Effective Physiotherapy Treatment for Postpartum Wrist Pain – Case Study

Effective Physiotherapy Treatment for Postpartum Wrist Pain – Case Study

A 31-year-old woman who recently gave birth sought physiotherapy treatment for her persistent wrist pain from our physiotherapist, Maritza Lue.

Four months after giving birth, she began experiencing pain in her right wrist, which intensified over the past month. Her pain was primarily triggered by activities involving lifting her baby, supporting the baby's head, pumping breast milk, and texting on her phone. Notably, she also noticed discomfort in her wrist while sleeping. As a right-handed individual, she predominantly used her right hand for daily tasks. After consulting with her doctor, she was referred to Prohealth Sports and Spinal for further evaluation and treatment.

Signs and Symptoms:

Upon examination, the patient presented the following signs and symptoms:

• Tenderness in the right wrist
• Mild swelling and increased temperature near the right thumb
• Decreased range of motion in the right thumb
• Muscle spasms in the right forearm muscles

Treatment:

The physiotherapist devised a comprehensive treatment plan to alleviate the patient's symptoms and promote healing. The treatment methods employed included:

1. Deep tissue release of the forearm muscles: This technique aimed to alleviate muscle tension and promote relaxation in the affected area.
2. Gentle release of the muscles around the thumb: By targeting the thumb muscles, the physiotherapist aimed to enhance mobility and reduce discomfort.
3. Ultrasound therapy: Ultrasound was applied to the wrist and thumb to reduce inflammation and promote healing.
4. Acupuncture: The physiotherapist utilized acupuncture to the forearm muscles, employing both traditional needles and electro acupuncture pens to improve blood circulation and alleviate pain.
5. Cryotherapy and thermotherapy: Ice packs were applied to the wrist and thumb to reduce inflammation, while hot packs were used on the forearm muscles to enhance circulation and flexibility.
6. Education on correct lifting, holding, and carrying techniques: The patient received guidance on proper techniques to minimize strain on the wrist during daily activities involving her baby.
7. Wrist brace: A wrist brace was prescribed to maintain the wrist in the appropriate position and minimize pain, particularly during sleep and aggravating activities.

Home Exercises:

The patient was instructed to perform specific exercises at home to aid in her recovery. These exercises included:

• Forearm stretches: Stretching exercises to improve flexibility and alleviate muscle tension in the forearm.
• Thumb stretches: Exercises aimed at enhancing thumb mobility and reducing discomfort.
• Hot pack application to the forearm muscles: Application of a hot pack to the forearm muscles to promote relaxation and improve blood flow.
• Ice pack application to the wrist and thumb: Use of ice packs on the wrist and thumb to reduce inflammation and alleviate pain.

Lifestyle Recommendations:

The physiotherapist provided the patient with lifestyle recommendations to further support her recovery process:

1. Night-time wrist brace usage: The patient was advised to wear the wrist brace during sleep to maintain proper wrist alignment and minimize discomfort.
2. Wrist brace usage during aggravating activities and baby care: The patient was encouraged to wear the wrist brace during activities that could strain the wrist, particularly while attending to her baby's needs.
3. Thumb usage modification: To reduce strain on the wrist, the patient was advised to use her index finger instead of her thumb while texting.
4. Equally utilizing both hands: The patient was recommended to minimize the use of her right hand and train her left hand to share the load, reducing strain on the affected wrist.

Treatment Progression:

As the treatment sessions progressed, additional interventions were implemented to further enhance the patient's recovery:

• Acupuncture with electric stimulation: Acupuncture was continued, with the addition of electric stimulation to the wrist, thumb, and forearm muscles for enhanced pain relief and improved blood circulation.
• Shockwave therapy: This therapy was employed to break up adhesions around the tendon in the wrist and thumb, facilitating healing and reducing pain.
• Tendon flossing techniques: Specialized techniques were utilized to improve tendon mobility and resolve any restrictions contributing to the patient's symptoms.
• Strengthening exercises: The patient engaged in specific exercises to strengthen the wrist and thumb, promoting long-term stability and reducing the risk of future injuries.

Physiotherapy treatment, including a combination of manual techniques, therapeutic modalities, and patient education, proved highly effective in alleviating postpartum wrist pain in this case. The patient's commitment to home exercises and lifestyle modifications, along with the progressive treatment plan, resulted in significant pain reduction and functional improvement. Physiotherapy interventions can play a crucial role in the holistic management of postpartum musculoskeletal conditions, enabling new mothers to regain optimal function and enjoy their motherhood journey.

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Written by Maritza Lue

Maritza Lue

  • BSc. Physiotherapy (HK)
  • Clinical Pilates Instructor (Level 4)/Pre-Post Natal Pilates Instructor
  • Accredited Acupuncturist
  • Natural Wellness Nutritionist
  • Registered Physiotherapist

Maritza is a dedicated and experienced physiotherapist at Prohealth Sports and Spinal Physiotherapy Centres in Hong Kong. She is a Clinical Pilates Instructor (Level 4), Pre-Post Natal Pilates Instructor, Accredited Acupuncturist, Natural Wellness Nutritionist, and Registered Physiotherapist. 

With the experience below:

  • Women's Health: incontinence, lactation -related conditions, pelvic floor dysfunction (using manual therapy and electric stimulation), painful sex 
  • Pelvic and sacrum pain and misalignment
  • Pre-natal and post-natal back and neck pain
  • Diastasis rectus (abdominal separation)
  • Pregnancy & post-natal Pilates with reformer
  • De Quervains (mummy's wrist pain) tenosynovitis, Frozen shoulder
  • TMJ pain, headache
  • Bell's palsy (using ultrasound, acupuncture, the Biotransducer and the Biomodulator)
  • Scoliosis
  • Acupuncture, dry needling and electro acupuncture pens (no needles)
  • Western cupping
  • Biotransducer and Biomodulator 

View her profile here

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