How to help carpal tunnel during pregnancy

Carpal tunnel syndrome is one of the most common causes of numbness, tingling, pain or a dull ache in the fingers, hands, wrists, and arms. It happens when the median nerve – a major nerve in the hand that travels through the wrist and arm – is squeezed or compressed.

And pregnant women, especially those who make repetitive hand movements, such as flexing and extending the wrists, while doing things like working on a computer, are more prone to carpal tunnel because of the swelling that occurs in the hands and wrists.

The excess fluid that collects in the tissues of the hands and wrists can compress the median nerve, causing numb hands during pregnancy. Carpal tunnel pregnancy can come and go, but symptoms are often worse at night because many people sleep with their wrists bent. 

Carpal tunnel syndrome in pregnancy can start any time, but it's more likely to begin or worsen during the second or third trimester – when swelling can develop. Carpal tunnel syndrome usually affects both hands. Some women may suspect they have carpal tunnel, but actually have de Quervain's tendinosis, or swelling of the thumb tendons. This condition is treated similarly to carpal tunnel, but you will need to talk with your doctor about your options.

What causes carpal tunnel during pregnancy?

During pregnancy, women are more prone to swelling because of the increase in blood volume to support the baby. Swelling increases the pressure in the blood vessels and tissues throughout the body, including those in the hands, wrists, and arms. This results in crowding of the nerves and ligaments, like the carpal tunnel.

Because the median nerve provides feeling in the thumb, index, middle, and ring fingers, you may have numb hands with carpal tunnel. If you do work that involves repetitive hand movement, like typing on a computer, try to take rest breaks and stretch your hands, wrists and arms throughout the day.

How can I relieve numb hands during pregnancy, and any other symptoms I may experience?

In addition to numbness, tingling, and pain, other carpal tunnel pregnancy symptoms are feeling a burning sensation in the wrists and hands and weakened grip strength or loss of finger dexterity. When this happens, you might find it difficult to do push and pull movements, open jars, or pick up small objects with your fingers.

To relieve discomfort, try to identify what activities tend to cause or aggravate carpal tunnel syndrome for you, and limit those activities during pregnancy as much as you can, especially activities where your wrist is in the same position for a long time. Doing yoga can improve hand strength and may relieve your symptoms.

You can also adjust your workstation:

• Change the height of your desk chair so your wrists don't bend downward as you type on your computer.
• Use an ergonomic keyboard or mouse.
• Take short breaks to move your arms and stretch your hands.
• Use a keyboard pad with wrist support.

If symptoms bother you at night:

• Avoid sleeping on your hands and try to keep your wrists straight.
• If you wake up with pain, try gently shaking your hands until the pain or numbness goes away.

If you don’t notice any changes to your condition with these adjustments, see your doctor. They may suggest you wear a wrist splint with a metal bar to keep your wrist from moving in different directions. However, it allows you to move your fingers so you can carry on with everyday tasks. A wrist splint may also help with relieving any swelling in the hands and wrists, allowing the median nerve to relax and heal. 

For immediate pain relief, ask your doctor about using over-the-counter topical or anti-inflammatory pain medications that are safe for pregnancy (don’t take any medications without consulting your doctor first). Just remember that these medications don’t actually resolve the issue; they just help you feel better temporarily.

In some cases, your healthcare provider may recommend occupational therapy, where you work with a physical therapist to do hand stretches, wrist-strengthening exercises, massage techniques. and nerve gliding. And in rare cases, your doctor may suggestion steroid injections if your condition is severe.

Carpal tunnel syndrome symptoms usually resolve on their own after pregnancy, when the swelling subsides. However, symptoms may linger for some women, especially those who are breastfeeding. The median nerve may also be exacerbated from carrying, feeding, and changing the baby.

If symptoms persist after your baby is born, or if your symptoms are severe (meaning you have constant numbness, muscle weakness, or loss of sensation), be sure to mention it to your healthcare provider at one of your postpartum visits so you can get a referral to a specialist.

Carpal tunnel during pregnancy: Can I prevent it?

There’s not much you can do to prevent carpal tunnel pregnancy because of the natural increase in blood volume and fluid retention. However, you can help reduce the stress on hands and wrists by taking frequent rest breaks throughout the day from repetitive movement and alternate hands if you’re able to.

As mentioned earlier, if you work at a desk all day, you can adjust the height of your chair so your wrists don’t bend, try using an ergonomic keyboard or mouse, and you can experiment with placing keyboard pad with wrist support at your workstation for extra support.

Get moving throughout the day to increase blood flow and relieve tense areas of the hand and wrist. Try doing wrist stretches, such as a wrist extension and wrist flexion. The wrist extension stretch, for instance, involves straightening your arm and bending your wrist back with the opposite hand as if you’re telling someone to “stop.”

Because other health conditions, such as hypothyroidism, diabetes, and rheumatoid arthritis, can cause inflammation in the body, they may contribute to carpal tunnel syndrome so talk to your doctor about the appropriate treatment for you.

Will having carpal tunnel during pregnancy affect my pregnancy or baby?

Carpal tunnel during pregnancy won’t actually affect your pregnancy or baby, but it will affect your hand and arm mobility and your ability to carry out everyday tasks.

That said, severe or sudden swelling during pregnancy is a sign of preeclampsia. Preeclampsia is high blood pressure that develops during pregnancy and is marked by high protein in the urine. If left untreated, preeclampsia can cause serious complications, including intrauterine growth restriction, low amniotic fluid, placental abruption, and premature birth.

