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Pregnancy: Carpal Tunnel Syndrome | Kaiser Permanente

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Overview

Tingling, numbness, and pain in the hands are common during pregnancy, especially in the last trimester. These problems are usually caused by carpal tunnel syndrome, and they usually go away after pregnancy.

Carpal tunnel syndrome is a specific group of symptoms that can include tingling, numbness, weakness, or pain in the fingers, thumb, hand, and occasionally in the arm. These symptoms occur when there is pressure on the median nerve within the wrist.

The carpal tunnel is a small space or "tunnel" in the wrist formed by the wrist bones (carpal bones) and a ligament (transverse carpal ligament). The median nerve and several tendons pass through the carpal tunnel from the forearm to the hand. The median nerve controls some movements of the thumb, and this nerve supplies feeling to most of the thumb and to the index finger, middle finger, and part of the ring finger.

Carpal tunnel syndrome occurs when a combination of health conditions and activities puts pressure on the median nerve as it passes through the carpal tunnel in your wrist. Anything that decreases the amount of space in the carpal tunnel, increases the amount of tissue in the tunnel, or increases the sensitivity of the median nerve can lead to carpal tunnel syndrome.

The swelling that is common in pregnancy can crowd structures in the tunnel and lead to carpal tunnel syndrome, especially when combined with forceful or repetitive hand and finger movement or the use of vibrating equipment.

If your symptoms are not severe, expect your health professional to recommend nonsurgical treatment to see whether symptoms improve. Nonsurgical treatment includes:

Changing or avoiding activities that may be causing symptoms, and taking frequent breaks from repetitive tasks.
Wearing a wrist splint to keep your wrist straight, usually just at night. See an illustration of a wrist splint.
Doing exercises to stretch and strengthen the muscles in the hand and arm.
Learning ways to protect your joints as you go through your daily activities.

Unless carpal tunnel symptoms become intolerable, a pregnant woman should delay surgery until after childbirth. After delivery, symptoms often disappear without treatment when pregnancy-related fluid buildup is relieved.

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MedBlog

Your Pregnancy Matters

October 20, 2020

Your Pregnancy Matters

Robyn Horsager-Boehrer, M. D. Obstetrics and Gynecology

Approximately 31% to 62% of pregnant patients have carpal tunnel syndrome.

Swelling – everywhere – is one of the most common symptoms of pregnancy. Patients often notice extra puffiness in their face, legs, and feet. But for some women, swelling manifests inside the wrist, resulting in carpal tunnel syndrome (CTS).

Approximately 4% of adults in the general population have carpal tunnel syndrome, but 31% to 62% of pregnant patients have it. Many patients notice symptoms after 30 weeks' gestation.

During pregnancy, your blood volume doubles. That extra fluid increases pressure and swelling in the blood vessels throughout your body. In tight spaces such as the carpal tunnel area of the wrist – through which nine tendons and one nerve pass – the swelling can compress the median nerve, which runs to the hand.

The median nerve gives sensation to the palm-side surface of thumb, index, and middle fingers, and half the ring finger. It's also responsible for helping to move the muscles in the hand that bend your fingers.

Nerve compression can cause pain, tingling, and numbness in the wrist and hand, which may increase when you're trying to sleep. Pregnancy may be the first time CTS symptoms arise or the last straw that causes a woman to see her doctor for ongoing symptoms.

The good news is that pregnancy-safe treatment is available, and symptoms typically subside for many patients after the baby arrives.

I've invited my colleague, Rupali Kumar, M.D., from UT Southwestern's Physical Medicine and Rehabilitation (PM&R) team to discuss CTS symptoms and treatment options.

Carpal tunnel symptoms in pregnancy

Dr. Rupali Kumar

When the median nerve is compressed during pregnancy, symptoms present as they would in any patient:

● Numbness and tingling

● Burning sensation

● Pain in the wrist or hand

At the onset of CTS, symptoms may come and go. But when numbness or weakness occurs frequently or constantly, that's a potential sign of nerve damage.

In severe cases, patients may have weakened grip strength or decreased finger dexterity. For example, you might have trouble picking up small objects with your fingers, opening jars, or buttoning clothes.

Related reading: 5 weird pregnancy symptoms you might not know about

Diagnosing carpal tunnel in pregnancy

We often can diagnose CTS by talking with you about your symptoms and medical history. If your symptoms are severe, we may recommend an electrodiagnostic study (EMG) to confirm the diagnosis and measure nerve function in the arm, wrist, and hand. An EMG can tell us whether you have nerve damage, how severe it is, and whether it might be reversible with intervention.

