What to Know About Carpal Tunnel Syndrome in Pregnancy

Compression of a Nerve to the Hand

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Carpal tunnel syndrome (CTS) is a condition where there is compression of the median nerve. This nerve is located on the palm side of the hand. CTS can affect one or both of your hands.

CTS is common in pregnancy and can occur in 31% to 62% of people who are pregnant. Researchers aren’t sure why CTS is so common in pregnancy. They speculate that pregnancy-related hormones might contribute to increased swelling throughout the body.

Learn more about carpal tunnel in pregnancy, including signs and symptoms, causes, and treatment.

Pregnant person

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Symptoms

The median nerve provides feeling to your thumb, index finger, long finger, and part of your ring finger. It is also responsible for pressures associated with the muscle going into your thumb.

When there is swelling inside the wrist, it can lead to compression that causes CTS. The compression of the median nerve leads to feelings of weakness, numbness, and tingling on the area of the hand closest to the thumb.

Additional symptoms of CTS that might be experienced in pregnancy include:

  • Pins and needles feeling in the hands, wrists, and fingers
  • A throbbing feeling in the hands, wrists, and fingers
  • Swelling of the fingers
  • Trouble with gripping objects and problems with fine motor skills (i.e., buttoning a shirt)

CTS can affect one or both of your hands. A study from 2012 in the journal Advanced Biomedical Research found 47.5% of pregnant study participants had CTS that affected both of their hands. The study’s researchers further note the prevalence and severity of CTS will increase as the pregnancy progresses.

Causes

CTS is the result of the median nerve becoming compressed as it passes through the carpal tunnel in the wrist. The carpal tunnel is a very narrow passageway containing the carpal bones and ligaments. When there is swelling occurring in the carpal tunnel, you get nerve compression. This results in pain and CTS symptoms.

Research has shown that many risk factors associated with pregnancy might be to blame for the frequency of carpal tunnel in pregnancy.

Risk factors for CTS in pregnancy might include:

  • Maternal age: According to a 2017 report in the UNM Orthopaedic Research Journal, women ages 35 to 40 years who are classed as advanced maternal age, are shown to have increased incidences of carpal tunnel during pregnancy.
  • Excessive weight gain or being overweight: The research is unclear as to how being overweight or obese contributes to CTS risk. But it seems that the condition is frequently diagnosed in people who are overweight.
  • Gestational metabolic changes (i.e., increase in blood glucose levels or blood pressure): Both diabetes and high blood pressure can increase fluid retention and swelling. These high levels increase the risk for CTS. High sugar levels can also contribute to inflammation, which promotes swelling in the carpal tunnel and increases CTS risk.
  • Having prior pregnancies: Relaxin may also play a part in the development of CTS, especially with subsequent pregnancies where it is seen in higher amounts. This hormone is responsible for the expansion of the pelvis and cervix in preparation for childbirth. Relaxin might also cause inflammation of the median nerve.

Diagnosis

Your doctor can diagnose CTS while you are pregnant by talking with you about your symptoms and medical history. If your symptoms are severe, your doctor may request a special scan called an electromyography (EMG).

An EMG can measure nerve function in your arm, wrist, and hand to confirm CTS. EMG can also check for nerve damage and help your doctor determine your treatment options.

During the EMG study, the clinician will attach small electrode stickers to your hand and arm in different areas and apply low-level electrical stimulation to measure nerve activity response.

Next, the clinician will insert a fine acupuncture-like needle in areas of the arm and hand to check muscle activity. This part of the study might be a bit uncomfortable, but it should not cause any long-lasting discomfort or pain.

Treatment

CTS during pregnancy is treated conservatively using nonmedicinal, natural treatment approaches. Research shows CTS symptoms for most pregnant individuals will resolve within weeks or months after giving birth.

One study reported in 2017 in the European Journal of Obstetrics & Gynecology and Reproductive Biology found that 34% of study participants reported CTS symptoms during pregnancy.

Only 11% were experiencing symptoms six weeks postpartum (after giving birth) and 6% at four months postpartum. Only 5% of the study participants were reporting CTS symptoms at 12 months postpartum.

The following treatments are generally safe for treating CTS in pregnancy:

  • Splinting: Use a brace or splint that keeps your wrist and hand in a neutral position. Make sure your wrist is not bent. Splinting is especially helpful when symptoms are severe. Bracing at night can also help to resolve symptoms and improve sleep.
  • Reduction of some activities: Reducing activities that cause you to bend the wrist, such as typing, can help resolve some CTS symptoms. 
  • Elevation and rest: Elevate the wrist with a pillow to improve symptoms. Anytime you feel pain or fatigue in your wrist, take a break to rest or switch to another activity that doesn’t put a strain on your wrist.
  • Cold therapy: Apply ice in a towel or a bag of frozen vegetables to your wrist for 10 minutes at a time, several times a day. You can also try a contrast bath where you soak the wrist in cold water for a minute and then in warm water for another minute. Alternate five times and repeat as needed.
  • Take Tylenol (acetaminophen) for pain: Tylenol is generally safe to take during pregnancy. However, do not exceed the recommended daily dosing limits. Avoid products that contain ibuprofen (Advil) during pregnancy unless your doctor has approved the use. Ibuprofen has been linked to dangerous effects during pregnancy.
  • Physical therapy: Research shows that a large percentage of people with CTS can benefit from physiotherapy rehabilitation programs. Notably, these programs can help restore hand function.
  • Practice yoga: Research shows yoga can offer significant changes in strength and decrease CTS pain, sometimes even better than splinting. More research is needed to better understand the benefits of yoga for CTS in pregnancy.

When To Call Your Doctor

Long-term nerve compression can cause damage that might become permanent. You should reach out to your doctor if you experience pain and numbness that lasts for days or affects your sleep or the ability to use your hands.

While it is known that CTS is common in pregnancy and the result of swelling and fluid retention during pregnancy, you should always seek help for severe pain and symptoms in your hands and wrists.

Swelling is also a common sign of preeclampsia, a pregnancy complication that causes dangerously high blood pressure. Much like carpal tunnel syndrome, preeclampsia also causes tingling and numbness of the hands.

Summary

Carpal tunnel syndrome is common during pregnancy. It is caused by swelling that compresses a nerve to the hand. Symptoms include weakness, numbness, and tingling near the base of the thumb. During pregnancy, it is treated conservatively. For most people, it resolves weeks to months after giving birth.

A Word From Verywell

Even if your doctor has diagnosed your symptoms as CTS, it is wise to keep an eye out for symptoms of preeclampsia during pregnancy. Symptoms of preeclampsia include severe headaches, vision changes (blurred or double visions), sudden weight gain unrelated to diet, dark urine, and swelling (edema) of the legs, hands, face, or entire body.

Preeclampsia can become severe and dangerous to the mother and baby leading to eclampsia, which is associated with seizures and stroke. Reach out to your doctor or go to an emergency room if you think you are experiencing signs of preeclampsia.

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11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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