It’s hard to not complain…at least a little bit…about pregnancy woes; from weight gain (of course); to face breakouts to heartburn, no one said pregnancy was a cakewalk. Ok, the last thing you may want to read about or experience is another pregnancy ailment. However, Carpal Tunnel Syndrome, especially in the wrists and fingers, is common in pregnant women. Ouch! We consulted with two top OB-GYN’s, inquiring about its causes, cures, and how to handle the joint pain. Read on to learn more.
What causes carpal tunnel (in the hands/wrist) during pregnancy? Is there a specific trimester it’s most common?
“Carpal Tunnel Syndrome in pregnancy occurs as a result of fluid retention during pregnancy that causes compression of the median nerve in the carpal tunnel,” says Dr. Jason S. James, a TopLine MD physician at Baptist Hospital in Miami. “It’s more commonly seen in the third trimester, though some women experience it in all trimesters. The amount of water retention can affect the severity of the condition. Carpal Tunnel Syndrome does tend to persist during postpartum, especially in women who are breastfeeding.”
Adds Dr. James: “The symptoms experienced by most women include pain, numbness, or tingling on the thumb, index finger, and middle finger. Up to 35 percent of pregnant women suffer from Carpal Tunnel Syndrome during some part of her pregnancy.”
Is it the same as DeQuervain’s tenosynovitis ?
No. According to Dr. Felice Gersh of the Integrative Medical Group of Irvine , De Quervain’s (also called “Mom Thumb”) is a form of tendonitis causing wrist pain. “In De Quervain’s, the tendon on the inside of the wrist leading to the thumb becomes thickened and inflamed.” It happens more often because we text so much in today’s society, and, according to Dr. Gersh, this can be a more common problem for women during pregnancy because of generalized inflammation and swelling. "It may be more common after pregnancy because of changes in hormones but also from performing new activities like carrying and lifting your baby."
Adds Dr. James: “The condition can be aggravated by the demands on a new mom positioning the baby for breastfeeding or while bottle feeding a baby for long periods of time. Since newborns feed every 2 to 3 hours around the clock, sometimes for 30-40 minutes or longer, new mothers may need to maintain their hands in the same flexed position for long periods at a time for weeks or even months.”
How can these symptons be alleviated?
According to Dr. Gersh, be aware of your hands when typing. “During pregnancy the primary treatment would be modifying your hand positions; for example, if you work at a computer keeping your elbows above wrist level and hands in neutral position to alleviate stress on the median nerve,” she explains. “Also be careful with how you are lifting objects and using your hands. At night, a wrist brace may provide relief but it can also put more pressure on wrist and make it worse. Icing to reduce swelling is recommended, and massage and acupuncture of the hand and wrist can provide relief as well.” Regarding De Quervain’s, she says, make sure not to stress the tendon, and learn to properly hold a baby. “In addition, texting with thumbs should be eliminated or limited. Hand massage and acupuncture are recommended.”
In addition, Dr. James advises pregnant women to avoid or minimize fluid retention by specifically avoiding excess salt intake. “While many patients complain of symptoms that can be fairly severe with carpal tunnel, injections or surgical intervention is exceedingly rare and the condition tends to resolve on its own with conservative measures. However, De Quervain’s is one of those conditions that responds quite well to steroid injection if conservative therapy doesn’t seem to make any improvements.”