When we consider the aches and pains of pregnancy, we usually think about an aching back or swollen ankles. However, many women experience pain in an unexpected place: their wrists.
Prevalence
The National Institute of Neurological Disorders and Strokes defines carpal tunnel syndrome as “a common neurological disorder that occurs when the median nerve, which runs from your forearm into the palm of the hand, becomes pressed or squeezed at the wrist.” According to the University of Texas Southwestern Medical Center, only approximately 4% of the general adult population have carpal tunnel syndrome. This percentage skyrockets when assessed among pregnant women. A study by Ablove and Ablove (2009) reports that up to 62% of pregnant women have carpal tunnel syndrome, also known as CTS.
What Causes Carpel Tunnel Syndrome?
The University of Texas Southwestern Medical Center states that during pregnancy, a woman’s blood volume doubles. This extra fluid can cause swelling. Narrow spaces like the wrist can be impacted by this as it can compress the nerves that run through it.
Another contributing factor during pregnancy is the hormone relaxin. The Cleveland Clinic describes relaxin as “a reproductive hormone produced by your ovaries and the placenta. It loosens and relaxes your muscles, joints and ligaments during pregnancy to help your body stretch. Relaxin can cause inflammation in the transverse carpal ligament in the wrist, which can put pressure on the nerve, according to Medical News Today.
Pregnant women are most likely to develop symptoms after 30 weeks gestation, or nearing the end of the pregnancy, when weight gain, extra fluids and hormone levels peak.
What are the Symptoms?
Ablove and Ablove state that the most common symptoms are numbness and tingling in the fingers, primarily the thumb through middle finger. Painful or burning sensations in the wrist can be common, and some people may experience a weakened grip or reduced dexterity in the affected hand. Symptoms can worsen at night and may also intensify with certain hand positions or forceful activities, like typing, texting or using power tools.
Diagnosis
Most clinicians can make a diagnosis based on symptoms and a physical exam of the hand and wrist. According to Medical News Today, they may assess pain tolerance, flexibility, sensory testing and grip strength. Healthcare providers may also order electromyography to assess the extent of nerve damage and help drive treatment.
Treatment Options For Carpel Tunnel Syndrome
Conservative treatment options are the best place to start, particularly during pregnancy. Many providers will first suggest a splint to immobilize the wrist and limit the range of motion to allow the wrist to heal.
To help minimize discomfort, it is recommended to try home remedies such as ice, maintaining good hand and arm positioning, elevating hands to reduce swelling, limiting activities that cause pain and taking frequent breaks in repetitive tasks.
Your provider may also order physical or occupational therapy to improve circulation and range of motion, as well as building hand strength and easing nerve discomfort. Oral medications and topical numbing agents can also help reduce pain and swelling. In severe cases, providers may order cortisone injections.
Symptoms often resolve within a year after delivery as fluid and hormone levels resume baseline status. The tasks of early motherhood involve frequent diaper changing, bottle feeding and baby holding, which may initially aggravate symptoms. Pay attention to activities that irritate the hand and wrist and limit as much as possible.
If you are experiencing pain, numbness or tingling in your wrist, hands or fingers, talk to your provider about your symptoms. They will help create a treatment plan that is most appropriate for your individual situation.