Pregnant carpal tunnel
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 - Better Health Channel
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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
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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Carpal tunnel syndrome in pregnant women
02/26/2020
At the end of the second trimester of pregnancy many women suffer from hand numbness. Around the 26th week there is tingling, numbness and pain in the fingers, sometimes extending to the shoulder.
This is carpal tunnel syndrome, which in pregnant women is associated with hormonal changes and water retention in the body.
As a result of stagnant fluid, compression of the nerves in the wrist reaches the fingers. The symptoms are worse especially at night. The pain can be so severe that it can wake the woman up or prevent her from getting a good night's sleep. Although carpal tunnel syndrome is a problem and usually resolves spontaneously 2-3 weeks after deliveries .
How to deal with hand numbness in pregnant women?
A woman with carpal tunnel syndrome should avoid positions that cause pressure on her arm. Sometimes symptoms come from shaking the numb limb or placing it below the heart line (eg on the knee) or loosely lowering the arm (also during sleep).
People who have symptoms of carpal tunnel syndrome should stop tasks that require repeating the same finger and hand movements. They include working on a computer (writing, graphic design), working on a production line, as well as embroidery, crocheting, or even peeling fruits and vegetables.
If it is not possible to completely eliminate these responsibilities, you should schedule frequent breaks. When working on a computer, you can take care of special pillows and ergonomic keyboards that will facilitate the correct positioning of the hand. The position of our body is also important for proper circulation. Avoid Crossbreeding feet and cross-legged position for prolonged sitting. It is better to rest with your legs up .
Proper Diet
Diet , rich in magnesium and vitamin B6, is useful in preventing and relieving symptoms of carpal tunnel syndrome. It is worth taking care of a variety of dishes based on poultry, fish, potatoes and milk. Other sources of vitamin B6 include nuts, beans, soybeans, avocados, sunflower seeds, eggs, and bananas. Magnesium deficiency can be supplemented by such foods: parsley, pumpkin seeds, dill, dark chocolate, buckwheat or cocoa. nine0003
A woman should also reduce her intake of salt, coffee and tea (not to mention smoking and alcohol!).
They flush out minerals from the body, making it difficult to prevent carpal tunnel syndrome .
When should I consult a doctor?
Although hand numbness is a common disorder in pregnant women, sometimes home remedies to reduce symptoms do not help. When the pain gets worse, there are problems with normal functioning or holding objects in the hands, it is worth contacting to doctor . It may be that this will require an increase in vitamin intake or taking painkillers (pregnant women are better off avoiding self-diagnosis and treatment in this regard).
Sometimes it may be necessary to immobilize the wrist with special devices or visit a specialist, namely orthopedist , neurologist or physiotherapist .
Published in Pregnancy and Pregnancy Management Premium Clinic
Carpal Tunnel and Pregnancy: What's the Connection? nine0001
contents
Carpal tunnel syndrome (CTS) usually occurs during pregnancy.
CTS occurs in 4 percent of the general population, but occurs in 31–62 percent of pregnant women, according to a 2015 study.
Experts aren't entirely sure why CTS is so common during pregnancy, but they think a hormonal factor may be the culprit. In the same way that fluid retention during pregnancy can cause ankle and toe sprains, swelling can lead to CTS. nine0003
Read on to learn more about CTS during pregnancy.
Common symptoms of CTS during pregnancy include:
- stiffness and tingling (almost like a needle) in the fingers, wrists, and hands, which may worsen at night
- throbbing sensation in the hands, wrists, and fingers
- swollen fingers
- problems catching objects and fine motor skills such as tying a shirt or working with a buckle on a necklace
It may affect one or both hands. A 2012 study found that it was over 50 pregnant women with CTS who held it in both hands.
Symptoms may worsen as pregnancy progresses.
One study found 40 place participants reported onset of symptoms of CTS after 30 weeks of pregnancy. This is when the greatest weight gain and fluid retention occurs.