So, if you notice severe or sudden swelling in the face, feet, ankles, and hands, call your doctor right away to get a proper diagnosis. In addition to severe or sudden swelling, other preeclampsia symptoms are severe headaches, vision changes, upper abdominal pain, nausea or vomiting, and shortness of breath.

When will carpal tunnel during pregnancy go away?

Carpal tunnel syndrome usually resolves after giving birth as the excess fluid and blood leaves your body, but if you’re still experiencing symptoms, check in with your doctor.

For those who still have severe swelling, it could be a sign of preeclampsia, which can also develop after giving birth.

Note that carpal tunnel syndrome does cause nerve damage, so don’t ignore the problem and make sure to seek medical help to prevent further issues.

When should I call my doctor about carpal tunnel during pregnancy?

If you experience carpal tunnel syndrome symptoms, you should contact your doctor as soon as possible to get a proper diagnosis. Explain your symptoms to your doctor and keep a record of when they started and how often they occur.

You'll likely be referred to an orthopedist to have an ultrasound, X-ray, or MRI scan to get a better picture of what’s happening in your hands and wrists. Electrophysiological tests also help doctors determine how well your median nerve is working and whether it’s experiencing too much pressure. And if you are diagnosed with carpal tunnel, your doctor can recommend the best treatment for you.

Carpal tunnel syndrome is a condition that occurs as a result of swelling around the nerves of the wrist. It can cause numbness, tingling or pain in one or both wrists.

Pregnant women are particularly prone to the disorder, with about 3 to 5 of every 10 women experiencing symptoms during pregnancy.

The carpal tunnel is a corridor that contains tendons and a nerve (the median nerve), that run through the base of your hand. The carpel tunnel can swell and press against this sensitive nerve, causing pain.

While pregnancy is one cause, other common causes include arthritis or repetitive hand movements, which can occur in professionals such as musicians, office workers and manual labourers.

For more information on carpal tunnel syndrome unrelated to pregnancy, click here.

How does pregnancy affect carpal tunnel syndrome?

When you are pregnant, your hormone levels trigger fluid retention, which can cause swelling. This swelling can, in turn, push against the median nerve in the carpal tunnel – increasing pressure in the carpal tunnel and sometimes causing pain in your wrist and hand.

The condition is more common in the third trimester, but it can also happen in the first 2 trimesters or after the birth. In most cases, symptoms will pass after your baby is born.

How do I know if I have carpal tunnel syndrome?

Common signs and symptoms of carpal tunnel syndrome include:

• Pain: especially in the wrist, thumb, index finger or middle finger. Pain may worsen when you move your hand or if the weather is particularly hot. It’s also more likely to occur at night.
• Numbness: especially in the thumb, index finger or middle finger. A particularly bad case can result in difficulty holding on to or picking things up, and you may feel clumsy.
• Tingling: especially in the thumb, index finger or middle finger. Tingling may worsen when you move your hand or if the weather is particularly hot. It’s also more likely to occur at night.
• Weakness: stress on the nerve in the carpal tunnel can cause weakness in the thumb, index finger or palm of your hand.

The intensity of symptoms can vary from mild irritation, to occasional soreness, to serious pain. Symptoms may stop you from sleeping or make it difficult to perform regular tasks such as working, getting dressed, cooking or caring for your baby.

Symptoms can be worsened by:

• repeating the same hand movements frequently
• keeping your hands in the same position for an extended time
• putting weight on straightened arms

Swelling is a symptom of high blood pressure in pregnancy. If your hands or feet are more swollen than usual, speak to your doctor.

How is carpel tunnel syndrome treated?

There are safe and effective treatments for carpel tunnel syndrome. Your choice of treatment will depend on several factors, including the severity of your symptoms and the stage of your pregnancy. Talk to your doctor if you think you may have carpal tunnel syndrome.

Some pregnant women find that pain is reduced by simple measures, such as:

• elevating your hands when you’re resting or not using them
• keeping your wrists in a neutral position (not bent forwards or backwards) during the day, and as much as possible while you’re sleeping
• maintaining good posture in your arms and wrists while working at a desk
• taking breaks every 20 minutes while working at a desk
• avoiding activities that strain your wrist

You can also reduce the swelling by applying an ice pack on your inner wrist or by placing your hand in cold water for between 30 seconds and 2 minutes. If your symptoms worsen, do not repeat.

Treatment options include physiotherapy or occupational therapy. This may involve fitting you with a brace or splint to keep your wrist in the best position to reduce strain. These splints must be adjusted to your specific wrist in order to be protective and supportive. Your therapist will be able to tell you how best to protect your wrist at home, including exercises and resting positions.

Your doctor may recommend medicine to reduce the amount of fluid retained in your body, or in certain circumstances may offer you an injection to reduce swelling.

Will I still have pain after my baby is born?

Carpal tunnel syndrome tends to ease, and often disappears, after birth. If you still have pain after your baby is born, you may need to change the way you use your wrist. This might impact on how you use your hand to hold and care for your baby, including how you feed your baby.

Speak to your physiotherapist, occupational therapist or lactation consultant for strategies and tips on how to minimise strain on your wrist while holding your newborn. Try to use a pram where possible to give your arm a chance to rest. It is also important to continue using your brace or splint if you have one.

While carpal tunnel syndrome is common during pregnancy, 19 out of 20 women will recover within the first 6 weeks after the baby is born. If your symptoms persist after your baby is 6 weeks old, speak to your doctor.