Pregnancy can affect the body in many different ways, including the wrist. Approximately 35% to 62% of women report having wrist pain during their pregnancy (mainly in the 3rd trimester) whereas around 50% of women report developing wrist pain post pregnancy. Inflammation and muscle weakness resulting from hormonal changes, as well as the reduction in physical activity are mainly to blame.
Many women find that their symptoms disappear within a few months of delivery. However, certain diagnosis may require professional attention and treatment. In severe cases, symptoms may worsen over time and result in the need for surgery to prevent permanent nerve damage.
During Pregnancy
Carpal tunnel syndrome is common during pregnancy. Hormonal changes are believed to contribute to the development of the condition. Fluid retention can also be a factor as it creates more pressure on the median nerve.
There are several other risk factors that may lead a pregnant woman to develop carpal tunnel during her pregnancy:
Being overweight or obese prior to pregnancy
While it is unclear if weight specifically causes carpal tunnel, more women who were overweight prior to pregnancy report developing CTS.
Pregnancy related diabetes or hypertension
Both conditions can lead to increased fluid retention which is a cause of carpal tunnel
Prior Pregnancies
Relaxin, a hormone which helps the pelvis and cervix expand during pregnancy, may be seen in higher doses in subsequent pregnancies. The hormone may also lead to inflammation which can cause carpal tunnel.
In most cases, the condition will resolve itself within a few months of the baby’s birth. If you begin to experience tingling and numbness, or pain traveling up the arm into your shoulder, you should call your physician.
Pregnancy Safe Treatments
You should make your OBGYN aware of carpal tunnel symptoms as soon as they arrive. While they may recommend you see a hand specialist, there are several ways women can find relief at home:
- -Wear a wrist splint at night
- -Perform wrist stretches and strengthening exercises
- -Rest as much as possible
A decrease in physical activity may exacerbate wrist pain. Keeping up with exercise and stretches will prevent wrist weakness and help prevent discomfort.
In mild cases of carpal tunnel, rest and a short-term wrist splint should be enough to get you through until after your baby is born. However, if your symptoms persist or become more severe , you may need to see a hand specialist .
Prescribed Treatment Options
If you choose to see a hand specialist, there are several options they may recommend:
Occupational Therapy
The occupational therapist will create a treatment plan specifically designed to treat each woman’s individual pain.
Cortisone Injections
Typically avoided during pregnancy. OTC pain relievers and anti-inflammatories should only be taken when directed by a doctor.
In severe cases, if symptoms don’t resolve on their own post pregnancy, surgery may be necessary. It is recommended to wait until after delivery to undergo any type of invasive procedure, but in severe cases it is possible to have surgery prior to delivery. Consult with your doctor if this is a concern.
Many women may shy away from surgery because they believe it will have a long downtime period which is not conducive to having a newborn. Thankfully, Dr. Brutus performs a newer, less invasive kind of surgery called endoscopic decompression. The surgery has an average recovery time of 14 days, which is about four times faster than with the open surgery method. Endoscopic decompression provides instant relief from pain and numbness with a smaller incision.
Post Pregnancy Wrist Pain
Women who experience wrist pain post pregnancy may have developed what’s called De Quervain’s Tenosynovitis also known as Mommy’s Wrist. While it is common, it can make caring for a newborn difficult for mothers.
The two most common symptoms are:
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- -Pain and swelling in the thumb, extending into the forearm
- -Pain with the use of the thumb and wrist when performing pinching, twisting, or pulling motions.
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The condition is thought to develop from the repeated motion of lifting and holding one’s baby, particularly when nursing. A physician should be seen if your pain interferes with your ability to hold your child or do other simple daily tasks.
Treatment Options
The easiest way to treat De Quervain’s Tenosynovitis is to rest as much as possible. While this is easier said than done with a newborn, there are other options in addition to rest. Your physician may recommend that you wear a wrist splint. This can be a generic store bought splint or a custom orthotic. Modifying breastfeeding position can also help.
If your symptoms last longer than six months without improvement, your physician may recommend you for surgery. Surgical treatment does come with more downtime, but it’s the only way to permanently cure the condition.
Surgery for De Quervain’s Tenosynovitis, aka De Quervain’s release, is an outpatient procedure performed with a local anesthetic. The surgeon will create a small incision in the wrist and locate the inflamed tendon. Once the tendon is cut, pressure is released allowing you to move your hand without pain again.
After one to two weeks, your surgeon will remove your stitches. Your splint may still need to be worn for up to four weeks after surgery. Most patients find their hand will be fully healed in six to twelve weeks.
Final Thoughts
The hormonal changes a woman experiences during and post pregnancy are a common cause for wrist pain. While most cases end up being mild and resolve themselves, more severe cases may require a visit to a hand surgeon.
The best way an expecting or new mother can best improve her symptoms is to take care of herself. While it’s easier said than done, rest, proper nutrition and hydration, physical activity and appropriate medical care are key to staying healthy.
