Carpal Tunnel Syndrome.

Carpal Tunnel Syndrome is a disorder of the wrist and hand which can occur in pregnancy, causing pain, tingling and numbness, commonly in the thumb, index and middle fingers. Some women only develop symptoms postpartum, however, and it can occur in other people as well.

While symptoms are most common in the fingers, you may also have pain further up the wrist and forearm, and some describe sensations including burning pain or a cold ache. Many pregnant women find their carpal tunnel symptoms are worse at night.

What causes Carpal Tunnel Syndrome?

The Carpal tunnel is a narrow channel in the wrist bordered by the wrist (or carpal) bones at the bottom, and a ligament called the Transverse Carpal ligament over the top. The flexor tendons, which allow you to bend your fingers and wrist, and the median nerve pass through this tunnel as they travel to the hand and fingers. Usually there is enough space in the carpal tunnel for all these structures to move without restriction.

During pregnancy, a combination of the extra blood volume circulating in your body, and the effects of certain hormones, like progesterone, relaxing the blood vessel walls, can cause fluid to “leak” into the soft tissues of the body. The fluid tends to accumulate more in the peripheries (the hands and feet). Swelling in the wrist area can compress the median nerve in the carpal tunnel, producing pain, tingling and numbness.

Treatment for Carpal Tunnel Syndrome

Treatment for Carpal Tunnel Syndrome in pregnancy mainly involves trying to limit the symptoms for the duration of the pregnancy.

Wearing wrist splints at night can help to hold the wrist in a more neutral (rather than flexed position) and elevating the affected hand can help to ease night time symptoms.

Ice baths (ice cubes in a bucket of cold water) can work well for managing morning swelling and soreness, or if you have daytime symptoms.

Learn how to do your daily tasks with less strain on the wrists and hands. Avoid or limit awkward or repetitive hand and wrist activities – you may need to break up your work tasks with alternate activities.

Gentle hand stretches can also be helpful to keep the flexor tendons mobile and prevent further stiffness and soreness. In the series below, the hand is taken back to the “rest” position at step 1 between each different movement, and the movements can be repeated 10 times each, 3-4 times daily.

Massage and stretches for tight muscles further up the forearm can also be useful.

If symptoms persist postpartum, you may be able to try anti-inflammatory medication, which you were unable to use in pregnancy.

Advice

It is best to consult a Physiotherapist or your GP with any bothersome or persistent symptoms of Carpal Tunnel Syndrome. You may have similar symptoms from other causes, including neck problems or entrapment of other nerves at the elbow or forearm.

Try not to delay treatment, as it is easier to resolve symptoms if treated early, rather than wait until they have become more persistent and painful.

You may be able to make some simple adjustments to the way you do daily tasks or your sleeping position to ease symptoms. A physiotherapist can help you with this.

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