The doctor will attach small electrode stickers to your hand and arm in different places and apply low levels of electrical stimulation to gauge the nerve activity. The doctor may also insert a fine acupuncture-like needle in certain areas of the arm and hand to test muscle electrical activity. The study can be a little uncomfortable, but should not cause lasting pain.

Pregnancy-safe treatment options

With CTS, it's best to start with the most conservative therapies. That's especially true in pregnancy. Here is a list of carpal tunnel treatment options that are safe for pregnancy, from least to most invasive.

Splinting

The first-line treatment is to immobilize the wrist in a neutral position to limit the range of flexion or extension. We use a neutral wrist splint with a metal bar inside that prevents the wrist from moving up, down, or side-to-side but allows the fingers to move.

Splinting gives the median nerve a break and can help alleviate swelling, which can allow mild to moderate nerve damage to heal. However, it's tough to wear a splint all day and do everyday activities. Your doctor may recommend wearing it while sleeping and as much as you can during the day.

Occupational therapy

Hand and wrist therapy can sometimes help relieve symptoms and prevent further nerve damage. A PM&R doctor or occupational therapist can create a personalized plan for you.

Therapy may include wrist and finger range of motion and strengthening movements, massage, and nerve gliding techniques. We may also recommend desensitization to decrease nerve pain, including alternating hot and cold water baths.

Medication

Topical numbing agents can relieve symptoms, but these ointments won't get to the root of the problem. Some patients may benefit from pain relief injections, which include a combination of steroids and a local anesthetic injected around the median nerve under ultrasound guidance.

However, if there are other therapies to try, we typically avoid prescribing steroids during pregnancy to avoid side effects.

Check with your Ob/Gyn before using any over-the-counter or prescribed topical medications. Our PM&R doctors will consult with your Ob/Gyn prior to recommending medication during pregnancy.

Surgery, in severe cases

Carpal tunnel release surgery is reserved for severe cases. In this procedure, a surgeon will cut the ligament that presses on the carpal tunnel, making more room for the median nerve and tendons. This usually improves function and pain.

Generally, we recommend waiting until after pregnancy to have surgeries that are not urgent. If wrist pain or hand weakness severely limits your daily function, talk with your Ob/Gyn about the risks and benefits of having carpal tunnel surgery prior to delivery.

When will symptoms improve?

After delivery, your fluid levels and the extra pressure in your blood vessels will decrease. As such, your symptoms will likely improve or resolve.

That being said, new mothers use their hands and wrists nearly constantly. Lifting, changing, and feeding the new baby may lead to worsened or new hand and wrist symptoms.

Let your Ob/Gyn know as soon as symptoms begin. If we catch carpal tunnel early enough, we can start conservative treatments to reduce the risk of nerve damage or lingering symptoms.

After pregnancy, keep an eye on your wrist health. You'll be lifting your baby a lot and making repetitive motions, which can lead to tendinopathies related to overuse.

Even if your new aches and pains don't seem overtly pregnancy-related, let your Ob/Gyn know. Pregnancy does strange things to the body, and your provider can help you find relief from painful or annoying symptoms.

To visit with an Ob/Gyn, call 214-645-8300 or request an appointment online.

what to do about it and how not to miss the body's signals about the presence of the disease

Table of contents

Causes and symptoms of hand numbness during pregnancy
What is dangerous numbness of hands and possible consequences
Prevention of numbness
Folk remedies for numbness
Cucumber tincture
Milk trays
Pumpkin Puree Wraps
Lemon and garlic tincture
Camphor ointment for the morning
Hand shower
Copper bracelets
Drawing conclusions

Pregnancy makes its own adjustments to the usual rhythm of life. Sometimes, a woman's body leads unexpectedly, and gives out symptoms that have never happened before. It arouses interest, and disturbs. One of these symptoms is that during pregnancy, hands become numb during sleep. Let's look into this issue, and understand whether the symptom is dangerous, and how to remove it.

Causes and symptoms of hand numbness during pregnancy

Do your hands go numb during sleep during pregnancy? The most common cause is circulatory problems. Nerve impulses transmit a signal of a lack of blood, and save the limbs by minimizing possible movements. However, during pregnancy, a few more are added to the characteristic cause:

Hormonal changes in the body.

A woman's body receives a powerful charge of hormones, which, on the one hand, makes bearing a fetus possible in principle, and on the other hand, makes adjustments to well-being, processes occurring in the body, appearance, mood, etc. Including hormones can cause hands to go numb during sleep during pregnancy.

Severe swelling.

