Carpal tunnel syndrome in pregnancy

Nerve pathways run throughout our body, sending a wide variety of signals from the peripheral nervous system, such as the arms and legs, to the central nervous system, the brain and spinal cord. As a result, peripheral nerve cells connected to muscles receive an impulse from the brain to perform a movement. There are numerous anatomical constrictions in our body in which the nerve tracts only have limited space. If additional pressure develops at these points, a loss of function or discomfort can be the result. The most common nerve compression that occurs during pregnancy is carpal tunnel syndrome.

The median nerve (middle nerve) in the hand area is damaged. It runs through the wrist through a narrow tunnel bounded by tight ligaments, the carpal tunnel. The median nerve is responsible for perceiving sensations from the thumb, index, and middle finger. In addition, it controls certain hand and finger muscles.

Symptoms of Carpal Tunnel Syndrome

The carpal tunnel syndrome is therefore primarily expressed by a tingling and numbness in the area from the thumb to the middle finger. These symptoms can only appear for a short time at first, they usually disappear as soon as the hand is shaken out or gently massaged. This occurs particularly at night, since the hand has less blood flow due to an angled position, for example. If the carpal tunnel syndrome is advanced, the symptoms remain permanent. They express themselves through pain in the fingers and in the palms of the hands, which mainly occur when gripping. If the nerve is severely attacked, the muscle strength of the thumb can decrease, a so-called muscular atrophy. This can even be seen from the outside, as the ball of the thumb is significantly smaller compared to the other hand.

Carpal tunnel syndrome in pregnancy

Carpal tunnel syndrome is caused during pregnancy by water retention in the arms and hands or by excessive weight gain. This compresses the median nerve between the carpal bones and the overlying carpal ligament.

Other causes of carpal tunnel syndrome

In addition, there are other causes that contribute to the development of carpal tunnel syndrome:

• family history and congenital bottleneck
• disc prolapse
• vertebral injury
• whiplash
• tendonitis
• Fractures of the carpal bones and associated changed bony structures
• Osteoarthritis in the wrist
• rheumatic diseases

Diagnosis of carpal tunnel syndrome

Based on the symptoms mentioned and the individual medical history, carpal tunnel syndrome can usually be diagnosed very quickly by a doctor. Since carpal tunnel syndrome is nerve compression, a neurologist should be consulted. To confirm the suspicion, the neurologist performs mobility tests and checks for sensory disturbances. To do this, the wrist is bent sharply in order to specifically trigger any numbness or tingling. The nerve conduction velocity is also measured for a reliable diagnosis. If the speed is reduced, this is taken as a clear indication of carpal tunnel syndrome.

In the case of diseases in the wrist area, further examinations may be necessary. These include, for example, an X-ray examination for arthrosis and an ultrasound examination for tendonitis.

Therapy of carpal tunnel syndrome

In general, if you have carpal tunnel syndrome caused by pregnancy, you can assume that the symptoms will go away on their own within a few weeks or months after the baby is born. Treatment of carpal tunnel syndrome is only necessary if the symptoms are persistent.

There are these therapeutic approaches:

• Splint: In a first step, a splint for the night can have a pain-relieving effect. This reduces the pressure on the carpal tunnel. Tapes that stabilize the wrist are suitable for the night.
• Cortisone injections: Cortisone injections can also be helpful.
• Surgery: An operation is only considered if these measures do not help or if the symptoms are too severe. In this procedure, the ligaments of the wrist, which form the cover of the carpal tunnel, so to speak, are divided in order to give the nerve more space. The operation is uncomplicated and can be performed on an outpatient basis. As a rule, no complications are to be expected. However, the usual symptoms associated with surgical interventions such as infections, postoperative bleeding or swelling can occur. After the operation, the hand should not be weight-bearing for six weeks. Depending on your professional activity, you can assume that you will be on sick leave for at least three weeks.
• Physiotherapy: An alternative to surgery for carpal tunnel syndrome is physiotherapy treatment combined with exercises that can be performed on a daily basis. However, physiotherapeutic treatment must also be carried out after the operation in order to promote the mobility of fingers and hands. The exercises should be carried out for several weeks.