Carpal Tunnel Syndrome in pregnancy
Carpal Tunnel syndrome (CTS) occurs in about 50% of pregnancies.
The carpal tunnel is a small narrow tunnel that runs from the wrist to the lower palm. Some of the feeling and movement in your hand is controlled by the median nerve which passes through the carpal tunnel.
During pregnancy, many women experience mild swelling in their hands. This is due to a build up of fluid in the tissues. The increased pressure in this relatively narrow and inflexible space compresses the median nerve and causes the painful symptoms of carpal tunnel syndrome. Although symptoms can be generally mild, in some cases it can be so painful that sleep is disturbed and hand movement is severely restricted. The main areas affected are the thumb, index finger, middle finger and half of the ring finger.
Carpal tunnel syndrome can occur at any stage of the pregnancy but most commonly presents itself during the second and third trimesters.
In most cases, the symptoms are mild and go away after you have had your baby. Occasionally carpal tunnel syndrome can be severe, last for months after you have delivered and be extremely debilitating.
Symptoms are generally worse at night and can include:
- Pins and needles in the fingers or the entire hand
- Pain and swelling especially in the fingers and thumb
- A weakened grip
- Numbness in your fingers and palm as the symptoms worsen
Sometimes the use of a wrist splint can help. The spilt keeps the wrist in a straight position which maximizes the space in the carpal tunnel. Otherwise if the pain is too severe, a steroid injection into the wrist often gives good relief. (This is safe in pregnancy).
If your symptoms have not improved within a few months of having your baby and oral anti-inflammatory medication has not improved the symptoms, you may need to be referred to a Hand Specialist for consideration of surgery. Whilst rare, sometimes surgery may be necessary to relieve the pressure on the median nerve if all other treatment options have been explored.