A rare woman can avoid swelling during pregnancy, numb hands during sleep due to swelling. The accumulation of water leads to increased pressure on the vessels, which complicates blood circulation.

Weight set.

Another common cause of sleep numbness during pregnancy. All mothers already know that it is important to control their weight throughout pregnancy. This is not so much an aesthetic issue as a health issue. The load on the body is already increased, and if obesity of any degree occurs, the vessels reduce their ability to conduct blood correctly.

Tunnel syndrome.

Tunnel syndrome is characterized by compression of the median nerve. Because of this, nerve conduction is disturbed, and you feel that your hands go numb during pregnancy, in particular fingers and hands. Along with numbness comes a burning sensation, tingling, redness and swelling.

Vitamin deficiency.

Iron deficiency is also a common cause. This is one of the main trace elements that mothers need to replenish from the first days of pregnancy. Its lack is characterized by weakness, fatigue, and a decrease in hemoglobin. This leads to the fact that the hands go numb during sleep during pregnancy.

Less commonly, osteochondrosis and chronic pathologies of various types can be added to the causes. In contrast, you can note the reason that lies on the surface - you sleep in an uncomfortable position, because of which the tissues do not receive enough blood. Therefore, if the numbness of the hands occurred for the first time, do not panic. If possible, contact a gynecologist with this question, and most importantly, follow the dynamics of the onset of symptoms.

The danger of hand numbness and possible consequences

The mere fact that hands go numb during pregnancy is not dangerous. This is an uncomfortable symptom that can be accompanied by both a slight tingling sensation and quite noticeable pain. However, what is behind this symptom can bring serious consequences.

We have already mentioned above that if your hands go numb during sleep during pregnancy once or from time to time, do not worry, this may be due to an incorrect posture during sleep. Constant and recurrent pain can signal the presence of a disease that needs to be treated.

Leaving your arm numb during sleep unattended during pregnancy, you run the risk of exacerbating a particular disease that will lead to pregnancy complications, negatively affect the baby or negatively affect the birth process.

Prevention of numbness

If hands become numb during pregnancy, preventive measures can help. Moreover, these recommendations are useful for pregnant women in general. By introducing some changes in your usual diet and lifestyle, you can achieve significant results in the regulation of your health.

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Meals.

First of all, it is necessary to remove spicy and salty foods from the diet. It is also worth completely abandoning sausages and canned food. Other products, on the contrary, should be introduced into the diet:

Protein products. They act as a building material for the circulatory system, muscles, improve the functionality of cells. In addition, the protein is simply necessary for the baby for proper development.
Foods rich in calcium. With all the benefits of dairy products, make sure that what you eat is actually made from milk. It is also worth monitoring the reaction of your body. He should be comfortable digesting glucose.
Also on a regular basis in the diet should be foods rich in magnesium and potassium.

Drinking.

Not only what you eat is important, but also what you drink. The diet should contain exclusively purified mineral water and herbal teas. Everything else should be left for later. At the same time, it is important to keep the water balance. Drink the correct amount of liquid, calculated according to your individual needs.

Physical activity.

The reason that hands go numb during pregnancy can be physical activity. Both their excess and their shortcomings negatively affect. So, you need to completely refuse to carry heavy objects, bags on one shoulder, and minimize the time spent sitting. What is worth doing?

Wear a support brace.
Walk outdoors more often.
Do pregnancy exercises before bed, go to yoga or go swimming.

Additional tips to prevent numb hands during pregnancy.

Also introduce a few good habits into your life that will help relieve unpleasant symptoms during pregnancy:

Completely give up uncomfortable clothes that squeeze. Of course, pregnancy is not a reason to look sloppy, but still, during this quivering period, the main thing is your comfort and the health of the baby.
If your hands go numb during pregnancy, choose an orthopedic mattress and pillow that is comfortable for you, purchase a special pillow for pregnant women (especially in the later stages).
Try to avoid hypothermia.
Get a massage.

But, the most important advice if your hands go numb during pregnancy is to consult a doctor. Perhaps the numbness of the hands is just a discomfort that will accompany you during one trimester, or even the entire pregnancy. Perhaps this is a signal from the body about a disease that needs to be treated today.

Folk remedies to combat numbness

To speed up the process of getting rid of an unpleasant symptom, or remove it "here and now", you can supplement the doctor's recommendations with folk methods. However, it is worth remembering that this is only an auxiliary part of the treatment. Traditional medicine offers safe and effective methods to relieve hand numbness during pregnancy, but with constant numbness, it is important to find and eliminate the cause.

