The carpal tunnel is a passageway containing nine tendons and one nerve (the median nerve) that runs through the base of the hand. In the case of carpal tunnel syndrome during pregnancy, the carpal tunnel swells and presses against this sensitive nerve, causing pain. Systemic illnesses, such as arthritis or trauma, and physical activities, such as repetitive hand movements, are common risk factors. Pregnancy also increases the possibility of developing carpal tunnel syndrome, which has an incidence rate of 62% in pregnancy. A report suggests that three to five in ten pregnant women experience the symptoms of carpal tunnel syndrome (1) (2). Read this post to learn about the symptoms, causes, diagnosis, and treatment of carpal tunnel syndrome during pregnancy.
What Causes Carpal Tunnel Syndrome In Pregnancy?
The pregnancy-related causes of swelling in the wrists or carpal tunnel syndrome include
Hormonal changes: Hormonal fluctuations during pregnancy can cause fluid retention in the body, resulting in swelling and compression of the wrist nerves and pain (1).
Increased blood flow: Your blood volume increases by up to 50% during pregnancy. This additional fluid increases pressure and swelling in the blood vessels throughout your body, including the carpal tunnel of the wrist, causing nerve compression and pain (3).
When Does Carpal Tunnel Syndrome In Pregnancy Start?
Carpal tunnel syndrome is most commonly noted in the third trimester or after 30 weeks but can occur at any time during the pregnancy or even after birth. The symptoms usually improve or disappear after childbirth as the additional fluid pressure and retention reduce (1). However, some experience persistent symptoms for a year or more after delivery (4) (5). It could be because new mothers use their hands and wrists almost continuously, resulting in exacerbated or new hand and wrist symptoms (3).
What Are The Symptoms Of Carpal Tunnel Syndrome In Pregnancy?
The severity of carpal tunnel syndrome symptoms ranges from minor discomfort and occasional ache to severe pain. You may experience (6) (7)
Numb hands Tingling pain such as pins and needles Pain in one or both wrists that may worsen at night Weakness such as loss of grip strength and dexterity (2) Pain in the fingers, thumb, and hand Burning sensations in the fingers Pain radiating into the arm and shoulder
These signs and symptoms may disrupt your daily activities and sleep and may worsen with (1) (2):
Repeated hand movements Extended periods of maintaining the same hand positions Forceful activities such as putting weight on stretched arms Extreme wrist positions Flexed or bent wrists while sleeping
Are Some Pregnant Women At An Increased Risk?
You may be at an increased risk of developing carpal tunnel syndrome in the following cases (4):
A first-degree relative has the condition Previous wrist injuries Pre-existing or gestational diabetes, causing slower nerve conduction (5) Carpal tunnel syndrome in a previous pregnancy
When Should You Call A Doctor?
Since swelling is a normal part of pregnancy, you may not notice it. However, you should consult your doctor in the following cases (1)
Your hands or feet are more swollen than usual Severe or persistent wrist pain Your pain has worsened Persistent symptoms even after six weeks of delivery
How Is Carpal Tunnel Syndrome Diagnosed During Pregnancy?
Your healthcare provider may diagnose carpal tunnel syndrome based on your medical history and symptoms. However, it is often a misdiagnosed condition. Therefore, if you have significant symptoms, your doctor may recommend the following tests to confirm the diagnosis and examine your nerve functioning: (3) (8):
Conventional tests: Tinel, Phalen, and median nerve compression tests (9)
Nerve conduction velocity test: An electrodiagnostic study where the doctor places small electrode stickers on the affected hand and arm and uses low-level electrical stimulation to measure nerve activity
Electromyography (EMG): An electrodiagnostic procedure where the doctor uses a small needle to examine muscle activity in various areas of the affected arm and hand
While these tests may be uncomfortable, they do not cause adverse perinatal outcomes and lasting pain.
How To Manage Carpal Tunnel Syndrome During Pregnancy?
The treatment of carpal tunnel syndrome can be determined by various factors, including the symptoms’ severity and your pregnancy stage. However, it is advisable to begin with conservative therapy during pregnancy. The following are some simple measures that may help alleviate the symptoms of carpal tunnel syndrome (7):
Avoid positions or activities that aggravate your symptoms Sit with the affected hand raised on the armrest Avoid sleeping on the side of your affected hand Maintain a straight wrist position Avoid complete flexion and extension positions Apply ice to your wrist (covered in a tea towel) for 20–30 minutes every 2–3 hours Run cold water over the wrist Wear a compression bandage Avoid smoking
Depending on the severity of your symptoms, your doctor may suggest the following treatment options:
Medications, such as topical numbing agents and pain relief corticosteroid injections (usually a combination of steroids and a local anesthetic), for symptomatic relief (3)
Physiotherapy and occupational therapy, including regular fluid drainage massage, gentle exercises, and the use of a wrist splint, particularly at night, to keep your wrist in a neutral position (1)
Open or endoscopic surgery in severe cases to enlarge the carpal tunnel. It frequently helps with pain and function. However, if the surgical treatment isn’t urgent, delay it until delivery (3).
What Are The Alternative Therapies For Carpal Tunnel Syndrome During Pregnancy?
Complementary and alternative medicine (CAM) or therapy is useful for relieving carpal tunnel syndrome symptoms. However, seek the advice of a qualified and registered complementary therapist who is skilled in treating pregnant women. Some CAM methods that are safe during pregnancy are listed below (4):
Acupuncture and acupressure: Carpal tunnel syndrome can be relieved by applying pressure to a specific point on the wrist, pericardium point six, at regular intervals. According to some studies, it is more effective than using wrist splints.
Aromatherapy: It includes using compresses soaked in warm or cool water with essential oils, such as cypress and lemon. However, not all essential oils are safe for use in pregnancy. For example, juniper berry oil may affect your kidney(s).
Osteopathy: It is a part of chiropractic care that focuses on realigning the muscles, bones, joints, and ligaments. While it may not treat carpal tunnel syndrome, it can help relieve pressure in your wrists, hands, and fingers.
Reflexology: It involves applying pressure to certain points on your foot to relieve wrist pain. While there is no conclusive evidence that reflexology helps with carpal tunnel syndrome, it can be a calming treatment.
Can Carpal Tunnel Syndrome Be Prevented During Pregnancy?
While carpal tunnel syndrome cannot be easily avoided during pregnancy, minimizing wrist swelling will likely provide symptomatic relief. You can reduce or prevent swelling during pregnancy by (4) (7)
Reducing your salt, sugar, and fat intake Taking frequent breaks while doing repetitive activities Avoiding heavyweights Avoiding hanging your arm by your side for a prolonged time Keeping your shoulder, elbow, and hands in motion to prevent arm stiffness Lying down to rest during the day Drinking plenty of water Elevating your legs while sitting Wearing compression garments and a supportive maternity bra to relieve the pressure on your rib cage and breastbone Maintaining a healthy weight and eating a well-balanced diet Eating at least five servings of fresh fruit and vegetables a day Staying warm (10)
Will Carpal Tunnel Syndrome During Pregnancy Affect The Baby Or Mother?
No. While carpal tunnel syndrome during pregnancy may affect your daily activities and the wrist pain and swelling may be uncomfortable, it does not otherwise affect the mother and baby. Carpal tunnel syndrome in pregnancy is quite common due to hormonal changes and increased blood flow. It mostly occurs during the third trimester and resolves after delivery. Simple measures such as applying ice packs, improving wrist positions, and avoiding repetitive hand movements can help alleviate pain. However, if your symptoms increase or are persistent, consult your doctor.
