Whether you are pregnant or a new mum, both, the physiological changes of pregnancy and the demands associated with caring for a baby may result in hand or wrist pain. This can often be debilitating and severely compromise your ability to perform the simplest of tasks. As a Women’s Health Physiotherapist, I commonly see women pre and postnatal, suffering from the following:
- Pregnancy related Carpal Tunnel Syndrome (CTS)
- Postpartum CTS
- De Quervain’s Tenosynovitis
Let’s elaborate on these…
WHAT IS CARPAL TUNNEL SYNDROME IN PREGNANCY?
Symptoms of Carpal Tunnel Syndrome commonly occur in the palm, thumb, index and middle fingers. Sometimes this may extend to the ring finger but seldom to the pinky. It can occur in one or both hands.
Whilst Carpal Tunnel Syndrome can commence early in pregnancy, it is most common and usually most severe in the final trimester as your blood volume increases to support the growth of your baby. At the same time, blood vessels become more compliant (softer) and this combination will often lead to fluid retention in the hands (and feet) which can cause compression of the median nerve. This compression is worse at night and will present as either a numbness, tingling and/or pain sensation. Don’t worry, your hand may feel like it will fall off, but it won’t!
This usually resolves itself in the days-week after delivery as the fluid retention subsides.
WHAT IS POSTPARTUM CARPAL TUNNEL SYNDROME?
Unlike pregnancy Carpal Tunnel Syndrome, postpartum Carpal Tunnel Syndrome does not occur due to fluid retention, but rather due to the placing of the wrist/hand in prolonged/sustained positions such as when feeding or carrying your baby. A bent wrist position can aggravate the median nerve giving rise to symptoms similar to those experienced during Carpal Tunnel Syndrome in pregnancy.
WHAT IS DE QUERVAIN’S TENOSYNOVITIS?
De Quervain’s is slightly different from Carpal Tunnel Syndrome. It is a painful condition that affects the thumb side of the wrist. It commonly arises in the postnatal period where there is an increase in repetitive activities such as lifting your baby, causing inflammation in the tendons at the side of your wrist. Tasks such as lifting or holding objects are most aggravating and there may be some stiffness and/or swelling to go with.
HOW CAN A WOMEN’S HEALTH PHYSIOTHERAPIST HELP ME WITH MANAGING MY CARPAL TUNNEL OR DE QUERVAIN’S SYMPTOMS?
Depending on the diagnosis, treatment may include some of the following:
- changing feeding and carrying positions
- Applying ice
- Manual therapy
- Splints to maintain a neutral hand/wrist position and also to give the tendons an opportunity to rest and heal
- Lymphatic drainage
- Range of motion and eccentric loading exercises
- Activity modification
Whatever the diagnosis, if left untreated, you may experience difficulty with fine motor tasks such as typing, pushing the stroller, holding the baby or changing its clothes, turning a key, etc. In severe cases, the numbness associated with CTS can also cause you to have difficulty holding objects, which can increase the risk of dropping your baby.
Note that not all hand/wrist conditions during pregnancy and postpartum are Carpal Tunnel Syndrome 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.
If you would like to discuss De Quervain’s Tenosynovitis or Carpal Tunnel Syndrome in pregnancy or postpartum, call/WhatsApp on 9780 7274 or get in touch over email. Make a booking for an accurate diagnosis and individualised treatment.
You can also visit our website to learn about other women’s conditions we treat through physiotherapy and how we can help you.