Cucumber tincture

The tincture will help relieve the numbness syndrome and eliminate unpleasant indications. Its disadvantage is long preparation. The tincture is prepared for 10 days. You need to chop a few pickles and a couple of red pepper pods. All this is done with vodka and stored in glass containers for 10 days. Infusion should take place in a cold place, so it is worth placing the jar in the refrigerator. As time passes, use the tincture to rub your hands before going to bed.

Milk baths

If your hands go numb during pregnancy, an effective and pleasant treatment is milk baths. To do this, take about a liter of milk, water in equal amounts, 50 grams of honey and 400 grams of salt. Mix all this in a saucepan and simmer over low heat for half an hour. After the mixture has cooled, dip your hands in it for 15 minutes. The full course consists of 14 procedures at bedtime.

Pumpkin puree wraps

Helps prevent nighttime numbness and pumpkin. To do this, boiled pumpkin porridge should be put on your hands in a thick layer, put on cellophane gloves. So it is necessary to spend half an hour before going to bed. After half an hour, wash your hands in warm running water.

Lemon-garlic tincture

In four days you can prepare an effective non-alcoholic tincture for oral consumption. Lemon zest + an equal share of garlic are poured into half a liter of water and left for 4 days. After you need to drink 50 ml. potions before bed.

Camphor ointment in the morning

If your hands go numb during pregnancy, and in the morning you feel unpleasant consequences, such as tingling, redness, take camphor ointment, eucalyptus essential oil and rub it well on your hands with soft massage movements.

Contrast hand shower

An immediate and easy way to relieve the symptoms of numb hands during pregnancy is a contrast hand shower. One has only to hold hands under hot-cold-hot water. However, it is worth remembering the ongoing pregnancy. This leaves an imprint on the permissible temperatures. At the same time, the effectiveness of the method may decrease.

Copper bracelets

Unproven medicine also recommends the use of copper bracelets. By putting them on your hands at night, you will get rid of numbness on the first night. How much it helps when hands go numb in a dream during pregnancy has not been studied, but this method does not cause harm, so you can try folk wisdom from your own experience.

Drawing conclusions

Summing up, I would like to remind you that such an unpleasant, but seemingly unimportant symptom, is the reason for visiting a doctor. Especially during pregnancy. It is also important to remember that traditional medicine is most effective in conjunction with the official one. If your hands go numb during pregnancy, follow the doctor's recommendations, take prescribed medications and supplement them with your favorite folk method. Be healthy!

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If fingers go numb: causes, treatment and prevention

Hand numbness is not a disease, but it can be a symptom of a disease that is important to identify and treat in time.

The sensation of numbness in the fingertips or hands is familiar to many. If this phenomenon does not last long and is associated with nerve compression (for example, after sleeping in an uncomfortable position), there is no reason to worry, but if it bothers you regularly, you should consult a doctor. Hand numbness is not a disease, but it can be a symptom of a disease that is important to identify and cure in time.

Anna Viktorovna Cherepenina, a neurologist of the Semeynaya clinic network, tells about the causes of decrease in the sensitivity of hands and fingers, and how to cure it.

Causes

If the numbness of the fingers passes quickly, there is no cause for concern. Most likely, it is associated with compression of blood vessels and nerves (more often in a dream). In order for the numbness to pass faster, raise your hands up, and then bend and unbend your fingers until sensation returns to them.

Often numbness of the hands can disturb pregnant women - the nerve endings of the fingers are compressed due to edema.

Causes related to disorders of the body:

Injuries;
Raynaud's disease, characterized by impaired circulation in the small vessels of the fingers;
Carpal tunnel syndrome. Often appears in those who work a lot at the computer. It is characterized by pinching of the median nerve in the wrist, in which the fingers can hurt and swell;
Osteochondrosis of the lower cervical region;
Herniated disc;
Diabetes;
Atherosclerosis;
Multiple sclerosis;
Angina pectoris;
Blockage of cerebral vessels;
Thrombosis of the vessels of the upper extremities.

As you can see, there are many reasons why fingers can become numb, and some of the diseases are quite dangerous. Therefore, a visit to the doctor should not be postponed.

Treatment

If you are concerned about such a problem as numbness of the fingers, do not self-medicate. Loss / decrease in sensitivity can be a symptom of various diseases, and it is very difficult to diagnose on your own which ones. Therefore, it is important to see a doctor.

You can only try to restore sensitivity on your own - by rubbing your fingertips or by rinsing your hands under a contrast shower.

The doctor will prescribe treatment after an examination and necessary examinations (for example, if necessary, MRI of the brain, X-ray / MRI of the cervical spine, dopplerography of the vessels of the neck), based on the established diagnosis.