CTS occurs when the median nerve is compressed while passing through the carpal tunnel at a joint. The median nerve runs from the neck down to the arm and to the wrist. This nerve controls the sensation of the fingers. nine0003
The carpal tunnel is a narrow passageway made up of tiny "carpal" bones and ligaments. When the tunnel narrows due to swelling, the nerve is compressed. This results in pain in the hand and stiffness or tingling in the fingers.
Diagram of the median nerve
[CUP BODIES: / maps of the human body / median nerve]
Some pregnant women are more likely to develop CTS than others. Here are some risk factors for CTS:
Overweight or obesity before pregnancy
It is unclear whether weight causes CTS, but overweight or obese pregnant women are diagnosed with the condition.
more often from pregnant women who are not obese or obese.
You have pregnancy-related diabetes or hypertension
Gestational diabetes and gestational hypertension can lead to fluid retention and subsequent swelling. This, in turn, may increase the risk of CTS.
High blood sugar can also cause inflammation, including in the carpal tunnel. This can further increase the risk of CTS. nine0003
Past pregnancies
Relaxin can be seen in higher amounts in later pregnancy. This hormone helps the pelvis and cervix expand during pregnancy in preparation for childbirth. It can also cause inflammation in the carpal tunnel, compressing the median nerve.
CTS is most often diagnosed based on a doctor's description of symptoms. Your doctor may also perform a physical examination.
During the physical examination, the physician may use electrodiagnostic tests to confirm the diagnosis, if necessary. Electrodiagnostic tests use thin needles or electrodes (wires on the skin) to record and analyze the signals that your nerves send and receive.
Damage to the median nerve can slow or block these electrical signals. nine0003
Your doctor may also use Tinel's sign to look for nerve damage. This test may also be performed as part of a physical exam. During the test, your doctor will gently tap the area of the affected nerve. If you feel ticklish, this may indicate nerve damage.
Tinel sign and electrodiagnostic tests are safe for use during pregnancy.
Most doctors recommend conservative treatment of CTS during pregnancy. This is because many people will feel relief within a few weeks and months after giving birth. In only one study, 1 in 6 participants who had CTS during pregnancy still had symptoms 12 months postpartum. nine0003
You are more likely to stay with CTS after delivery if your CTS symptoms started earlier in your pregnancy or if your symptoms are severe.
The following treatments are safe to use during pregnancy:
- Use glitter. Look for a bracelet that keeps your wrist in a neutral (not bent) position.
When symptoms worsen, wearing the bracelets at night can be especially helpful. If practical, you can wear it throughout the day. nine0070 - Reduce activity that causes joint distortion. This includes typing on the keyboard.
- Use cold therapy. Apply ice wrapped in a towel to your wrist for about 10 minutes several times a day to reduce swelling. Try a "contrast bath": soak your wrist in cold water for about one minute and then in warm water for another minute. Hold alternately for five to six minutes. Repeat as often as possible.
- The rest. Whenever you feel pain or fatigue in a joint, take some rest or switch to another activity.
- Raise your wrists whenever you can. You can use pillows for this.
- Practice yoga. Findings from one study found that yoga could reduce pain and increase grip strength in people with CTS. More research is needed, especially to understand the pregnancy-related benefits of CTS.
- Get physical therapy. Myofascial release therapy can reduce pain associated with CTS and improve hand function.
This is a type of massage to relieve tension and stiffness in ligaments and muscles. - Take pain medication. Using acetaminophen (Tylenol) at any time during pregnancy is generally considered safe as long as you do not exceed 3,000 mg per day. If in doubt, consult your doctor. Avoid taking ibuprofen (Advil) during pregnancy unless your doctor has specifically approved it. Ibuprofen has been linked to low amniotic fluid levels and a number of other conditions. nine0070
Breastfeeding can be painful with CTS because you will need to use your wrist to keep your baby's head and chest in the correct position for feeding. Try experimenting with different positions. Use pillows and blankets to support, support, or hold them down as needed.
You may find that breastfeeding while lying on your side, face up, works well. "Football Wrist" can also be lighter on the wrist. In this position, sit up straight and place the baby on the side of your arm so that the baby's head is close to your torso.
