Wrist pain affecting new mothers can be painful and debilitating.
About 34% of pregnant women experience wrist pain during the last trimester of pregnancy. While severity of symptoms generally decrease 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/ DE QUERVAIN’S TENOSYNOVITIS?
WHAT IS CARPAL TUNNEL SYNDROME/ 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.
Carpal Tunnel Syndrome (CTS) is musculoskeletal disorder which causes compression of the median nerve which travels 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 which can cause symptoms of pain and numbness.
De Quervain’s Tenosynovitis is another musculoskeletal disorder, causing pain in the wrist and hand due to an inflammation of the tendons help with 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 breast-feeding (Cherni et al 2019).
WHAT ARE THE SYMPTOMS OF CARPAL TUNNEL 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 (all or part of)
- Pain, may be worse at night
- Weakness
- Burning sensations in the fingers
- Sharp darting pains from the wrist
- Radiating pain into the arm and shoulder
WHEN TO SEE A WOMEN’S HEALTH PHYSIOTHERAPIST?
It can be helpful to see a Women’s Health Physiotherapist early for this condition, to manage it early and to prevent your symptoms from progressing. Your Women’s Health Physio can advise if you then need to be referred on to your GP or specialist.
HOW CAN MY WOMEN’S HEALTH PHYSIOTHERAPIST HELP?
Your Women’s Health Physiotherapist will advise you on feeding and lifting positions and provide treatment to reduce pain and increase functional strength of the 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.
WHAT CAN I DO TO MANAGE MY SYMPTOMS?
- Minimise positions or activities that make your symptoms worse. (Caring for a newborn can be hard, but asking for help when it’s not essential for you to do things can be beneficial)
- Minimise repetitive tasks and heavy lifting (outsource when you can)
- Keep your wrist in a neutral (straight) position as much as possible while doing repetitive tasks eg feeding.
- Minimise prolonged positions of full flexion and extension especially when feeding or holding your baby for prolonged periods.
- Ice ice baby…(wrapped in a tea-towel) over your wrist for 20-30 minutes every 2-3 hours or run your hand under cold water for pain relief.
- In conjunction with your doctor a course of anti-inflammatories maybe required in severe circumstances
- Wear a compression band or a wrist splint, especially at night, to keep your wrist neutral.
- Perform regular fluid drainage massage and gentle wrist mobility exercises.
Note that not all hand/wrist conditions during pregnancy and postpartum are Carpal Tunnel Syndrome or De Quervain’s Tenosynovitis.
If you are struggling with your day to day due to your hand and wrist symptoms, reach out, things can get better. Call/WhatsApp on 9780 7274 or get in touch over email to 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.
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.
