When most people think of aches and pains associated with pregnancy, they likely think morning sickness, backaches and sore feet. Issues with the hands and wrists would probably not even make the list. That is, unless you are among the hundreds of thousands of pregnant women each year who experience these problems.
Hand and wrist specialists, including myself, see and treat these issues regularly in pregnant patients who seek our care. Unfortunately, there are likely many more women who never seek care because they are either unaware that there are safe (and relatively easy) treatment options or believe they should just “tough it out.” Here are three common issues I see in pregnant women and new moms — and what you can do about them.
Carpal tunnel syndrome
Carpal tunnel syndrome (CTS) during pregnancy is due to natural hormonal changes and fluid shifts that impact the nerve and tendons within the carpal tunnel during pregnancy. Some studies suggest as many as 35 percent of pregnant patients experience this issue. It usually goes away after giving birth but not always.
- Symptoms: Numbness and tingling in the thumb, index, middle and ring finger, especially if these symptoms are worse at night.
- Home remedies: Be careful with posture by keeping the wrist in a neutral position. This position decreases the pressure in the carpal tunnel. Over-the-counter night-time splints can keep the wrist in a neutral position while sleeping.
- When to seek care: Numbness that seems to deepen. Any symptom causing serious, ongoing discomfort.
- Available treatment: Nighttime splinting and injections can relieve symptoms through pregnancy for most cases. For more serious cases, a carpal tunnel release procedure performed under local anesthesia can minimize downtime.
The physiological changes that occur during pregnancy can also contribute to changes in the tendons that bend the fingers and thumb and their associated system of pulleys. While trigger digits can go away after delivery, women remain at higher general risk than men of this painful condition.
- Symptoms: Fingers that snap, pop, catch or generally are not working well, with these symptoms often reported as worse in the morning.
- Home remedies: Rest and over-the-counter pain medication may temporarily control symptoms, but there are limited options for long-term relief at home.
- When to seek care: Finger becomes overly stiff or discomfort begins to interfere with daily activities.
- Available treatment: One steroid injection will completely relieve symptoms for 70 percent of patients. For persistent symptoms, additional injections or a minor procedure performed under local anesthesia can provide reliable and lasting resolution of this problem.
While this painful condition of the wrist and forearm can occur during pregnancy, I see it a lot more often after delivery, especially in new moms and even grandparents who provide childcare. It is considered an overuse injury that occurs when the tendon lining becomes inflamed, often related to childcare activities. This condition has received considerable attention on popular parenting blogs and social media where it is often referred to as “Mom Wrist.”
- Symptoms: Pain radiating from the base of the thumb to the back of the forearm.
- Home remedies: Avoid reaching up and grasping objects with the forearm in a neutral position (hand perpendicular to the floor). Instead grab with the palm up or down. An over-the-counter brace also may help.
- When to seek care: If it is causing ongoing discomfort or is impacting ability to carry out daily tasks.
- Available treatment: Most patients can be successfully treated with a steroid injection. Occupational or physical therapy also can help. In rare cases, minor surgery may be needed.
Recognizing symptoms and finding relief for hand and wrist issues during and after pregnancy are essential not only for the health of women suffering, but for the families who rely on them. If you’re experiencing hand and wrist pain, find a doctor who can help.
About the author
Christopher Casstevens, MD, is an orthopedic surgeon specializing in surgery of the hand and upper extremities. He sees patients at Baylor Scott & White clinics in north and south Austin as well as Lakeway. He enjoys using a broad array of techniques to address injuries and conditions affecting the detailed anatomy of the hand and wrist.