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De Quervain's Tenosynovitis in Primary Caregivers
Ellen Ferraro1, Joseph Ferraro2, Sonja Pavlesen3
1SUNY at Buffalo Department of Otolaryngology, Buffalo, New York.
Insights
Newborn caregiving activities are a primary cause of de Quervain
Area of Science:
- Orthopedics
- Reproductive Medicine
- Occupational Health
Background:
- De Quervain's tenosynovitis is a common condition affecting the tendons on the thumb side of the wrist.
- Newborn caregiving involves repetitive motions that may contribute to wrist pain.
- Factors like child's age, weight, and lactation status are potential contributors.
Purpose of the Study:
- To determine the incidence of de Quervain's tenosynovitis in male and female newborn caregivers.
- To identify associated factors, including child's age, weight, and lactation status.
Main Methods:
- Surveys were administered to parents of young children in the Buffalo, NY area.
- Participants reported wrist pain, caregiving hours, child's age, and lactation status.
- Wrist pain sufferers performed a Finkelstein test and completed the QuickDASH questionnaire.
Main Results:
- 121 surveys returned; 20 reported wrist pain and a positive Finkelstein test (Group C).
- Group C had significantly higher QuickDASH scores than Group B (pain, negative Finkelstein).
- Child age was significantly different across pain groups, with the oldest children in Group C.
Conclusions:
- Mechanical aspects of newborn caregiving significantly contribute to postpartum de Quervain's tenosynovitis.
- Hormonal changes during lactation do not appear to be a major factor.
- Maintain a high index of suspicion for de Quervain's tenosynovitis in caregivers presenting with wrist pain.
Introduction:
The purpose of this study is to evaluate the incidence of de Quervain's tenosynovitis in newborn caregivers - both male and female - as well as potential associated factors, such as child's age or weight and lactation status.
Methods:
Surveys were administered from August 2014 to April 2015 to parents with young children in the greater Buffalo, New York area. Parents were asked to report wrist pain symptoms and location, number of hours spent caregiving, child's age, and lactation status. Participants who reported wrist pain performed a self-guided Finkelstein test and completed a QuickDASH questionnaire.
Results:
One-hundred twenty-one surveys were returned: 9 from males and 112 from females. Ninety respondents reported no wrist/hand pain (group A), 11 reported wrist/hand pain and a negative Finkelstein test (group B), and 20 reported wrist/hand pain and a positive Finkelstein test (group C). The mean QuickDASH score in group B was significantly smaller than that of group C. On average, child age was statistically significantly different across categories of pain with the oldest population in the positive Finkelstein group (group C) (272.8 ± 196.5 vs 481.9 ± 488.9, P = 0.007).
Conclusions:
This study supports the hypothesis that mechanical components of newborn caregiving play a major role in the development of postpartum de Quervain's tenosynovitis. It also supports the concept that hormonal changes in the lactating female are not an important contributor to the development of postpartum de Quervain's tenosynovitis. Our results, as well as previous studies, suggest a high index of suspicion for the condition must be maintained when seeing primary caregivers with wrist pain.
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