Nerve pain in hand during pregnancy
Carpal tunnel syndrome and pregnancy
Carpal tunnel syndrome and pregnancy | Pregnancy Birth and Baby beginning of content6-minute read
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Key facts
- Carpal tunnel syndrome is a condition that occurs when swelling in your wrist presses on a nerve and causes pain in your hand.
- It’s common in pregnancy and usually goes away after your baby is born.
- It can cause pain, numbness and tingling in your thumb, index finger and middle finger. It can also cause weakness in your hand and pain going up your arm.
- You can modify your daily activities to reduce your pain.
- See a physiotherapist or occupational therapist to learn exercises and get a special wrist splint fitted to help relieve pain.
What is carpal tunnel syndrome?
Carpal tunnel syndrome is a condition that occurs as a result of swelling around the nerves of your wrist. It can cause numbness, tingling or pain in one or both of your hands.
If you are pregnant, you’re particularly susceptible to the disorder. Up to 5 out of every 10 people who are pregnant develop carpal tunnel syndrome.
What causes carpal tunnel syndrome?
The carpal tunnel is a passage in your wrist that contains tendons and a nerve, called the median nerve, that run through the base of your hand. The carpal tunnel can swell and press against this sensitive nerve, causing pain.
While pregnancy is one cause, other common causes include arthritis or repetitive hand movements, which may occur in some jobs. Visit this healthdirect page for information about carpal tunnel syndrome unrelated to pregnancy.
How does pregnancy cause carpal tunnel syndrome?
When you are pregnant, your hormones cause fluid to build up in your body, which can cause swelling. This can lead to swelling within the carpal tunnel.
The condition is more common in the third trimester, but it can also happen in the first and second trimesters or after you give birth. In most cases, symptoms will go away after your baby is born.
What are the symptoms of carpal tunnel syndrome?
Common symptoms of carpal tunnel syndrome include:
- pain, numbness, tingling, or weakness of your hand
- difficulty with hand coordination
- pain spreading to your arm or shoulder
You will probably feel the symptoms most in your thumb, index finger and middle finger. Symptoms can get worse at night.
The intensity of symptoms can vary from mild irritation or occasional soreness, to severe pain. Symptoms may stop you from sleeping or make it difficult to perform regular tasks such as working, getting dressed, cooking or caring for your baby.
Things that may make your symptoms worse include:
- repeating the same hand movements frequently
- keeping your hands in the same position for an extended time
- supporting your weight with straightened arms
Swelling may be a sign of high blood pressure in pregnancy. If your hands or feet are more swollen than usual, speak to your doctor or midwife.
What can I do to relieve carpal tunnel syndrome?
You may find that your pain is reduced by the following:
- Keep your hands elevated as much as you can.
- Keep your wrists in a neutral position (not bent forwards or backwards), as much as you can.
- Maintain good posture in your arms and wrists while working at a desk and take breaks every 20 minutes.
- Sleep on the side of your less affected hand.
- Put an ice pack on your wrist or run cold water over your hand.
Here are some things you should avoid:
- Avoid any repeated movements that make your pain worse.
- Avoid lifting heavy objects.
- Avoid tasks where you do the same movement repeatedly.
- Don’t bend your wrist as far as it can go.
Here are some things you can do to relieve general swelling in your body:
- Lie down whenever you can, with your feet elevated.
- Cut down on salt in foods.
- Elevate your legs when you’re sitting down.
- Wear compression socks or stockings.
Are there any treatments for carpal tunnel syndrome?
Treatment options include physiotherapy or occupational therapy. This may involve fitting you with a splint to keep your wrist in the best position to reduce strain. The splint must be adjusted to fit your wrist in order to be protective and supportive. You should wear your splint at night to keep your wrist in the right position while you’re asleep.
Your therapist will be able to tell you how best to protect your wrist at home, including exercises and resting positions.
You can try fluid drainage massage to reduce the swelling in your hand. You can do this by lifting your arm up and using your other hand to sweep gently along your skin from your fingers towards your shoulder. Be careful not to sweep the other way.
There are other treatments available for carpal tunnel syndrome, such as a cortisone injection into your wrist or even surgery.
Will I still have pain after my baby is born?
Carpal tunnel syndrome tends to ease, and often disappears, after birth. If you still have pain after your baby is born, you may need to change the way you use your wrist. This might affect how you use your hand to hold and care for your baby, including how you feed your baby.
Speak to your physiotherapist, occupational therapist or lactation consultant for strategies and tips on how to minimise strain on your wrist while holding your newborn. It’s a good idea to continue using your splint, if you have one.
