10 Tips Relieve Carpal Tunnel Pain During Pregnancy

Carpal tunnel syndrome (CTS) is a common condition during pregnancy that causes tingling, numbness and occasionally pain in the fingers and hands. Up to 62% of pregnant women may experience CTS symptoms and often worsen as the pregnancy progresses. 

The median nerve, which controls sensation and motion in the fingers and hands, passes through the carpal tunnel in the wrist. Hormones during pregnancy can cause fluid retention in the body resulting in swelling of the hands, ankles and feet. This swelling places extra pressure on the median nerve, which causes CTS symptoms such as throbbing and reduced dexterity in the fingers and hands.

How To Treat Carpal Tunnel Pain In Pregnancy

Rest

Over-using your hands may increase CTS symptoms. Rest the hand and wrist where possible whenever there is pain or fatigue or change to a different task.

Reducing non-essential activities that cause the wrist to bend repeatedly, such as typing on a keyboard or using a mouse, may reduce pressure on the median nerve. Try to avoid repetitive tasks that require a solid gripping or wringing action of the wrists. 

Elevation 

Reduce swelling in the fingers and hands by keeping the forearm, hand and wrist elevated whenever possible. Elevate by placing a rolled-up towel, or a small pillow under the wrist, preferably in a position raised higher than your heart if possible. 

Massage

Gently massaging hands and wrists may reduce pain by easing tension and relieving pressure on the median nerve, and improving circulation.

Cold and Heat Therapy

Using cold therapy, such as applying a small ice pack to the wrist for ten minutes or running the wrist under a cold tap several times a day, may provide relief. 

Alternating heat and cold therapy may also help by bathing the hand in a basin with warm water for one minute, then applying a cool ice pack for another minute. Alternate between warm and cool for a few minutes, several times a day. 

Splints and Supports 

Splints and braces hold the wrist in a neutral position to reduce compression on the median nerve by minimizing flexing and overextending of the hand or wrist. Pregnant women can wear splints during the day or night. Wearing splints while sleeping may relieve symptoms upon waking by preventing bending of the wrist overnight. 

There are many types of supports and splints, some more effective than others depending on the severity of symptoms and individual preferences. Soft hand splints and neutral wrist splints both restrict motion of the joints, which reduces pressure against the median nerve at different points in the carpal tunnel. 

Splints and supports are recommended during pregnancy as they are relatively inexpensive, non-invasive and have minimal side effects, such as minor skin irritations. Often, wearing a splint and avoiding excess pressure on the joint’s affected areas provides enough relief in symptoms for some pregnant women. 

Exercise

Some pregnant women with CTS find relief with hand exercises while others do not.

Gently moving the wrists and hands occasionally (particularly after wearing splints) may improve circulation and reduce pressure on the median nerve, reducing swelling. Here are some gentle exercises that may be helpful, each repeated several times a day:

• While keeping the fingers straight, bend the wrist gently forwards and backwards.
• Make a fist, gently straightening the fingers, then form a fist again.
• Use the thumb and finger to make an ‘O’ shape, using each finger one at a time.
• Rotate the thumb in a circular motion, clockwise, then anticlockwise. 

Sleeping position

CTS symptoms can worsen at night, particularly during sleep, as the wrist naturally bends; wearing a wrist splint can prevent this. Sometimes hanging the hand out of bed, shaking it from side to side can relieve discomfort. 

Avoid sleeping on the affected side where possible, and elevating it on a raised surface, such as a pillow while sleeping, may ease symptoms.

Pain relievers

If needed, pregnant women can safely take pain medication such as acetaminophen (in the recommended doses) throughout pregnancy. Other pain relievers, such as ibuprofen, are not recommended as the risk of asthma and other conditions developing in the newborn increases and the amniotic fluid can decrease.

Avoid salty foods

Eating a healthy diet and consuming less salt may reduce overall swelling in the rest of the body.

Other therapies

Practicing yoga may increase hand strength and reduce overall pain for those with CTS, but more research is needed to understand the benefits fully.

CTS During Pregnancy

The carpal tunnel is a narrow passage in the wrist, made up of small bones surrounded by connective tissues and ligaments. Running through the carpal tunnel are blood vessels, tendons and nerves, including the median nerve, which controls movement and sensation in the fingers and hands. When this median nerve is compressed in any way, it causes CTS. 

During pregnancy, hormones cause the body to retain more fluid, resulting in swelling (oedema) of the tissues in the hands, ankles and feet. When this fluid accumulates in the wrist, it places pressure on the median nerve, compressing it, causing fingers and hands to feel different.  

Symptoms

CTS Symptoms range from mild tingling to severe throbbing pain, affecting one or both hands. A study found that almost half of pregnant women with CTS involved both hands. 

Symptoms are often worse upon waking and at night; they include:

• numbness and tingling (pins and needles)
• dull ache or throbbing pain
• hot and swollen thumb and fingers
• reduced dexterity and difficulty gripping objects with the thumb and fingers

CTS symptoms may worsen as the pregnancy progresses since pregnant women gain more weight resulting in greater fluid retention by the body. 

Risks

During pregnancy, some women may be at a higher risk of developing CTS than others. Certain conditions such as diabetes increase the risk of CTS in the general population; likewise, gestational diabetes during pregnancy can lead to fluid retention resulting in oedema of the hands, causing CTS. 

A study shows pregnant women who are overweight or obese before pregnancy may increase the risk of CTS. Similarly, in the general population, living a sedentary lifestyle with a high body mass index (BMI) may increase the risk of developing CTS. 

Diagnosis

CTS is diagnosed by combining a history of symptoms, a physical exam and sometimes nerve conduction tests. 

A physical exam evaluates the fingers, hands and wrists for signs of redness, tenderness and swelling. A Tinel’s sign is sometimes used to check for nerve damage in CTS. A gentle tap is applied over the affected area, and a tingling sensation can indicate nerve damage. 

Nerve conduction tests measure the speed of nerve impulses to the hand. A slower response than average may indicate CTS, as damage to the median nerve affects these signals. 

Managing CTS after delivery

CTS during pregnancy usually resolves within a year after giving birth as fluid retention gradually reduces. Women who continue to have symptoms after delivery can minimize discomfort by placing a pillow under the baby, which takes most of the weight and reduces the support the baby needs from the mother. 

New mothers can make breastfeeding more comfortable by lying on one side rather than sitting up straight or using the forearm instead of the hand to support the baby’s head.

Conclusion

• CTS is common during pregnancy as hormones cause swelling and oedema, compressing the median nerve, which causes CTS symptoms.
• Simple adjustments such as resting, elevating and avoiding activities that repeatedly bend and overextend the wrist may bring some relief. Wearing splints can help to keep the joints in a neutral position, relieve pressure and reduce pain. Some pregnant women find gentle hand and wrist exercises helpful and can improve blood circulation. 
• CTS during pregnancy generally resolves soon after delivery as fluid retention gradually reduces, relieving pressure on the median nerve.

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