A woman in her 20s with severe thumb and wrist pain after childbirth
A woman in her 20s who lives in Kannai, Yokohama, visited Spine Chiropractic with significant pain around the base of her right thumb and the thumb side of her wrist.
Her symptoms had started after giving birth. What initially felt like mild discomfort gradually became much more painful, particularly when she used her right hand.
She visited an orthopedic clinic and was diagnosed with De Quervain’s tenosynovitis (stenosing tenosynovitis). She was prescribed medication and advised to return for a follow-up visit.
When her symptoms did not improve, she was given a thumb support brace and instructed to perform therapeutic exercises.
She eventually visited the hospital five times in total and received a corticosteroid injection. The injection provided significant relief, but approximately one month later, the pain returned.
This cycle repeated, with temporary improvement following the injection followed by recurrence.
Because the pain continued to interfere with everyday activities, she searched online for information about wrist and thumb pain and found a case report on the Spine Chiropractic website. She decided to visit the clinic to explore another conservative treatment option.
Initial Examination
Interview
The patient was caring for a young child and frequently needed to carry and hold her child.
She reported experiencing sharp pain around the thumb side of her right wrist whenever she picked up or carried her child.
Everyday activities such as holding a frying pan while cooking or using a kitchen knife also caused significant pain.
She had been managing her symptoms with pain medication and a wrist brace, but the repeated recurrence of pain had become physically and emotionally exhausting.
Although the treatment she received at the hospital had provided temporary relief, the symptoms continued to return.
Visual Inspection
No obvious abnormalities were observed during visual inspection.
Static Palpation
There was clear tenderness around the tendons on the thumb side of the right wrist.
The right forearm was noticeably more tense than the left.
Increased muscle tension was also observed around the thenar region at the base of the thumb.
Motion Palpation
Moving the thumb inward toward the palm produced more pain than lifting the thumb upward.
Differences in mobility were also noted around the carpal bones on the thumb side of the wrist, particularly around the scaphoid and trapezium.
Orthopedic Tests
No additional orthopedic tests were considered necessary at the initial examination.
Muscle Strength Examination
Thumb extension could not be adequately assessed because of the patient’s pain.
Thumb flexion strength was preserved, although the movement itself produced significant discomfort.
[Initial Treatment]
Because the patient’s pain was quite strong during the first visit, I chose a gentle and conservative approach.
Ultrasound therapy was applied around the painful area on the thumb side of the wrist.
I also worked on the surrounding forearm and thumb-related muscles to reduce excessive muscle tension and improve their mobility.
Because everyday use of the hand was unavoidable, I also applied kinesiology tape to help reduce stress on the painful area during daily activities.
The patient was asked to monitor her symptoms over the next few days and return in approximately three to four days so that her response to treatment could be assessed.
Treatment Outcome
Second Visit — Four Days Later
When asked about her symptoms, the patient reported:
“The pain is still there, but it’s a little better than before.”
When asked to rate her original pain of 10 out of 10, she rated it at approximately 7 out of 10. She also reported that the pain had temporarily decreased to around 5 out of 10 for a couple of days after the previous treatment.
Because there had been some improvement, I continued with a similar approach, including treatment of the forearm and surrounding tissues.
The patient was asked to return one week later.
Third Visit
The patient reported that the pain had again improved for approximately two to three days after treatment, but had gradually returned to a similar level.
At this point, it became clear that the symptoms were responding temporarily to the initial approach but were not yet being maintained between visits.
I therefore expanded the assessment to include the mobility of the carpal joints around the thumb side of the wrist.
Differences in mobility were noted around the scaphoid and trapezium, so these areas were addressed with chiropractic joint-mobility techniques.
Kinesiology tape was applied again to help support the area during daily activities.
Fourth Visit — One Week Later
The patient reported a more noticeable improvement.
She had also continued using the tape at home and said:
“I got through this week with less than half the pain I had before.”
Because she had a hospital appointment scheduled a few days later, we decided to extend the interval before the next visit and reassess her condition one month later.
Fifth Visit — One Month Later
The patient still experienced some discomfort, particularly because her child was becoming heavier and she continued to carry the child regularly.
However, the pain was significantly more manageable than before.
At this visit, treatment was expanded beyond the forearm and wrist.
