What to do for carpal tunnel during pregnancy
Carpal Tunnel and Pregnancy: What’s the Connection?
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Medically reviewed by Holly Ernst, PA-C — By Donna Christiano on June 4, 2018
Carpal tunnel syndrome and pregnancy
Carpal tunnel syndrome (CTS) is commonly seen in pregnancy. CTS occurs in 4 percent of the general population, but occurs in 31 to 62 percent of pregnant women, estimates a 2015 study.
Experts aren’t exactly sure what makes CTS so common during pregnancy, but they do think hormone-related swelling may be the culprit. Just as fluid retention in pregnancy can cause your ankles and fingers to swell, it can also cause swelling that leads to CTS.
Read on to learn more about CTS in pregnancy.
What are the symptoms of carpal tunnel syndrome in pregnancy?
Common symptoms of CTS in pregnancy include:
- numbness and tingling (almost like a pins-and-needles feeling) in fingers, wrists, and hands, which may worsen at night
- throbbing sensation in hands, wrists, and fingers
- swollen fingers
- trouble gripping objects and problems performing fine motor skills, such as buttoning a shirt or working the clasp on a necklace
One or both hands may be affected. A 2012 study found that almost 50 percent of pregnant participants with CTS had it in both hands.
Symptoms may worsen as the pregnancy progresses. One study found 40 percent of participants reported the onset of CTS symptoms after 30 weeks of pregnancy. This is when the most weight gain and fluid retention occurs.
What cause carpal tunnel syndrome?
CTS occurs when the median nerve becomes compressed as it passes through the carpal tunnel in the wrist. The median nerve runs from the neck, down the arm, and to the wrist. This nerve controls feeling in the fingers.
The carpal tunnel is a narrow passageway made up of tiny “carpal” bones and ligaments. When the tunnel is narrowed by swelling, the nerve is compressed. This leads to pain in the hand and numbness or burning in the fingers.
Median nerve diagram
[BODY MAP IMBED: /human-body-maps/median-nerve]
Are some pregnant women at an increased risk?
Some pregnant women are more prone to develop CTS than others. Here are some risk factors of CTS:
Being overweight or obese before becoming pregnant
It’s unclear if weight causes CTS, but pregnant women who are overweight or obese receive diagnoses with the condition more frequently than pregnant women who aren’t overweight or obese.
Having pregnancy-related diabetes or hypertension
Gestational diabetes and gestational hypertensioncan both lead to fluid retention and subsequent swelling. This, in turn, can increase the risk of CTS.
High blood sugar levels can also cause inflammation, including of the carpal tunnel. This may further increase the risk of CTS.
Past pregnancies
Relaxin may be seen in higher amounts in subsequent pregnancies. This hormone helps the pelvis and cervix expand during pregnancy in preparation for childbirth. It can also cause inflammation in the carpal tunnel, squeezing the median nerve.
How is CTS diagnosed in pregnancy?
CTS is most often diagnosed based on your description of symptoms to your doctor. Your doctor may also conduct a physical exam.
During the physical exam, your doctor may use electrodiagnostic tests to confirm the diagnosis, if needed. Electrodiagnostic tests use thin needles or electrodes (wires taped to the skin) to record and analyze signals your nerves send and receive.
Damage to the median nerve can slow down or block these electrical signals.
Your doctor may also use Tinel’s sign to identify nerve damage. This test can be done as part of a physical exam, too. During the test, your doctor will lightly tap over the area with the affected nerve. If you feel a tingling sensation, this can indicate nerve damage.
Tinel’s sign and electrodiagnostic tests are safe for use during pregnancy.
How to treat carpal tunnel syndrome in pregnancy
Most doctors recommend treating CTS conservatively in pregnancy. This is because many people will experience relief in the weeks and months after giving birth. In one study, only 1 out of 6 participants who had CTS during pregnancy still had symptoms 12 months after delivery.
You’re more likely to continue to experience CTS after delivery if your CTS symptoms began earlier in your pregnancy or if your symptoms are severe.
The following treatments may be safely used during pregnancy:
- Use a splint.
Look for a brace that keeps your wrist in a neutral (not bent) position. When symptoms tend to be worse, wearing a brace at night may be particularly beneficial. If it’s practical, you can wear it during the day as well. - Reduce activities that cause your wrist to bend. This includes typing on a keyboard.