Sources:
Royal Women’s Hospital (Pregnancy-related carpal tunnel syndrome), Australian Government Department of Health (Carpal tunnel syndrome), Western Australia Department of Health (Carpal tunnel syndrome), Western Sydney local Heath District (Fact Sheet Carpal Tunnel Syndrome)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: June 2022
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Related pages
- Physiotherapy advice after pregnancy
- Swelling during pregnancy
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Carpal tunnel syndrome and pregnancy go hand in hand | Your Pregnancy Matters
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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 KumarWhen 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.
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Intercostal neuralgia during pregnancy - Omega-Kyiv reference book
Neuralgia is dangerous not only for a woman, but also for an unborn baby. Intercostal neuralgia during pregnancy is a rather unpleasant phenomenon, because the pathology is always accompanied by a serious pain syndrome. Unpleasant symptoms can be traced not only in the area of the ribs, but also on other parts of the body.
Intercostal neuralgia during childbearing occurs as a result of the fact that the expanding and enlarging uterus begins to put pressure on the nerve between the ribs. The pain syndrome can be so strong that sometimes a woman is not even able to move. The cause of neuralgia can also be hypothermia, colds, medication. It is important to immediately visit a doctor if negative symptoms are detected. The doctor will prescribe treatment after examination. If treatment is not carried out, then complications may arise that will turn into problems for the woman and the baby.
Symptoms of intercostal neuralgia during pregnancy
Intercostal neuralgia during pregnancy is manifested by unpleasant symptoms. The main symptoms include:
- Excessive sweating.
- Muscle cramp.
- Persistent and intermittent pain in the chest. Pain is often confused with pain in the heart.
- When staying in one position for a long time, the pain syndrome radiates to the scapula or lumbar region.
- Pale skin or redness.
- Loss of sensation in certain areas of the skin.
The disease is diagnosed by ultrasound, ECG. Also, a general blood test, an MRI, and a CT scan are prescribed. Only after diagnosis can a correct diagnosis be made and effective treatment prescribed. It is forbidden to use any methods of therapy on your own, as this can harm not only the expectant mother, but also the baby.
How to treat intercostal neuralgia in pregnant women?
Treatment of intercostal neuralgia in pregnant women is a mandatory process. It is important to consult a doctor and not to panic, a specialist will help.
If intercostal neuralgia is detected during pregnancy, treatment may be as follows:
- Pain relief. Pain is eliminated with the help of gels, ointments, creams, the basis of which is bee venom. If a woman does not have an allergy, then these remedies will perfectly relieve pain, relax, and warm the muscles. Ointments are applied to active points. Bee venom stimulates nerve endings.
- Taking vitamins. Be sure to take B vitamins. With a deficiency of vitamins B1, B12 and B6, the disease progresses.
- Anesthetics should only be taken as directed by a physician, as they are not recommended during pregnancy. Novocaine blockade or muscle relaxants will help eliminate the spasm.
- Bed rest is important during the acute period. Sleep on a hard bed. In addition, the doctor may recommend physiotherapy.
In addition, acupuncture, manual therapy, acupressure can be prescribed. Often, the doctor may prescribe some alternative medicine methods. However, it should be remembered that folk recipes can adversely affect health. Nevertheless, warm baths, with the addition of sea salt and sage, rubbing the chest with fir oil, rubbing the chest with birch bud tincture will bring great benefits.
Pinched sciatic nerve during pregnancy: symptoms, treatment
For the female body, pregnancy is a difficult test. It is during this period that all hidden pathologies can appear or those that were known before pregnancy can worsen. Not a rare case during the period of bearing a child for a woman is such a neurological disease as a pinched sciatic nerve (another name is “sciatica”). How this disease manifests itself and how you can fight it without harming the unborn baby will be described in this article.
Causes of pinching of the sciatic nerve in pregnant women
Among the most common causes of pinched sciatic nerve during pregnancy are:
- Pressure on the sciatic nerve of the enlarged uterus. Accordingly, as the fetus grows in the uterus, this pressure increases.
- Displacement of intervertebral discs in the lumbar region. This, in turn, can occur due to excessive weight gain, multiple pregnancies, polyhydramnios.
- Traumatic injuries of the spine in the lumbar region.
In cases where sciatica has already occurred in a woman’s history, but after appropriate treatment, its symptoms have disappeared, a relapse may occur during pregnancy. In addition, pinching, inflammation of the sciatic nerve during pregnancy can be the result of an intervertebral hernia, diabetes mellitus, a malignant or benign tumor, osteochondrosis and other diseases. That is why, in order to be able to prevent the occurrence of sciatica or be prepared for its manifestation, a woman needs to tell her doctor everything about her health. At risk of pinching of the sciatic nerve together with a gynecologist a woman will be observed by a neurologist .
