Pregnancy can be uncomfortable at times. You may be dealing with morning sickness, heartburn, or swollen ankles. But, what about pain, numbness, and tingling in your hands and wrists? If you have these symptoms, it could be carpal tunnel syndrome (CTS).
CTS is a common discomfort of pregnancy that you don’t often hear about. Here’s what you need to know about the causes, symptoms, and treatment of carpal tunnel in pregnancy.
What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a condition that affects a nerve in your wrist called the median nerve. Nerves send signals from your brain to your body and your body to your brain. They are responsible for body movements and the ability to touch and feel sensations. The median nerve goes down your arm to your hand. It passes the wrist through a narrow area called the carpal tunnel. The carpal tunnel is made up of a ligament and a group of small hand bones called carpal bones. If anything squeezes or puts pressure on the median nerve as it passes through this tight space, it can cause the symptoms of carpal tunnel syndrome.
Carpal Tunnel in Pregnancy
Carpal tunnel syndrome may be annoying or even a little painful, but it isn’t considered a serious medical condition during pregnancy. It is more likely to show up toward the end of pregnancy in first time moms who are over 30 years old, and if you have it in one pregnancy, there is a greater chance it will come back again in the next pregnancy.
Up to 60 percent of women experience symptoms of carpal tunnel during pregnancy. Most of the time it’s mild and tolerable. However, for approximately 10 percent of pregnant women, it can be painful and interfere with sleep and daily life.
During pregnancy, the body goes through a lot of physical and hormonal changes that can lead to swelling in the body. When extra fluid causes swelling in the wrist, it puts pressure on the median nerve and causes the symptoms of carpal tunnel. Some of the pregnancy-related causes of CTS are:
- Excessive weight gain
- Water retention (edema)
- Pregnant with more than one baby
- Gestational diabetes
Carpal tunnel can also develop during pregnancy from issues that are not related to the pregnancy. These include rheumatoid arthritis, an injury to the wrist, or repetitive hand movements such as typing on a keyboard.
The symptoms of carpal tunnel can show up anytime but are more common during the second or third trimester. You can get CTS in both hands, but your dominant hand may show more symptoms since you use it more. The symptoms of carpal tunnel are:
- Pins and needles in your fingers and hand
- Feeling like your hand is falling asleep
- Numbness in the part of your hand near your thumb
- Numbness in your thumb, index, and middle fingers
- Clumsiness with your hands and dropping things
- Weakness when trying to grab objects
- Pain in the hand, wrist, and forearm
- There may also be pain in the elbow, arm, shoulder, and neck
- A burning sensation in your hand and arm
- A feeling of swelling in the fingers and wrist
Carpal Tunnel at Night
Carpal tunnel can cause wrist pain at night and wake you up. While you’re sleeping, your wrists can bend up or down and press on the nerve. If you shake your hands when you wake up, it usually feels better. Wrist splints can also help, as they keep your wrists straight while you’re sleeping and relieve pressure on the nerve.
If you are experiencing symptoms of carpal tunnel, you should talk to your doctor. The doctor will listen to your symptoms and examine your hands and wrists to check for swelling and pain. The doctor can perform some simple tests to check how well you can feel and if there is any weakness in the muscles of your palm or fingers. These tests are:
- Durkan’s Compression Test: The doctor will press on the median nerve with her thumbs to check for pain or tingling.
- Tinel’s Test: The doctor will lightly tap the nerve to see if you feel tingling in your fingers.
- Phalen’s Test: The doctor will have you hold your forearm up with a bent elbow and allow your wrist to flex naturally down by gravity, or you will have both your wrists flexed down with the backs of your hands touching and pressing against each other to see if you feel burning, tingling, or numbness.
Doctors use other tests to diagnose CTS, but you are not likely to have them while you’re pregnant. However, if your symptoms do not go away after the birth of your child, you may have the following:
- A nerve conduction test or electromyography (EMG)
- Magnetic Resonance Imaging (MRI)
Treatment During Pregnancy
The treatment of carpal tunnel during pregnancy will depend on how CTS is affecting your daily life and how much you can tolerate it. In mild cases, your doctor may provide you with information and treatment options to relieve your symptoms. Severe cases are not common, but when they do arise, your doctor may refer you to a neurologist who specializes in nerves or an orthopedic doctor who specializes in bones and muscles.
While you’re pregnant, you should do what you can to manage and tolerate the symptoms of CTS. If you can get through the rest of your pregnancy, it should get much better after the delivery of your child. Your doctor may recommend that you try:
- Alternating hot and cold to the area
- Avoiding repetitive hand movements as much as possible since repetitive actions contribute to the pain
- A keyboard hand rest to support your wrists when you’re typing or working on your computer
- Taking breaks often especially if you have a job that requires you to type, write, or use equipment that vibrates
- Elevating your arms to help the fluid drain from the area
- Massaging the area
- Using gentle finger and hand strengthening exercises
- Wearing braces called wrist splints to keep the wrists in a neutral position especially at night
- Taking Tylenol (acetaminophen) or a pain relief medication that is safe to use during pregnancy
- Trying acupuncture or yoga
- Physical therapy
If the symptoms are severe, steroid medication injected with a needle directly into the carpal tunnel area may help to relieve pain and swelling.
Treatment After Childbirth
Once your baby is born, the symptoms of CTS may gradually get better on their own as fluid and hormone levels return to normal. Time is often the best treatment for the symptoms of pregnancy-related carpal tunnel syndrome. Continue to talk about it with your doctor at your follow-up appointments. If your symptoms do not improve in the weeks and months after childbirth, your doctor may recommend:
- Anti-inflammatory medications to reduce pain and swelling. While you’re pregnant, you should not take over-the-counter pain medications such as Motrin and Advil (Ibuprofen) unless they are prescribed by your doctor. But, you can talk to your doctor about using them after delivery.
- Diuretics (water pills) to help remove excess fluid from the body through urination
- Continuing physical or occupational therapy as needed
- Steroid injections
- Surgery is rarely needed but is available if necessary.
CTS and Breastfeeding
The symptoms of carpal tunnel tend to go away after delivery, but they may continue with breastfeeding. Some women don’t suffer from CTS during pregnancy, only to have the symptoms start a few weeks after childbirth while they’re breastfeeding. The treatment of carpal tunnel during breastfeeding involves being aware of your hand position as you hold and breastfeed your baby, wearing hand splints, resting as much as possible, taking water pills to release fluid from the body, and getting steroid injections if necessary. Breastfeeding related carpal tunnel usually resolves once the baby weans.