it healed me for years! Hmmm...interesting.

Glad you had a better experience with this doc, and hope the therapy works (and quickly!).

This will sound strange, but I'm oddly relieved to hear the story about taking off the wrist braces in your sleep. I used to do that with my headgear when I had braces, and no one believed me--the orthodontist and my mom both thought I was taking it off before I went to bed!

*raises tingling hand (with numb fingers)* yeah... what Kerri said. Buttons are becoming a challenge, too. I hope the physical therapy helps you and gives you some relief! ...and soon!

You may want to try acupuncture as well at the PT.

Kerri,

I've got the same thing going on in my wrist. I have a 3 1/2 mo old son. I had Carpal Tunnel while pregnant. It became De Quervain's after he was born. I also got cortisone shots & did physical therapy. For me, it relieved the pain a lot, but not completely. So, I just had surgery yesterday to cut out the inflamed tissue. The doc said this was a permanent solution & it wouldn't come back. I hope you have full relief w/the PT! Good luck!!

Pts are awesome!

As someone who has done a tone of PT (for achilles tendonitis), they really saved me. It's totally worth it, and I wish I'd known that sooner too. You don't deserve to be in pain. Really!

Melissa

Therapists and midwives are always so much more attentive and helpful than the OTHER kinds of healthcare professionals! I have had great success with both a physical and and occupational therapist. I'll bet you're feeling better in no time!
:O)

Yay for PTs! I'm a physical therapist and absolutely love your comments. I find as a PT and a diabetic, it's a great field to be in to educate people on diabetes. :)

holy cow, i think i must have had this after my first baby. i always blamed it on having to carry the baby carrier/ car seat thing - it was so unergonimically friendly. best of luck with your therapy it sounds like it should fix it up.

I was diagnosed with De Quervain's and PT cured me. I hope it cures you, Kerri. I always felt a little silly doing my hand exercises in the PT room when everyone else was working on their backs and legs, but it all worked out. Feel better!

About the taking your brace off in the night.... I can't sleep in socks. I put them on and go to sleep and when I wake up, they're gone. :) I think it's our subconscious saying "I don't like this!"

Yep, I had Dequervains (sp?) and a couple of cortisone shots were crazy painful, but made the ongoing wrist pain go away. I eventually had to have a trigger thumb released around the same time (couldn't straighten my thumb) but it was all very worth it. DeQ is super common in new parents, even some new dads, too.

Who would have thought there was a tendinitis specific to new moms? My wrists kill after breast feeding and I still can't feel the tips of my fingers on my right hand due to carpel tunnel brought on my by pregnancy. Still, it was all worth it! :-)

Kerri,
So glad you had a good experience with PT! I am a PT and have lots of people that come in and are SO worried because they had such a bad experience before.

If you do your homework, it will get better, trust me! Like someone else said, it may not get completely better because of the work you do, but splints and breaks and exercises are really the key.

Good luck!

I had Occupational Therapy after my carpal tunnel surgery as my recovery was not great. I did all the things you are doing, but the thing that worked the absolute best was this funky Kinesio taping technique, ask your therapist about it.

http://www.kinesiotaping.com/kinesio/articles.html

Hoping for some much needed relief for you Kerri. Pain sucks, and not being able to do things you love because of it sucks too.

I'm glad to hear that you were happy with these folks!

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