Carpal tunnel and pregnancy: what to do?
Carpal tunnel syndrome: increased risk during pregnancy
Carpal tunnel syndrome can cause discomfort to pregnant women, especially during sleep, and can cause pain in the hand. Although the syndrome usually disappears after childbirth, there are treatments to relieve its symptoms.
Pregnancy comes with its share of ailments. While some are well known, such as nausea and vomiting , for example, others are less so. This is the case with carpal tunnel syndrome (CTS).
Pregnancy: What is carpal tunnel syndrome?
Carpal tunnel syndrome is a compression of the median nerve , the one that runs through the wrist. The carpal tunnel forms a tunnel made up of bone and tissue that surrounds and protects the median nerve and tendons. These tendons are what allow the fingers of the hand to move. The syndrome occurs when tissues located in this carpal tunnel, such as ligaments and tendons, are swollen. They then compress the median nerve and hinder the normal functioning of the hand.
What are the possible causes?
There are several causes that can explain the appearance of a CTS, although most of the time it occurs without any particular cause being identified.
- A repeated movement: Some professions require a repeated wrist bending movement that can promote this syndrome. This is the case for example for assembly line workers, mechanics, people working on computers, musicians… This repeated movement can also occur in the context of hobbies such as sewing, gardening, golf…
- An injury: A fall on the wrist (fracture, etc.) can cause carpal tunnel syndrome due to crushing, compression of the nerve linked to the displacement of the fracture or edema induced by this fall.
- A disease: Several diseases such as diabetes, hypothyroidism, amyloidosis, among others, can lead to the appearance of this syndrome.
- Pregnancy: Water retention and the swelling it causes can promote compression of the median nerve. Hormonal fluctuations can also create a breeding ground for this syndrome, including during breastfeeding. “ Carpal tunnel syndrome often appears during the third trimester of pregnancy when the body gains weight and adapts for the passage of the baby. There is a rapid hormonal change that can explain the appearance of this syndrome ,” says Dr. Laurent Thomsen, hand surgeon at the Drouot clinic.
What are the characteristic symptoms?
Symptoms of CTS can vary from woman to woman. They often appear during the third trimester of pregnancy when the woman's body has gained weight and hormones are very active. They can also occur after childbirth, especially during breastfeeding .
Numbness, tingling and pain in the fingers, hand and sometimes arm
Symptoms of carpal tunnel syndrome usually manifest as tingling, numbness , and a feeling of swelling in the fingers and hand, especially at night. Loss of sensitivity in the fingers and pain in the wrist and hand may be felt. This pain can sometimes radiate to the elbow. These symptoms can bother women and cause a loss of dexterity and some more clumsy movements. These symptoms are often more pronounced at night, which can disrupt the sleep of expectant mothers. " These symptoms most often appear at night because we often sleep with our wrist bent and therefore compress the median nerve more". " Normally, if carpal tunnel syndrome appeared during pregnancy, within six months of giving birth, these symptoms disappear on their own".
Although carpal tunnel syndrome during pregnancy is generally temporary, it is advisable to monitor it and consult your doctor if you experience discomfort in your daily life.
Diagnosis: How to be sure it's carpal tunnel?
To be sure that it is indeed carpal tunnel syndrome, the doctor talks to the mother-to-be and performs a clinical examination . This is usually enough to confirm the pathology.
If in doubt, and if wearing a night splint is not enough to calm the symptoms, the doctor may sometimes prescribe an ultrasound of the carpal tunnel or an electromyography (EMG) test to confirm the diagnosis, determine its severity and choose the best treatment. " This examination is carried out by a neurologist. He places electrodes on the forearm and studies the speed of conduction of the current through the nerve. If it is compressed, the speed decreases".
Treatment: How to relieve carpal tunnel during pregnancy? What are the solutions?
Carpal tunnel syndrome can disappear on its own after giving birth or breastfeeding, but this is not always the case. In addition, the intensity of the symptoms sometimes increases with a new pregnancy.
In order to prevent the risk of compression of the median nerve, the pregnant woman can perform exercises such as stretching her wrists. "To relieve the pain , shake your hand a little or hang it along the bed and it usually feels better ". If you have to perform repeated hand movements, it is advisable to take regular breaks or change hands when possible.
In the event of daily discomfort, it is necessary to consult your doctor to find solutions to relieve and get rid of carpal tunnel syndrome.
Wearing a splint
Initially, treatment often involves wearing a wrist splint at night to keep the wrist in a good position and prevent it from bending. This splint can also be worn during the day if necessary throughout the pregnancy. "Wearing the splint works very well on cases of typical carpal tunnel syndrome".
Corticosteroid injections
Corticosteroid injections into the carpal tunnel are an option to temporarily relieve carpal tunnel syndrome, but they are rarely offered during pregnancy.
Surgery
If these different solutions have not been enough to relieve the symptoms, if they are severe and the woman is in a lot of pain, surgery may be considered. "If the woman has already had a child, if more than 6 months after giving birth and breastfeeding, the syndrome is still there and she is considering a second pregnancy, surgery is recommended because it is likely that these symptoms will bother her more afterwards". The procedure is performed on an outpatient basis under local anesthesia. It involves widening the circumference of the tunnel to free the median nerve from its compression. Carpal tunnel syndrome does not usually recur.
“The pain can be very annoying, but even if you do not receive treatment, you will not lose the use of your hand or your sensitivity overnight. It can happen, but it is the result of a process that develops over several years. There are treatments that can help you get back to your original state, and there is no need to panic.”
