3 min read
BY LAUREN BRENTON | Clinical Midwifery Specialist | Childbirth Educator |
1. What is carpal tunnel syndrome?
Carpal tunnel syndrome is a condition that is common during pregnancy, especially in the third trimester.
The carpal tunnel is a small passage in the wrist where nerves and tendons pass from your arm into your hand and fingers. Hormonal changes are the most likely cause for carpal tunnel syndrome in pregnancy, causing the body to retain fluid and softening the ligament that forms the roof of the tunnel.
This then squashes the median nerve (the nerve running through the tunnel) within the carpal tunnel in the hand. It is estimated that carpal tunnel syndrome impacts between 2-72% of pregnant women.
2. What are the symptoms of carpal tunnel syndrome?
Carpal tunnel can impact sensory and motor function in the hand and can include:
- Tingling
- Burning pain (often worse at night)
- Weakness
- Numbness
- Swelling
- Radiating pain into the arm and shoulder
The good news is that carpal tunnel syndrome usually resolves after the birth. But what can be done to help make life a little easier and more comfortable throughout the pregnancy.
3. What are ways to ease carpal tunnel syndrome?
- Compression wrist sleeve - this can help by keeping the wrist in a straight position reducing further aggravation as well as providing the necessary compression to bring the inflammation dow
- Wrist splint: especially at night to help keep your wrist straight
- Steroid injections - (dexamethasone)
- Activity modification – avoiding positions of extreme flexion or extension of the wrists, heavy lifting or repetitive tasks
- Avoiding exposure to vibration
- Elevatuion - elevate your hand/hands
- Sleep position - avoid sleeping on the side of your most affected hand
- Wrist position - try to keep your wrists in a neutral (straight) position as much as you can
- Fluid drainage massage - Perform regular fluid drainage massage and gentle exercises to reduce swelling. Elevate your affected hand, use your other hand to gently stroke your hand/arm from the fingertips towards your shoulder. Never stroke towards your fingertips. Fluid drainage massage is a good technique to reduce swelling by encouraging the fluid to move towards your heart and then apply your compression wrist sleeve.
- Rest, ice and elevate regularly
4. What is de Quervain's tenosynovitis (mother’s wrist)?
Similar to carpal tunnel syndrome, is de Quervain's tenosynovitis (mother’s wrist). The name was given, as many new parents suffer from this condition due to the awkward hand positions required to hold and care for an infant.
The pain comes from inflammation of the tendon that runs down the forearm, through to the wrist and thumb from repetitive strain on the tendon.
The pain caused by de Quervain's tenosynovitis is severe and hinders even the simplest of tasks (such as – bathing, changing or feeding a new baby)
5. What are the symptoms of de Quervain's tenosynovitis?
- A snapping sound when moving the thumb
- Swelling or tenderness of the thumb (radial) side of the wrist
- Pain that radiates out to the thumb or forearm
6. What are some treatments for de Quervain's tenosynovitis?
Treatment for de Quervain's tenosynovitis is very similar to carpal tunnel syndrome, with non-surgical treatments attempted first.
These include:
- Compression wrist sleeve - wearing a wrist compression sleeve to reduce inflammation and limiting extension and flexion of the wrist
- Modifying activities - reducing or modifying activities to avoid extension and flexion of the wrist
- Medications - to reduce inflammation called NSAIDs (Nonsteroidal anti-inflammatory drugs)
If none of these help after several weeks, then wrist surgery may be required
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One Mama Midwife - Lauren Brenton
Clinical Midwifery Specialist | Childbirth Educator | Mama of 4