1st Year of Life

1)  DeQuervain’s Tendinitis

Due to combination of fluid over loading and repetitive carrying of baby, some new moms may develop painful thumb and wrist. Also known as “writers’ thumb”, deQuervain’s  tendinitis affects tendons controlling the thumb and outside aspect of  the wrist.  Conservative treatment includes medication, physiotherapy, protection, and activity  modification.

2) Carpal Tunnel Syndrome

Due to overloading of fluid during pregnancy, some expecting or new moms may  develop numbness or pins/needles over the palm of hands. This is caused by irritation of the  median nerve inside the wrist.  Our wrist joint is like a tunnel with limited space and can only accommodate certain amount of contents.  With fluid overload, the container  inside the carpal tunnel is “flooded”. With space becoming insufficient, the median nerve is irritated  causing symptoms such as numbness and pins/needles.  In more severe cases, there can even be loss of co-ordination and weakness in hands.  Diagnosis is most accurate with nerve conduction studies. Physiotherapy treatment may include ultrasound, laser, massage, and acupuncture for symptomatic relief. Splints or taping is also beneficial for support and immobilization. 

3)  Torticollis

Congenital Muscular Torticollis is a paediatric condition caused by tightness in one of the two neck muscles in the front (Sternocleidomastoid) resulting in muscle imbalance. Typically, children with this condition would present with a head tilt to side of the shortened muscle, turning to the opposite side, possible asymmetry of the face, and flattening of the skull on the shortened side due to the sleep position.  

Although the exact etiology is not known, one of the main contributing factors is trauma at birth.  Other theories suggest lack of blood flow (ischemia) to the muscle during pregnancy. Conservative treatment usually includes physiotherapy to “stretch out” the shortened sternocleidomastoid muscle by a) physiotherapist, b) the child’s parents on a regular basis at home, c) positioning, and d) activities to stimulate play away from the side of restriction.