Carpal Tunnel in Pregnancy

Thick hair and nails, radiant skin, and…hand numbness? The later weeks of pregnancy bring some welcomed physical changes that others may notice and comment how a woman has “a pregnancy glow.”  But in a portion of women, the third trimester may also bring the uncomfortable symptoms of carpal tunnel syndrome.

Approximately one quarter to one third of pregnant women will experience carpal tunnel syndrome¹.  These symptoms include numbness and/or tingling in the thumb, index, middle and a portion of the ring fingers; burning in the wrist; weakness with gripping and general loss of dexterity in the hand.  Often, these symptoms are more pronounced at nighttime.

The carpal tunnel refers to an anatomical tunnel in the wrist.  The carpal bones make up the floor of the tunnel, with tendons that flex the wrist, digits, and thumb above to bones, the median nerve above the tendons and the large flexor retinacular ligament comprising the top of the tunnel (closest to palmar surface).

There are several factors that make this condition so common in pregnancy.  In the general (non-pregnant) population, women exhibit carpal tunnel syndrome symptoms more frequently than men.  The accepted hypothesis for this sex-related discrepancy is that women have smaller bone structures and a smaller space for the median nerve to travel through the wrist²  Although undesirable, swelling is considered normal during the third trimester, and this increased edema causes the tunnel to narrow as well¹.  The hormone relaxin, which is secreted to allow the pelvis to increase space to allow for delivery, is non-selective, affecting all joints in the body, including the wrist.  This relaxing of the wrist joints can alter the anatomy enough to create pressure on the superficial median nerve.

Unfortunately, it has been documented that less than half of the women who are experiencing these uncomfortable symptoms mention it to their physician².  Although delivery is considered the “cure” for pregnancy related carpal tunnel syndrome, an OBGYN or PCP can refer a woman to a hand therapist for splinting, massage and stretching, and body mechanics instruction to relieve some of the edema and help with pain, burning, and tingling sensations.  Severe symptoms can be relieved with a local steroidal injection, but typically after conservative methods have been explored first.  After delivery, some women do continue to experience symptoms long-term and at this time, referral to a hand surgeon is appropriate.

Although relatively common, symptoms of carpal tunnel syndrome should not be something a pregnant woman ignores or has to endure until delivery.  There are splinting, stretching, and postural techniques that can provide relief to allow women to happily anticipate of the arrival of their baby. To speak to an Athletico hand therapist, request an appointment below.

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The Athletico blog is an educational resource written by Athletico employees. Athletico bloggers are licensed professionals who abide by the code of ethics outlined by their respective professional associations. The content published in blog posts represents the opinion of the individual author based on their expertise and experience. The content provided in this blog is for informational purposes only, does not constitute medical advice and should not be relied on for making personal health decisions.

References:
Ablove, RH and TS Ablove (2009).  Prevalence of carpal tunnel syndrome in pregnant women. Wisconsin Medical Journal, Vol. 108, 4.  194-196.
Viotik, AJ, et al. (1983).  Carpal tunnel syndrome in pregnancy.  Canadian Medical Association Journal., Vol. 128.  277-281.