Carpal tunnel syndrome and pregnancy

Carpal tunnel syndrome (CTS) is commonly seen in pregnancy. CTS occurs in 4 percent of the general population, but occurs in 31 to 62 percent of pregnant women, estimates a 2015 study.

Experts aren’t exactly sure what makes CTS so common during pregnancy, but they do think hormone-related swelling may be the culprit. Just as fluid retention in pregnancy can cause your ankles and fingers to swell, it can also cause swelling that leads to CTS.

Read on to learn more about CTS in pregnancy.

What are the symptoms of carpal tunnel syndrome in pregnancy?

Common symptoms of CTS in pregnancy include:

  • numbness and tingling (almost like a pins-and-needles feeling) in fingers, wrists, and hands, which may worsen at night
  • throbbing sensation in hands, wrists, and fingers
  • swollen fingers
  • trouble gripping objects and problems performing fine motor skills, such as buttoning a shirt or working the clasp on a necklace

One or both hands may be affected. A 2012 study found that almost 50 percent of pregnant participants with CTS had it in both hands.

Symptoms may worsen as the pregnancy progresses. One study found 40 percent of participants reported the onset of CTS symptoms after 30 weeks of pregnancy. This is when the most weight gain and fluid retention occurs.

What cause carpal tunnel syndrome?

CTS occurs when the median nerve becomes compressed as it passes through the carpal tunnel in the wrist. The median nerve runs from the neck, down the arm, and to the wrist. This nerve controls feeling in the fingers.

The carpal tunnel is a narrow passageway made up of tiny “carpal” bones and ligaments. When the tunnel is narrowed by swelling, the nerve is compressed. This leads to pain in the hand and numbness or burning in the fingers.

Median nerve diagram

[BODY MAP IMBED: /human-body-maps/median-nerve]

Are some pregnant women at an increased risk?

Some pregnant women are more prone to develop CTS than others. Here are some risk factors of CTS:

Being overweight or obese before becoming pregnant

It’s unclear if weight causes CTS, but pregnant women who are overweight or obese receive diagnoses with the condition more frequently than pregnant women who aren’t overweight or obese.

Having pregnancy-related diabetes or hypertension

Gestational diabetes and gestational hypertensioncan both lead to fluid retention and subsequent swelling. This, in turn, can increase the risk of CTS.

High blood sugar levels can also cause inflammation, including of the carpal tunnel. This may further increase the risk of CTS.

Past pregnancies

Relaxin may be seen in higher amounts in subsequent pregnancies. This hormone helps the pelvis and cervix expand during pregnancy in preparation for childbirth. It can also cause inflammation in the carpal tunnel, squeezing the median nerve.

How is CTS diagnosed in pregnancy?

CTS is most often diagnosed based on your description of symptoms to your doctor. Your doctor may also conduct a physical exam.

During the physical exam, your doctor may use electrodiagnostic tests to confirm the diagnosis, if needed. Electrodiagnostic tests use thin needles or electrodes (wires taped to the skin) to record and analyze signals your nerves send and receive. Damage to the median nerve can slow down or block these electrical signals.

Your doctor may also use Tinel’s sign to identify nerve damage. This test can be done as part of a physical exam, too. During the test, your doctor will lightly tap over the area with the affected nerve. If you feel a tingling sensation, this can indicate nerve damage.

Tinel’s sign and electrodiagnostic tests are safe for use during pregnancy.

How to treat carpal tunnel syndrome in pregnancy

Most doctors recommend treating CTS conservatively in pregnancy. This is because many people will experience relief in the weeks and months after giving birth. In one study, only 1 out of 6 participants who had CTS during pregnancy still had symptoms 12 months after delivery.

You’re more likely to continue to experience CTS after delivery if your CTS symptoms began earlier in your pregnancy or if your symptoms are severe.

The following treatments may be safely used during pregnancy:

  • Use a splint. Look for a brace that keeps your wrist in a neutral (not bent) position. When symptoms tend to be worse, wearing a brace at night may be particularly beneficial. If it’s practical, you can wear it during the day as well.
  • Reduce activities that cause your wrist to bend. This includes typing on a keyboard.
  • Use cold therapy. Apply ice wrapped in a towel to your wrist for about 10 minutes, several times a day, to help decrease swelling. You might also try what’s called a “contrast bath”: Soak your wrist in cold water for about one minute, then in warm water for another minute. Keep alternating for five to six minutes. Repeat as often as practical.
  • Rest. Whenever you feel pain or fatigue in your wrist, rest it for a bit, or switch to a different activity.
  • Elevate your wrists whenever you can. You can use pillows to do so.
  • Practice yoga. Results from one study found that practicing yoga can reduce pain and increase grip strength in people with CTS. More research is needed, though, especially to understand the benefits for pregnancy-related CTS.
  • Get physical therapy. Myofascial release therapy may reduce CTS-related pain and increase hand function. This is a type of massage to reduce tightness and shortness in ligaments and muscles.
  • Take pain relievers. Using acetaminophen (Tylenol) at any point in pregnancy is generally considered safe, as long as you don’t exceed 3,000 mg daily. Talk to your doctor if you have concerns. Avoid ibuprofen (Advil) during pregnancy unless it’s specifically approved to use by your doctor. Ibuprofen has been linked to low amniotic fluid and a number of other conditions.

Carpal tunnel syndrome and breastfeeding

Breastfeeding may be painful with CTS because you’ll need to use your wrist to hold your baby’s head and your breast in the proper position for nursing. Try experimenting with different positions. Use pillows and blankets to prop, support, or brace when needed.

You may find that breastfeeding while lying on your side with the baby facing you works well. The “football hold” may also be easier on the wrist. With this position, you sit upright and place your baby on the side of your arm with your baby’s head close to your torso.

You may prefer hands-free nursing, where your baby feeds while in a sling worn close to your body.

If you’re having trouble breastfeeding or finding a position that’s comfortable for you and your baby, consider talking to a lactation consultant. They can help you learn comfortable positions and can help identify any problems that you or your baby are having with nursing.

What’s the outlook?

CTS is common during pregnancy. Simple measures like splinting and taking acetaminophen are standard therapies and usually bring relief.

Most people will see their symptoms resolve within 12 months after delivery. However, it can take years in some cases. Talk to your doctor about ways to safely manage your symptoms.