The physiological changes of pregnancy or the demands associated with being a mum may take a toll on you and may lead to conditions like hand or wrist pain. This discomfort can be debilitating and significantly impact your ability to perform even the simplest tasks. We frequently encounter women, both during pregnancy and postpartum, experiencing the following issues:
- Pregnancy-related carpal tunnel syndrome (CTS)
- Postpartum CTS
- De Quervain’s Tenosynovitis
Let’s take a more detailed look at each of these!
PREGNANCY-RELATED (CTS)
Carpal tunnel syndrome during pregnancy develops with symptoms in the palm, thumb, index, and middle fingers, with occasional extension to the ring finger but rarely affecting the pinky. It can occur in one or both hands.
While CTS may start early in your pregnancy, it is most common and often more severe during the final trimester. This severity is attributed to increased blood volume, which is important for supporting your baby’s growth. At the same time, blood vessels become more compliant or softer, leading to fluid retention in the hands (and feet), and compressing the median nerve. This compression is particularly noticeable at night, causing sensations of numbness, tingling, and/or pain. The good news is that this discomfort typically resolves in the days to weeks following delivery as fluid retention diminishes.
POSTPARTUM CTS
Postpartum CTS differs from having it during pregnancy, as it is not primarily caused by fluid retention. Instead, it results from prolonged or sustained positions of the wrist and hand, often associated with activities like feeding or carrying the baby. The discomfort arises when the bent wrist position aggravates the median nerve, leading to symptoms similar to those experienced during pregnancy-related CTS.
DE QUERVAIN’S TENOSYNOVITIS?
De Quervain’s is distinct from CTS, primarily affecting the thumb side of the wrist. This painful condition typically starts in the postnatal period, when there are increased repetitive activities like lifting the baby, leading to inflammation in the tendons at the side of the wrist. Activities such as lifting or holding objects can be particularly aggravating, accompanied by possible stiffness and swelling.
HOW CAN A WOMEN’S HEALTH PHYSIOTHERAPIST HELP ME WITH MANAGING MY CARPAL TUNNEL OR DE QUERVAIN’S SYMPTOMS?
Depending on the diagnosis, a women’s health physiotherapist can provide treatment, which may involve:
- Changing your feeding, and carrying positions
- Applying ice
- Manual therapy
- Splints to maintain a neutral hand or wrist position and allow tendons to rest and heal
- Lymphatic drainage
- Range of motion and eccentric loading exercises
- Activity modification
Regardless of the diagnosis, timely intervention is important to prevent difficulties with everyday fine motor tasks like typing, pushing a stroller, holding the baby, changing clothes, and turning a key, among others. In severe cases, untreated symptoms may lead to difficulty holding objects, increasing the risk of dropping your baby. Note that not all hand or wrist conditions during pregnancy and postpartum are CTS or De Quervain’s tenosynovitis. It is very important to have an accurate assessment by a women’s health physiotherapist to determine what is going on.
Wrist and hand symptoms in pregnancy or after birth are common and treatable.
Note: While I am a physiotherapist, I am not your personal physiotherapist. The contents of this website are for informational purposes only and are not intended to serve as personal medical advice.
References
- https://www.thewomens.org.au/images/uploads/fact-sheets/Pregnancy-related-carpal-tunnel-210319.pdf
- https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/diagnosis-treatment/drc-20355608
- https://www.embracephysio.sg/why-do-my-wrists-hurt-after-giving-birth/#contenthttps://orthoinfo.aaos.org/en/diseases–conditions/de-quervains-tendinosis/
- https://cityphysiotherapy.com.au/carpal-tunnel-post-pregnancy/