- Use cold therapy. Apply ice wrapped in a towel to your wrist for about 10 minutes, several times a day, to help decrease swelling. You might also try what’s called a “contrast bath”: Soak your wrist in cold water for about one minute, then in warm water for another minute. Keep alternating for five to six minutes. Repeat as often as practical.
- Rest. Whenever you feel pain or fatigue in your wrist, rest it for a bit, or switch to a different activity.
- Elevate your wrists whenever you can. You can use pillows to do so.
- Practice yoga. Results from one study found that practicing yoga can reduce pain and increase grip strength in people with CTS.
More research is needed, though, especially to understand the benefits for pregnancy-related CTS. - Get physical therapy. Myofascial release therapy may reduce CTS-related pain and increase hand function. This is a type of massage to reduce tightness and shortness in ligaments and muscles.
- Take pain relievers. Using acetaminophen (Tylenol) at any point in pregnancy is generally considered safe, as long as you don’t exceed 3,000 mg daily. Talk to your doctor if you have concerns. Avoid ibuprofen (Advil) during pregnancy unless it’s specifically approved to use by your doctor. Ibuprofen has been linked to low amniotic fluid and a number of other conditions.
Carpal tunnel syndrome and breastfeeding
Breastfeeding may be painful with CTS because you’ll need to use your wrist to hold your baby’s head and your breast in the proper position for nursing. Try experimenting with different positions. Use pillows and blankets to prop, support, or brace when needed.
You may find that breastfeeding while lying on your side with the baby facing you works well. The “football hold” may also be easier on the wrist. With this position, you sit upright and place your baby on the side of your arm with your baby’s head close to your torso.
You may prefer hands-free nursing, where your baby feeds while in a sling worn close to your body.
If you’re having trouble breastfeeding or finding a position that’s comfortable for you and your baby, consider talking to a lactation consultant. They can help you learn comfortable positions and can help identify any problems that you or your baby are having with nursing.
What’s the outlook?
CTS is common during pregnancy. Simple measures like splinting and taking acetaminophen are standard therapies and usually bring relief.
Most people will see their symptoms resolve within 12 months after delivery. However, it can take years in some cases. Talk to your doctor about ways to safely manage your symptoms.
Last medically reviewed on June 4, 2018
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- Pregnancy
- Pregnancy Health
How we reviewed this article:
Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
- Carlson H, et al. (2010). Current options for nonsurgical management of carpal tunnel syndrome. DOI:
10.2217/IJR.09.63 - Carpal Tunnel Fact Sheet [Fact Sheet]. (2017).
ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-Sheet - Carpal tunnel syndrome. (2016).
orthoinfo.aaos.org/en/diseases--conditions/carpal-tunnel-syndrome/ - Carpal tunnel syndrome during pregnancy [Fact sheet].
(2015).
uhs.nhs.uk/Media/Controlleddocuments/Patientinformation/Pregnancyandbirth/Carpal-tunnel-syndrome-during-pregnancy-patient-information.PDF - Daluiski A, et al. (2009). Carpal tunnel syndrome: Myths, facts, diagnosis, and treatment.
hss.edu/conditions_carpal-tunnel-syndrome-myths-facts-diagnosis-treatment.asp - Hamoda R. (2014). Effect of myofascial release on carpal tunnel syndrome during pregnancy.
scholar.cu.edu.eg/?q=reham_hamoda/publications/effect-myofascial-release-carpal-tunnel-syndrome-during-pregnancy - Hashempur MH, et al. (2015). Carpal tunnel syndrome in lactation: A challenging issue. DOI:
10.17795/whb-31414 - Khosrawi S, et al. (2012). The prevalence and severity of carpal tunnel syndrome during pregnancy. DOI:
10.4103/2277-9175.100143 - Meems M, et al. (2015). Prevalence, course and determinants of carpal tunnel syndrome symptoms during pregnancy: A prospective study.
