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New Mum, But Feeling Numb: Postnatal Carpal Tunnel Syndrome

Wrist pain affecting new mothers can be painful and debilitating. About 34% of pregnant women start experiencing wrist pain during their last trimester of pregnancy. While the severity of symptoms generally decreases after delivery, according to the current literature, 4% to 54% of women with symptoms during pregnancy report ongoing symptoms at one year postpartum (Meems et al 2017). Furthermore, many women report onset and exacerbation of symptoms after delivery, due to the demanding and repetitive nature of caring for and feeding a baby. Pain that occurs in the wrist and hand after delivery is commonly known as ‘baby wrist’ or ‘mum thumb’.

WHAT IS CARPAL TUNNEL SYNDROME AND DE QUERVAIN’S TENOSYNOVITIS?

The carpal tunnel is a small passage in the wrist where nerves and tendons pass from your arm into your hand and fingers. Having carpal tunnel syndrome (CTS) means having a musculoskeletal disorder that causes compression of the median nerve travelling through the carpal tunnel. During pregnancy and after delivery, hormones cause you to retain fluid and soften the ligament that forms the roof of the tunnel. When this happens, the nerve running through the tunnel may become squashed, causing pain and numbness.

On the other hand, De Quervain’s tenosynovitis is another musculoskeletal disorder, causing pain in the wrist and hand from inflammation of the tendons that are in charge of the movements of the thumb and wrist. The repetitive movements of caring for a baby can cause friction between the structures in the wrist leading to inflammation of the tendons, causing pain.

Symptoms of CTS and De Quervain’s have been found to be worse in women who are breastfeeding (Cherni et al 2019).

WHAT ARE THE SYMPTOMS OF CTS OR DE QUERVAIN’S SYNDROME?

  • Difficulty with tasks such as lifting or feeding your baby, brushing your hair, or doing up your bra
  • Pain at the base of the thumb—extending towards the wrist
  • Pins, needles, or numbness of the wrist, hands, or fingers
  • Pain, which may also be worse at night
  • Weakness
  • Burning sensations in the fingers
  • Sharp darting pains from the wrist
  • Radiating pain in the arm and shoulder

WHEN SHOULD I SEE A WOMEN’S HEALTH PHYSIOTHERAPIST?

It can be helpful to see a women’s health physiotherapist early for this condition, to manage it and prevent your symptoms from progressing. Your women’s health physiotherapist can advise if you need to be referred to your GP or specialist.

HOW CAN MY WOMEN’S HEALTH PHYSIOTHERAPIST HELP?

They will advise you on feeding and lifting positions, and provide treatment to reduce pain and increase the functional strength of your wrist. Each course of treatment depends on the nature, duration, and severity of the symptoms and diagnosis. Treatment might include manual therapy for pain relief, wrist splinting, and wrist stabilisation exercises, as well as advice and education. In some cases, referral for a cortisone injection may be recommended.

WHAT CAN I DO TO MANAGE MY SYMPTOMS?

  • Minimise positions or activities that may make your symptoms worse. Don’t hesitate to ask for assistance with non-essential tasks.
  • Reduce repetitive tasks and heavy lifting whenever possible. Delegate responsibilities when you can.
  • Maintain a neutral (straight) position for your wrist, particularly during repetitive activities like feeding.
  • Avoid prolonged positions of full flexion and extension, especially when holding or feeding your baby for extended periods.
  • Apply ice to your wrist for 20-30 minutes every two to three hours, or run your hand under cold water, to soothe your pain.
  • Consult with your doctor to explore the possibility of anti-inflammatory medication in severe cases.
  • Wear a compression band or wrist splint, especially at night, to keep your wrist in a neutral position.
  • Incorporate regular fluid drainage massage and gentle wrist mobility exercises into your routine.

It’s important to remember that not all hand or wrist conditions during pregnancy and postpartum are carpal tunnel syndrome or De Quervain’s tenosynovitis. It’s best to be sure by seeking a professional.

If you are struggling with your day-to-day tasks due to hand and wrist pain, reach out, we can help you! Please call or WhatsApp us at 9780 7274, or email us at help@embracephysio.sg to discuss the treatment you need.

Feel free to look through our website, where you can learn about other women’s health conditions we treat. This is a safe space where we can discuss how we can help you with physiotherapy.

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 individual medical advice.

References

  1. Meems M, Truijens SEM, Spek V, Visser LH, Pop VJM. Follow-up of pregnancy-related carpal tunnel syndrome symptoms at 12 months postpartum: A prospective study. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2017;211:231-2.
  2. Cherni Y, Desseauve D, Decatoire A, Veit-Rubinc N, Begon M, Pierre F, et al. Evaluation of ligament laxity during pregnancy. Journal of gynecology obstetrics and human reproduction. 2019;48(5):351-7.
  3. https://www.embracephysio.sg/how-to-deal-with-carpal-tunnel-syndrome-in-pregnancy-and-postpartum/
  4. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/diagnosis-treatment/drc-20355608
  5. https://www.thewomens.org.au/images/uploads/fact-sheets/Pregnancy-related-carpal-tunnel-210319.pdf
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