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Carpal Tunnel Syndrome During Pregnancy
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Carpal Tunnel Syndrome During Pregnancy: Tips & Tricks to Ease the Pain

International Journal of Childbirth Education, March 2010

by Heather Jeffcoat, DPT

Carpal Tunnel Syndrome (CTS) during pregnancy is a commonly overlooked problem by healthcare practitioners. It presents as mild to severe pain, numbness, and sometimes weakness in the hands, wrists and forearms along the distribution of the median nerve. At times, the muscles in the forearm ache due to compensations in movement or activity that may result.

The pain can occur at night, further disrupting sleep patterns. These symptoms may arise due to postural changes, increased edema, occupational stressors, or a combination of these. Often patients are told their symptoms will resolve after delivery. Although this is usually the case, patients can perform a few simple exercises that may ease or even eliminate this pregnancy complaint.

When Carpal Tunnel Syndrome occurs in the general population, it is most often associated with the stresses of repetitive motion such as typing, using a computer mouse, work related tasks, or even hobbies as diverse as cooking, knitting, bowling, or tennis (it can also manifest in the elbow as "tennis elbow").

Pregnancy and Carpal Tunnel Syndrome

When manifesting during pregnancy, CTS due to edema tends to worsen in the third trimester, and it often occurs bilaterally. (Turgut, et al 2001). Since edema worsens when the upper extremity is placed in a gravity dependent position, instructing your patient to elevate her arms is a good place to start. Rolling an ice cube over the wrist, called ice massage, can also reduce local swelling.

Exercises to improve flexibility may provide additional relief. Specific areas to include are the postural muscles as well as wrist and elbow.

Doorway Stretch:

Doorway Stretch

Hold onto doorframe as pictured above for 30 seconds. Perform 3 repetitions 2-3 times daily.

Wrist flexor stretch:

Wrist Flexor Stretch

Pull fingers back as shown. Hold a gentle stretch for 30 seconds. Perform 3 repetitions, 2-3 times daily.

Resting posture of the wrists should also be given consideration. At night, some women have the tendency to curl their wrists into a flexed position. Since they are sleeping, the best way to ensure their wrists stay in a neutral position is through the use of wrist splints. The ideal splint would have stays to keep the wrist from moving into flexion or extension, thereby keeping it in a neutral position. As an inexpensive alternative, some women are able to prevent the flexed wrist posture by sleeping with a pillow between their hands.

If a patient's symptoms do not improve with the above techniques and exercises or if the symptoms are severe, additional intervention may be required. Presence of numbness and tingling warrants follow-up with a physician immediately to rule out more severe causes of her symptoms. A women's health physical therapist may then be recommended to provide a directed treatment plan. If you don't know of one in your area, contact the American Physical Therapy Association Section of Women's Health at This email address is being protected from spambots. You need JavaScript enabled to view it. or (800) 999-APTA, extension 3229.

References

Stephenson, R., O'Connor, L. 2000. Obstetric and Gynecologic Care in Physical Therapy. New Jersey: Slack, Inc.

Turgut, F., Cetinsahinahin, M., Turgut, M., Bolukbasi, O. 2001. The management of carpal tunnel syndrome in pregnancy. Journal of Clinical Neuroscience 8:4 332-334.

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Read more: Testimonial by R.D., age 38

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Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

Read more: Testimonial by Lauren B.

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by Amanda W.

Heather's unique physical therapy program literally changed my life! After years of struggling with vaginismus, a condition that made it impossible for me to have intercourse and very difficult to use tampons without pain, a gynecologist referred me to Heather. I was nervous for my first appointment, but Heather's professional and friendly demeanor put me at ease. She did a great job explaining each technique she was using to help my muscles relax. Heather uses a combination of internal and external stretches and exercises to relax the pelvic floor and build muscle strength. Her specially developed home program helped me quickly recover from an issue that seemed insurmountable before meeting Heather. She was optimistic about my progress and incredibly encouraging. Less than 6 months after my first session, I was able to have pain-free sex for the first time in my life! If you are suffering from vaginismus or any other pelvic floor issues, I highly recommend making an appointment with Heather and reading her book!

-- Amanda W., 2/15/16 via Yelp!

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