DOI:
10.1111/1471-0528.13360 - Meems M, et al. (2017). Follow-up of pregnancy-related carpal tunnel syndrome symptoms at 12 months postpartum: A prospective study. DOI:
10.1016/j.ejogrb.2017.02.030 - Viera AJ. (2003). Management of carpal tunnel syndrome.
aafp.org/afp/2003/0715/p265.html - Wright C, et al. (2014). Who develops carpal tunnel syndrome during pregnancy: An analysis of obesity, gestational weight gain, and parity. DOI:
10.1177/1753495X14523407
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Current Version
Jun 4, 2018
Written By
Donna Christiano
Medically Reviewed By
Holly Ernst, PA-C
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Medically reviewed by Holly Ernst, PA-C — By Donna Christiano on June 4, 2018
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Tips to Deal with Pregnancy Carpal Tunnel Syndrome
The carpal tunnel is quite literally a tunnel — a packed fibro-osseous tunnel — located on the palm side of the wrist. Normal pressures in this tunnel are 20-30 mmHg. The median nerve, which runs down the length of your arm, passes through the carpal tunnel to your palm side. The median nerve is responsible for controlling sensation and movement in the thumb and first three fingers.
When the median nerve becomes chronically compressed, this first will result in demyelination and eventually in axonal death, which will lead to tingling, numbness, and pain in the thumb, index, middle, and ring fingers. This is carpal tunnel syndrome.
Carpal tunnel syndrome occurs when there is swelling or a buildup of fluid in the wrist. It is often associated with professions that require repetitive movement of the wrist, or strong grips, such as computer workers, mechanics, assembly line workers, musicians, painters, and gardeners.
Since swelling and water retention are incredibly common during pregnancy, so are conditions like carpal tunnel syndrome, may occur as a result of swelling.
Not sure whether the symptoms you’re experiencing are due to CTS? These are the most common signs and symptoms of CTS, experienced in most cases from week 30 and on of pregnancy.
- Tingling or numbness in part of the hand (thumb, index, middle, and ring fingers)
- Throbbing or burning sensation in the hands, wrists, and fingers
- Stiffness or cramping of hands, especially in the morning
- Thumb weakness
- Trouble gripping objects or performing tasks such as opening jars or buttoning a shirt.
CTS is usually worse in your dominant hand, and in more than half of pregnancy carpal tunnel syndrome cases, it occurs in both hands.
Some women are more likely to develop CTS during pregnancy than others. They include:
- Women who were overweight or obese before pregnancy
- Women carrying multiples
- Women with gestational diabetes or gestational hypertension
- Women who have experienced CTS in past pregnancies.
While carpal tunnel syndrome may cause a lot of discomfort, it is usually not a serious condition. In most cases, it resolves within 3 months after birth once swelling has subsided and hormone levels have returned to normal.
Between carpal tunnel syndrome and pregnancy in general, it can be difficult to get a good night's sleep. Normal daily tasks will suddenly seem impossible to accomplish due to the exhaustion, discomfort, and pain you’re experiencing.
We’re right there with you, mama-to-be! Here are a few things you can do that are safe during pregnancy for carpal tunnel relief.
Reduce your sodium intake
If you’re looking to reduce swelling in the body, the first place to start is by reducing your intake of salt.
Sodium is quickly absorbed by cells, and it draws water in with it, causing water retention.
Cut down on the amount of salt you eat and increase your water intake and you’ll probably see a big difference quickly.
Wear a splint while you sleep and during the day if possible
While you sleep, you may not notice how your hands fold, flop, or get twisted into awkward positions until you wake up in pain. A splint will help to keep your hand in a neutral position so that you don’t end up putting pressure on your carpal tunnel.
Avoid repetitive motions
Find new ways to perform daily tasks that require repetitive motions by using your forearms or body weight to put power behind a movement, instead of using just your wrist. If your job requires a lot of typing, consider dictating instead.
Practice good posture
Your changing body can cause you to unknowingly sit, stand, and move in unnatural and awkward ways. Make sure that your neck and shoulders are not curved, causing added pressure on the median nerve.
These tried and true CTS treatments can help to ward away and keep away symptoms of pregnancy carpel tunnel.
- Massage
You can perform massage on yourself, have your partner help you, or visit a professional massage therapist for pregnancy carpal tunnel relief.
Start from the inner fold of your elbow and work your way down toward your wrist. Use your thumb and apply firm pressure, moving in a circular motion all around your wrist, then work your way back up your arm again.
- Exercise and stretching
Stretches are a great way to relieve CTS pain. Do them once an hour, especially if you have a profession that requires you to do repetitive motions or sustained positions with your hands.
Warm up. Make a firm fist with your hand, then stretch out your fingers as far apart as you can. Hold for 5 seconds and repeat 4 times.
