THIS IS PART OF THE ULTIMATE GUIDE TO HAND, WRIST AND ELBOW INJURIES
A medical side effect and risk factor during the second and third trimester of pregnancy can be carpal tunnel syndrome. Carpal tunnel is what happens when the median nerve to the hand is constricted as it goes through the wrist, which can cause nerve compression, leading to symptoms. The median nerve controls the finger’s feeling and muscles at the base of the thumb.
Symptoms of carpal tunnel include:
- Numbness, pain or tingling in the thumb, index, middle and ring fingers.
- A shock sensation to the thumb, index, middle and ring fingers.
- Weakness of the hand.
- Tingling or pain from the forearm to the shoulder.
Many people sleep with their wrists bent, which worsens symptoms and causes carpal tunnel to interfere with sleep.
What causes carpal tunnel during pregnancy?
It is more common for women who retain fluid during gestation to experience carpal tunnel. Swelling caused by hormonal changes are also thought to cause carpal tunnel during pregnancy.
There are some factors that put pregnant women at an increased risk, which includes:
- Experiencing diabetes or hypertension related to pregnancy. These conditions cause more swelling and inflammation.
- Previous pregnancies. Certain hormones have higher levels in sequential pregnancies.
- Weight before pregnancy. This isn’t a known cause, but carpal tunnel occurs more in women who are overweight before pregnancy or who gain excess weight during pregnancy.
Carpal tunnel syndrome can be diagnosed by your doctor in several ways:
- Tinel’s sign. Your doctor will examine the affected nerve for tingling sensations, which implies nerve compression. Your doctor may perform other physical tests to verify the diagnosis. This examination should always come before testing because that may be all that is needed.
- An electrodiagnosis test can verify the diagnosis. Electrodes on the skin examine the signals of nerves, which can be altered by a compressed median nerve.
- Ultrasounds show bones and tissue. They can also show signs that the median nerve is being compressed.
- Magnetic resonance imaging scans (MRI) show soft tissues. They can rule out other causes and can determine if there is a problem with the nerve on its own. An MRI without contrast is generally safe for pregnant women and their fetus.
Before getting any imaging done, ensure your doctor is aware you are pregnant.
Does pregnancy carpal tunnel go away?
Carpal tunnel will usually alleviate after pregnancy. Most experience relief within six weeks after pregnancy and others find relief four to 12 months after pregnancy. By 12 months postpartum, 85 percent of women no longer have symptoms of carpal tunnel. Therefore, non-surgical options are preferred unless symptoms continue for a prolonged period after giving birth.
Management of carpal tunnel syndrome in pregnancy
The best treatments for carpal tunnel during pregnancy include:
- Using a splint. This prevents bending of the wrist.
- Avoiding activities that bend your wrist.
- Resting your wrist when you experience symptoms.
- Icing your wrist to decrease swelling.
- Contrast baths. Alternate soaking your wrist in cold water for a minute to soaking in warm water for a minute. Continue for about five minutes.
- Elevating the wrist when possible.
- Physical therapy, particularly myofascial release therapy, can help. This is a massage to relieve tightness.
- Pain relievers. Acetaminophen is the safest during pregnancy.
- Cortisone shot. If symptoms are severe, your doctor may recommend a cortisone shot, which is safe during pregnancy.
Learn more about hand, wrist and arm treatment at OrthoIndy.
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