I worked on the muscles of the hand and forearm and reassessed the mobility of the wrist and elbow.
The elbow was also included because the muscles and tendons that control the hand and fingers extend through the forearm and cross the elbow region.
Home Exercises
Because childcare was an unavoidable part of her daily life, we also focused on improving her ability to tolerate the repeated use of her hand.
I introduced simple exercises targeting the muscles involved in gripping and hand function.
These included:
- Book Hold: Pinch a book between the fingertips and hold for 20 seconds × 3 sets
- Flat-Surface Finger Grip: Grip the edge of a desk or other flat surface using the fingers only, 20 repetitions × 3 sets
She was instructed to perform these exercises daily, while avoiding movements that significantly increased her symptoms.
Sixth Visit — One Month Later
At the following visit, the patient reported that she had experienced very little pain during the previous month.
She had consistently performed the exercises at home and felt that this had helped her manage the demands of childcare.
Her wrist pain was now almost completely gone.
She had also stopped using the wrist brace and had finished her hospital treatment.
At this point, the intensive treatment phase was concluded, and she continued with approximately monthly maintenance visits for her general musculoskeletal condition.
Practitioner’s Opinion
De Quervain’s tenosynovitis is a condition involving pain and tenderness on the thumb side of the wrist, typically affecting the tendons that control movement of the thumb.
It can be aggravated by repetitive thumb and wrist use, particularly activities involving lifting, gripping, or repeated wrist movement.
The condition is also commonly seen during pregnancy and the postpartum period. Caring for a young child can place considerable repetitive load on the thumb and wrist, particularly when repeatedly lifting or carrying a baby.
In this case, the patient’s symptoms began after childbirth and were consistently aggravated by childcare activities.
Carrying her child, holding a frying pan, and using a kitchen knife all reproduced or increased her symptoms.
Because these activities were unavoidable, simply telling her to stop using her hand was not a realistic long-term solution.
During the examination, there was clear tenderness around the thumb-side wrist, together with increased tension throughout the right forearm and around the thenar muscles.
Differences in carpal mobility were also observed around the scaphoid and trapezium.
Initially, treatment focused on reducing the patient’s symptoms and improving the mobility of the surrounding soft tissues.
Although her symptoms improved temporarily after the first two treatments, the improvement did not initially last.
This led me to broaden the approach and assess the mobility of the wrist and surrounding joints, as well as the muscles extending from the hand through the forearm and elbow.
Kinesiology taping was also used to help manage the mechanical demands placed on the wrist during daily activities.
As her symptoms became more stable, we introduced simple strengthening exercises that she could perform at home.
This was particularly important in this case because childcare was an ongoing physical demand that could not simply be eliminated.
The goal was therefore not only to reduce her current pain, but also to help her better tolerate the repeated use of her hand and wrist in everyday life.
It is important to note that this case does not establish that a specific carpal alignment problem was the underlying cause of the patient’s De Quervain’s tenosynovitis.
Likewise, the temporary recurrence of symptoms after corticosteroid injection does not mean that the medical treatment was ineffective or that it addressed only the symptoms rather than the cause.
De Quervain’s tenosynovitis can be managed using several conservative approaches depending on the individual, including activity modification, splinting, medication, corticosteroid injection, and exercise-based rehabilitation.
In this case, chiropractic treatment was used as part of a broader conservative approach that also included taping, home exercises, and consideration of the patient’s daily physical demands.
The patient’s symptoms gradually became more manageable, and she ultimately reported almost complete resolution of her wrist pain.
She was able to stop using her wrist brace and continue her daily activities, including caring for her child, without the previous level of pain.
Chiropractic Care for Thumb and Wrist Pain in Yokohama
Spine Chiropractic is located in Bashamichi, Yokohama, just a one-minute walk from Bashamichi Station Exit 6.
The clinic is also approximately seven minutes from JR Kannai Station, eight minutes from Nihon-Odori Station, and 12 minutes from JR Sakuragicho Station.
We provide chiropractic care in both Japanese and English for patients in Yokohama, including Kannai, Bashamichi, Minatomirai, Sakuragicho, and surrounding areas.
If you are experiencing thumb pain, wrist pain, or discomfort related to repetitive hand use, childcare, work, or other daily activities, Spine Chiropractic can assess your musculoskeletal condition and determine whether chiropractic care may be appropriate.