Prayer stretch. Start with your palms together right in front of your chest.
Lower your hands, keeping them together until you begin to feel a stretch. Hold the position for 20 seconds and repeat 3 times.
Traffic stop stretch. Hold your arm straight out in front of you with your palm facing out as if you were stopping traffic. Using your other hand, pull back on your fingers as if trying to bend them back toward your forearm. Hold for 15 seconds and repeat 3 times.
- Physical therapy
If your CTS is affecting your daily functioning, it may be time to seek help from a doctor or physical therapist. A physical therapist will assess you, show you stretches and exercises to do, and will make sure that you’re doing them right.
Conservative treatment can include corticosteroid injection of the carpal syndrome. Surgical release of the carpal tunnel is a widely accepted treatment, particularly for fixed sensory loss, thenar weakness, or intolerable symptoms with no improvement after splinting and /or glucocorticoids.
- Pain relievers
Avoid ibuprofen, as it has been linked to severe pregnancy complications.
If you have any concerns or questions about what medications are safe to take during pregnancy, consult your doctor.
Carpal tunnel syndrome and breastfeeding
Breastfeeding is way more physically demanding than it looks. Most breastfeeding moms experience neck, shoulder, and back pain, and with carpal tunnel syndrome, it can get even worse.
Instead of holding your baby with your hands, experiment with different positions and prop your baby up using nursing pillows, couch pillows, and blankets and pillows to support yourself as well.
Try switching up how you position and hold your baby each time you breastfeed to avoid repeated and sustained postures that could put pressure on your wrist. Try nursing lying down with baby facing you.
If you’re really struggling, make an appointment with a lactation consultant. She can help you find positions that work for both you and your baby.
Takeaways
Carpal tunnel syndrome can be anything from mildly annoying to severely painful.
To keep swelling down during pregnancy, eat a healthy diet with plenty of fruits and vegetables, whole grains, fatty fish, and low-fat dairy products. Avoid eating too much sodium, which can increase swelling and inflammation. Regular exercise and stretching are excellent ways to keep chronic pain and discomfort at bay.
If you are experiencing severe pain, visit your doctor as soon as possible.
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.
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 syndrome - treatment, symptoms, causes, diagnosis
Karpal - this word comes from the Greek Karpos, which means "wrist". The wrist is surrounded by bundles of fibrous tissue, which normally performs a supporting function for the joint. The confined space between these fibrous bands of fibrous tissue and the bony structures of the wrist is called the carpal tunnel.
The median nerve, which runs through the wrist, provides sensation to the thumb, index, and middle fingers. Any condition that causes swelling or repositioning of tissues in the wrist can compress and irritate the median nerve. Irritation of the median nerve, in such cases, results in tingling and numbness of the thumb, index, and middle fingers, a condition known as "carpal tunnel syndrome."
Causes of Carpal Tunnel Syndrome
Given the limited space of the carpal tunnel, any swelling in this area can put pressure on the median nerve, causing the symptoms of carpal tunnel syndrome. There are many different causes leading to the development of this syndrome, but often the exact cause cannot be determined. Some people initially have an anatomically narrower carpal tunnel, which makes them more at risk of developing carpal tunnel syndrome. It is believed that this tendency can be genetically determined, and if there are cases of this syndrome in the family, then the likelihood of pressure on the median nerve increases significantly.
You are also more likely to develop carpal tunnel syndrome if you are overweight, smoke, or drink too much alcohol. The same risk factor is age - the older the person, the higher the likelihood of developing carpal tunnel syndrome. Women are more prone to this syndrome than men due to the narrower carpal tunnel. There is also a greater tendency to develop carpal tunnel syndrome if there was a wrist injury (rupture or sprain) or there are diseases such as:
- diabetes mellitus
- osteoarthritis
- rheumatoid arthritis
- hypothyroidism
It is possible that hormones play a role in the development of carpal tunnel syndrome, as some women develop the syndrome during pregnancy or menopause. Hormones produced during pregnancy can lead to fluid retention, which in turn can cause swelling in the wrist. It is noted that the performance of certain activities can lead to the development of this syndrome. People who do a lot of heavy manual work or repetitive wrist movements, such as on an assembly line or working with their hands in cold temperatures, are also at greater risk of developing carpal tunnel syndrome.
But the probability increases significantly if the load is combined with the presence of systemic diseases.
