Swelling, tingling, and pain in the hands are common during pregnancy, particularly in the last trimester. These issues are generally caused by carpal tunnel syndrome, and they usually disappear after pregnancy. Carpal tunnel syndrome occurs in 31 to 62 percent of pregnant females; however, 4 percent of the general population approximates a 2015 research study. Professionals aren’t sure what makes CTS so familiar during pregnancy; however, they believe hormone-related swelling might be the culprit.
What actually happens?
During pregnancy, your blood volume increases. The extra fluid puts pressure and causes swelling in your blood vessels throughout your body. Swelling can compress the median nerve, which runs from the wrist to the hand, in narrow spaces or spaces like the carpal tunnel, through which nine tendons and one nerve pass. The median nerve controls some of your thumb movements and supplies sensation to most of the thumb and the index finger, middle finger, and part of your ring finger. The great news is that pregnancy-safe treatment is now available, and your symptoms usually go away after the child’s birth.
Symptoms of carpal tunnel syndrome
Common symptoms of CTS during pregnancy include:
- Numbness and tingling sensation in fingers, wrists, and hands, which could get worse at night.
- Pain in the hand and wrist.
- Swollen fingers
- Trouble with holding or gripping objects and fine motor abilities, such as buttoning a shirt or working a necklace’s clasp.
In most severe cases, grip, strength, or finger dexterity decreases. As a result, picking up small objects with your fingertips, opening jars, and buttoning your clothes may be challenging for you.
Gestational diabetes or hypertension: both of the conditions cause fluid retention and subsequent swelling. This, subsequently, can increase the risk of CTS. In addition, if you have a high blood sugar level, know that this can also trigger carpal tunnel.
Being overweight before becoming pregnant: Obese or overweight pregnant women, on the other hand, are more likely to be diagnosed with the condition than pregnant women who aren’t overweight or obese.
The doctor diagnoses the condition by talking with you about your symptoms and medical history. If your symptoms are severe and persist, your medico may suggest an electrodiagnostic study (EMG) to diagnose the condition and measure nerve function in your wrist, arm, and hand. An EMG professional can appraise your medico whether you have nerve damage, how serious it is, and whether it may be reversible with intervention or not.
The medical professional will attach small size electrode stickers to your hand and arm in different locations and use a low level of electrical stimulation to assess the nerve activity. Your doctor might put a fin acupuncture-like needle in your arm and hand areas to check electrical muscular activity.
According to the majority of doctors, carpal tunnel syndrome should be treated conservatively in pregnancy. This is because many patients will feel better in the weeks and months just after their delivery.
Use a splint
The first-line treatment is immobilization. Your doctor immobilizes the affected wrist in a neutral position to minimize the wrist’s range of flexion or extension. The doctor then suggests wearing a neutral wrist splint with a metal bar inside to keep the wrist from moving up, down, or side to side.
Splinting relieves pressure on the median nerve and reduces swelling, allowing the nerve damage to recover. Nonetheless, wearing a splint all day and going about your daily activities is difficult. So, your doctor may advise you to wear it while sleeping and as much as possible during the day. Occupational therapy is a type of therapy that focuses on hands and wrists. It can often help you feel better and avoid further nerve damage. An occupational therapist from PM & R can create a customized plan for you. Treatment usually includes wrist range of motion and strengthening motions, massage, and nerve gliding methods.
Occupational therapy is a type of therapy that focuses on hands and wrists. It can often help you feel better and avoid further nerve damage. An occupational therapist from PM & R can create a customized plan for you. Treatment usually includes wrist range of motion and strengthening motions, massage, and nerve gliding methods. The therapist can also advise desensitization.
If you feel tired or pain in your wrist, take a rest for a while, or you can switch to a different activity. However, activities that cause your wrist to bend, such as typing on a keyboard, should be avoided. Elevate your hand instead. You can use a pillow for that.
Because acetaminophen (Tylenol) is considered safe during pregnancy, you can take it anytime, but don’t take more than 3,000 mg per day. Likewise, ibuprofen should be avoided because it has been associated with low amniotic fluid and various other problems.
A topical numbing agent can alleviate your symptoms. These ointments, on the other hand, will not resolve the root of the problem. Furthermore, doctors will usually avoid prescribing steroids during pregnancy to avoid side effects.
Surgery, in severe cases
Carpal tunnel release surgical treatment is reserved for severe cases. A cosmetic surgeon will cut the ligament that presses on the carpal tunnel in this treatment, making more space for the median nerve and tendons. This generally improves function and pain. Surgical treatments that aren’t needed right away are usually postponed until after delivery. However, if wrist pain or hand weakness badly restricts your day-to-day function, talk with your gynecologist about the dangers and benefits of having carpal tunnel surgical treatment before delivery.
Breastfeeding and carpal tunnel syndrome
You’ll need to use your wrist to hold your baby’s head and breast in the appropriate posture for breastfeeding with carpal tunnel syndrome so that it would be difficult for you. Try different positions. Support and brace with pillows and blankets.
The “football hold” position is less painful and easier. You have to sit upright and place your baby on the side of your arm with your baby’s head near to your torso.
Ask a lactation consultant if you need help nursing or finding a comfortable position for you and your baby. They can teach you how to nurse comfortably and identify any issues you or your baby may be facing.