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Sore wrist during pregnancy


Wrist Pain and Pregnancy | Dr Brutus

Pregnancy can affect the body in many different ways, including the wrist. Approximately 35% to 62% of women report having wrist pain during their pregnancy (mainly in the 3rd trimester) whereas around 50% of women report developing wrist pain post pregnancy. Inflammation and muscle weakness resulting from hormonal changes, as well as the reduction in physical activity are mainly to blame.

Many women find that their symptoms disappear within a few months of delivery. However, certain diagnosis may require professional attention and treatment.  In severe cases, symptoms may worsen over time and result in the need for surgery to prevent permanent nerve damage.

 

During Pregnancy

Carpal tunnel syndrome is common during  pregnancy. Hormonal changes are believed to contribute to the development of the condition. Fluid retention can also be a factor as it creates more pressure on the median nerve.

There are several other risk factors that may lead a pregnant woman to develop carpal tunnel during her pregnancy:

Being Overweight or Obese Prior to Pregnancy

  • While it is unclear if weight specifically causes carpal tunnel, more women who were overweight prior to pregnancy report developing CTS.

Pregnancy Related Diabetes or Hypertension

  • Both conditions can lead to increased fluid retention which is a cause of carpal tunnel

Prior Pregnancies 

  • Relaxin, a hormone which helps the pelvis and cervix expand during pregnancy, may be seen in higher doses in subsequent pregnancies. The hormone may also lead to inflammation which can cause carpal tunnel.

In most cases, the condition will resolve itself within a few months of the baby’s birth. If you begin to experience tingling and numbness, or pain traveling up the arm into your shoulder, you should call your physician.

 

Pregnancy Safe Treatments

You should make your OBGYN aware of carpal tunnel symptoms as soon as they arrive. While they may recommend you see a hand  specialist, there are several ways women can find relief at home:

  • Wear a wrist splint at night
  • Perform wrist stretches and strengthening exercises
  • Rest as much as possible

A decrease in physical activity may exacerbate wrist pain. Keeping up with exercise and stretches will prevent wrist weakness and help prevent discomfort.

In mild cases of carpal tunnel, rest and a short-term wrist splint should be enough to get you through until after your baby is born. However, if your symptoms persist or become more severe , you may need to see a hand specialist .

 

Prescribed Treatment Options 

If you choose to see a hand specialist, there are several options they may recommend:

Occupational Therapy

  • The occupational therapist will create a treatment plan specifically designed to treat each woman’s individual pain.

Cortisone Injections

  • Typically avoided during pregnancy.
    • OTC pain relievers and anti-inflammatories should only be taken when directed by a doctor.

    In severe cases, if symptoms don’t resolve on their own post pregnancy, surgery may be necessary. It is recommended to wait until after delivery to undergo any type of invasive procedure, but in severe cases it is possible to have surgery prior to delivery. Consult with your doctor if this is a concern.

    Many women may shy away from surgery because they believe it will have a long downtime period which is not conducive to having a newborn. Thankfully, Dr. Brutus performs a newer, less invasive kind of surgery called “endoscopic decompression.” The surgery has an average recovery time of 14 days, which is about four times faster than with the open surgery method. Endoscopic decompression provides instant relief from pain and numbness with a smaller incision.

     

    Post Pregnancy Wrist Pain

    Women who experience wrist pain post pregnancy may have developed what’s called De Quervain’s Tenosynovitis also known as “Mommy’s Wrist.” While it is common, it can make caring for a newborn difficult for mothers.

    The two most common symptoms are:

    • Pain and swelling in the thumb, extending into the forearm
    • Pain with the use of the thumb and wrist when performing pinching, twisting, or pulling motions.

    The condition is thought to develop from the repeated motion of lifting and holding one’s baby, particularly when nursing. A physician should be seen if your pain interferes with your ability to hold your child or do other simple daily tasks.

     

    Treatment Options

    The easiest way to treat De Quervain’s Tenosynovitis is to rest as much as possible. While this is easier said than done with a newborn, there are other options in addition to rest. Your physician may recommend that you wear a wrist splint. This can be a generic store bought splint or a custom orthotic. Modifying breastfeeding position can also help.

    If your symptoms last longer than six months without improvement, your physician may recommend you for surgery. Surgical treatment does come with more downtime, but it’s the only way to permanently cure the condition.

    Surgery for De Quervain’s Tenosynovitis, aka “De Quervain’s release,”  is an outpatient procedure performed with a local anesthetic. The surgeon will create a small incision in the wrist and locate the inflamed tendon. Once the tendon is cut, pressure is released allowing you to move your hand without pain again.

    After one to two weeks, your surgeon will remove your stitches. Your splint may still need to be worn for up to four weeks after surgery. Most patients find their hand will be fully healed in six to twelve weeks.

     

    Final Thoughts

    The hormonal changes a woman experiences during and post pregnancy are a common cause for wrist pain. While most cases end up being mild and resolve themselves, more severe cases may require a visit to a hand surgeon.

    The best way an expecting or new mother can best improve her symptoms is to take care of herself. While it’s easier said than done, rest, proper nutrition and hydration, physical activity and appropriate medical care are key to staying healthy.

     

     

    Carpal tunnel syndrome and pregnancy

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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

    Need more information?

    Carpal tunnel syndrome - Better Health Channel

    Carpal tunnel syndrome can be caused by repetitive hand movements, pregnancy and arthritis.