Symptoms of carpal tunnel syndrome
Patients with carpal tunnel syndrome initially feel numbness and tingling in the hand along the median nerve innervation (thumb, index, middle, and part of the fourth fingers). These sensations are often more pronounced at night and may even lead to awakening from sleep. The reason for the worsening of symptoms at night may be due to the flexed position of the wrist during sleep and / or the accumulation of fluid around the wrist and hand while it is in a horizontal position. Carpal tunnel syndrome may be a temporary condition that resolves completely on its own, or symptoms may persist and progress.
As the syndrome progresses, patients may develop a burning sensation and/or spasms and hand weakness. Decreased grip strength can cause objects to fall out of the hand frequently. Sometimes sharp shooting pains can also be felt in the forearm.
Chronic carpal tunnel syndrome can also lead to muscle atrophy in the hand, especially the muscles at the base of the thumb on the palmar surface.
Diagnosis
Carpal tunnel syndrome can be diagnosed based on the symptoms and characteristic areas of numbness in the hand. But at the same time, it is often necessary to exclude other possible causes of symptoms that mimic carpal tunnel syndrome. It could be neck, shoulder or elbow problems. The doctor examines the wrist to detect swelling, local temperature increase, tenderness, and discoloration. Sometimes pressing on the front of the wrist can produce a tingling sensation in the hand and is called the Tinel sign, which is characteristic of carpal tunnel syndrome. Symptoms can also be reproduced from time to time with forward flexion of the wrist (called the Phalen symptom). The final diagnosis can be made with ENMG. As a rule, with carpal tunnel syndrome, there is a slowdown in the conduction of a nerve impulse after the nerve passes through the wrist.
Testing of limb muscles, an electromyogram, is sometimes done to rule out or detect other conditions that may mimic carpal tunnel syndrome.
Laboratory tests may be performed in order to diagnose conditions associated with carpal tunnel. These tests include thyroid hormone testing, complete blood counts, blood sugar levels, etc. An x-ray of the hand may also be ordered to check for bony changes (abnormalities in the bones and joints of the wrist). MRI is necessary in cases where it is necessary to visualize changes in ligaments, cartilage.
Treatments for carpal tunnel syndrome
The choice of treatment for carpal tunnel syndrome depends on the severity of the symptoms and the underlying disease that may be causing the symptoms.
In the first stage, treatment usually includes rest, immobilization of the wrist in a brace, and sometimes local cold. If the patient's profession is associated with a load on the wrist, then it is necessary to change activities for a while.
In addition, it is possible to improve the ergonomics of the workplace, for example, you can adjust the computer keyboard and chair height and optimize the load on the hands. These measures, along with occasional periods of rest and wrist stretching, can actually prevent the symptoms of carpal tunnel syndrome, which are caused by repetitive excessive motion of the wrist, from developing. If there are systemic diseases or injuries, then individual treatment of these diseases is carried out. In case of fractures, orthopedic correction (gypsum, orthosis) may be required. Overweight patients should be advised to reduce weight. In rheumatoid arthritis, specific treatment of the inflammatory autoimmune process is carried out. Swelling of the wrist, which may be associated with pregnancy, disappears after the birth of the child.
Medications
Several types of medications can be used to treat carpal tunnel syndrome. Vitamin B6 (pyridoxine) is often prescribed in the treatment of carpal tunnel syndrome, and although the mechanism of therapeutic action is not entirely clear, nevertheless, many doctors note a certain effect of using this drug.
Non-steroidal anti-inflammatory drugs may also be helpful in reducing inflammation and reducing pain. But these drugs have side effects and therefore it is necessary to take this into account when prescribing them. Corticosteroids may also be used. They can be given orally or by injection into the affected wrist joint. Corticosteroids can lead to a rapid improvement in symptoms, but the side effects of these drugs prevent their use for a long time and in the presence of certain conditions (for example, in diabetes mellitus, their use may lead to a worsening of the condition). They should also not be used in the presence of infections. In addition to drug treatment, physiotherapy and acupuncture also provide a certain therapeutic effect. Most patients with carpal tunnel syndrome can be treated with conservative therapy. But sometimes chronic pressure on the median nerve can lead to permanent numbness and weakness. In order to avoid serious and permanent nerve and muscle damage, surgical treatment may be recommended in such cases.