Symptoms
Pinched sciatic nerve during pregnancy does not go away without symptoms and often the disease is urgently required. Usually, this pathology is manifested by pain that occurs in various areas of the lower body and has different intensity and frequency of occurrence. The main symptoms of sciatica include:
- Discomfort or pain in or just below the lumbar region. Further, the pain can move to the sacrum, and then go down to the very foot.
- Pain may present as shootings and occurs only at certain points along the path of the sciatic nerve.
- Pain may occur when bending the torso, with sudden movements, turning the torso.
- In cases where the compression of the sciatic nerve is too strong, the pregnant woman may have trouble walking. There may also be numbness and loss of sensation in areas of nerve damage.
- When inflammation of the sciatic nerve occurs due to pinching, body temperature may rise.
- Violation of the process of urination, disruption of the intestines.
About any of the listed symptoms, and even more so if they are observed in combination, a pregnant woman should be told to her doctor.
How to diagnose pinching during pregnancy?
What to do if during pregnancy there is a suspicion of a pinched sciatic nerve? First of all, consult a doctor for a diagnosis. To confirm this diagnosis, doctors conduct an external examination, palpation, and also ask the woman to perform several simple motor tests (for example, tilt the torso, lie on her back and raise one leg without bending). If during palpation, with certain movements of the body or legs, a woman feels pain, then most likely the nerve is pinched.
Also, as part of the diagnosis, standard blood tests are prescribed to assess the general health of a woman, to understand if there is inflammation in the body. Diagnosis of sciatica during pregnancy is difficult because not all possible and informative methods can be used. For example, X-rays and tomography are contraindicated during pregnancy, although these diagnostic methods could give the most complete picture of the development of the disease.
How to treat?
Any treatment during pregnancy requires special care. When prescribing certain methods of treatment, the doctor must evaluate the intended benefit to the mother and the possible risk to the fetus. If it is possible to postpone treatment for the postpartum period, then this path is chosen. If the painful condition of a pregnant woman prevents her from moving normally, resting, she is tormented by unbearable pain, then a course of treatment is necessary. For help in the treatment of sciatica, as well as many other diseases, including during pregnancy, you can contact the qualified specialists of the Energo clinic.
exercise therapy and gymnastics
With the help of physical therapy and special gymnastics, you can fight various neurological diseases, including sciatica. Specific types of exercises to be performed should be prescribed by the doctor, assessing the general condition of the patient. Basically, each exercise is aimed at strengthening the muscles of the back. One of these exercises is the arching of the back from the starting position while standing on all fours (the so-called "kitty").
Massage
Massage for pinched sciatic nerve allows you to relieve tension from the muscles, increase their tone, improve the general condition of the patient, improve blood flow and metabolism. It can be done only when there are no acute attacks of pain. This applies not only to pregnancy, but also to the general appointment of massage for pinched sciatic nerve.
Warm-up
Warming can be used to relieve pain. To do this, you can use, for example, a belt made of dog hair, pads with buckwheat or flaxseed and other coolants.
Yoga
Calm, relaxing yoga classes help restore emotional balance, relieve muscle tension, increase muscle tone. After yoga, many pregnant women notice that their overall health improves, their mood improves, their appetite is restored, which, of course, has a positive effect on the development of the fetus.
Manual therapy
Manual therapy helps relieve pain and reduce its attacks. The impact occurs on certain points on the back, legs, where pain is localized.
Compresses
For compresses and rubbing, you can use herbal tinctures. This should be done with great care, following the clear instructions of the doctor, since almost all such tinctures contain alcohol. You also need to remember that in the presence of an inflammatory process in the body, elevated temperature, compresses are contraindicated.
Prenatal Band
To reduce the load on the spine, to maintain it in the correct position, it is recommended that pregnant women wear a prenatal bandage. Doctors usually recommend wearing it from the middle of the second trimester. No need to wear it all day - about 2-3 hours. The bandage makes it easier to walk or stand. Sitting and resting in it can be uncomfortable.
Medical treatment
Drug treatment during pregnancy is rarely used. Most drugs have a number of contraindications in their description, which almost always includes pregnancy (especially the 1st and 3rd trimesters). In extreme cases, painkillers, B vitamins, anti-inflammatory drugs may be prescribed.
Preventive measures
Any disease is easier to prevent than to treat it later. Sciatica is no exception. As a preventive measure for this disease, women planning a pregnancy, as well as everyone else, should lead an active lifestyle, attend aerobics, yoga classes, go to the pool and so on several times a week.