Managing Carpal Tunnel Syndrome during pregnancy

What is Carpal Tunnel Syndrome?

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 is a common condition that causes a tingling sensation, numbness and sometimes pain in the hand and fingers.

Why does pregnancy cause Carpal Tunnel Syndrome?

During pregnancy hormones cause you to retain fluid, they also 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 like pins and needles, numbness and stiff, painful hands.

Most symptoms will resolve within 3 weeks to 3 months following delivery of your baby.

Symptoms of Carpal Tunnel Syndrome

• Pins and needles
• Numbness
• Burning in the hand affecting the thumb, index, middle or ring fingers.
• Radiating pain from your hand as far as your shoulder.
• Pain, often worse at night or first thing in the morning.
• Weakness in your hand and forearm, making it harder to grip objects.
• Sharp pains in the wrist.
• Hands may be hot, swollen and sweaty.

Reducing symptoms

• Reduce or avoid positions that make your symptoms worse (such as ironing and driving).
• Reduce or avoid repetitive tasks (such as typing or writing).
• Reduce heavy lifting.
• Elevate your arms with pillows when resting to help reduce any swelling.
• Keep your wrist in a neutral (straight) position as this is when the pressure in the carpal tunnel is at its lowest.
• Avoid placing hands in hot water as this will increase any swelling.
• Speak to your GP or pharmacist about medication that may help the pain but is safe to take during pregnancy.

Wrist extension stretch  

This stretch should be done throughout the day, before and after activity as needed.  

Directions  

1. Straighten your arm and bend your wrist back as if signaling  
   to “stop”.
2.  Use your opposite hand to gently apply pressure across the palm and pull it toward you until you feel a stretch on the inside of your forearm.
3. Hold the stretch for 15 seconds.
4. Repeat 5 times and perform on the other side. 
5. Do not lock your elbow. 

Repetitions: 5 reps, 4 times a day  

Days per week: 5-7  

Wrist flexion stretch  

Doing this stretch throughout the day is recommended, particularly prior to engaging in any activity. Please be aware that your fingers may become numb for a short while after doing this stretch. If the numbness becomes bothersome, stop the stretch. 

Directions  

1. Straighten your arm out in front of you with your palm facing down and bend your wrist so that your fingers point down to the ground. 
2. Use your opposite hand to
3. Hold the stretch for 15 seconds. 
4. Repeat 5 times and perform on the other side.
5. Try to not lock your elbow. 

Repetitions: 5 reps, 4 times a day 

Days per week: 5 to 7 

Ball squeezes

Performing hand exercises with a ball can help improve muscle strength, balance, and blood flow in the hand, wrist, and elbow. These exercises help by promoting better circulation and reducing swelling around the median nerve.  

1. Hold a soft exercise ball or rolled towel in your palm. 
2. Squeeze the ball/towel as hard as you can without causing pain.
3. Hold the squeeze for 3-5 seconds, then slowly release. 

Repetitions: 8 reps, 3 times  

Days per week: 2 times per week.  

Median Nerve Glide 

Nerve gliding exercises can help reduce Carpal Tunnel Syndrome (CTS) symptoms by improving movement of the median nerve, reducing pressure inside the carpal tunnel. These exercises: 

1. Reduce swelling and improve blood flow. 
2. Enhance nerve function by increasing oxygen and nutrient supply.
3. Relieve pain caused by nerve compression. 

Regular practice of these exercises can help manage Carpal Tunnel Syndrome (CTS) symptoms and promote hand mobility. 

Directions  

1. Lift arm up to the side so that your wrist is in line with your shoulder with your palm facing up. 
2. Place your other hand onto your shoulder and apply some gentle pressure.
3. Extend your hand back so your fingers are pointing to the ground.
4. Bring your ear to your shoulder on the side that’s affected.
5. Flex your hand up so your fingers are pointing to the sky and at the same time take your other ear to your other shoulder.
6. Complete sequence 3-5, 10-15 times and symptoms should ease off the more you do it. 
7. To create a stretch along the nerve, point your fingers down to the ground again and this time take your ear on the opposite side down the shoulder (as shown in image 6).

Splinting  

Purchasing and wearing a wrist splint can help relieve Carpal Tunnel Syndrome (CTS) by keeping the wrist in a neutral position, which results in reducing pressure on the median nerve. This helps: 

1. Prevent wrist bending, which can worsen symptoms. 
2. Reduce numbness, tingling, and pain, especially at night.
3. Support the wrist during daily activities to prevent strain. 

For best results, wear the splint at night and during activities that  
trigger symptoms. 

When using a splint for carpal tunnel syndrome you will have to flatten the metal bar of the splint. 

Flatten the splint by placing the splint on the edge of a table and gently push the end down so that it is flat.  

You can order wrist splints online or from a Pharmacy/Chemist.  
Please check with your local branch. 

You can also order from the following companies.  
Other stockists and suppliers are available. 

Promedics Phone 01475 746410. Order online: http://www.promedics.co.uk  

Performance Health Phone 08444 124 331. Order online: http://performancehealth.co.uk

Massage  

Gentle massage of the fingertips, hand, and wrist can help reduce swelling, improve circulation, and relieve muscle tension. Massage promotes fluid drainage, reducing pressure on the median nerve, while also relaxing tight muscles and encouraging better movement. Simple techniques like gentle upward strokes, circular motions on the palm and wrist, can provide pain relief and improve hand function.  

Directions 

1. Elevate your forearm.
2. Using large sweeping strokes massage the palm of the hand and forearm towards the elbow.
3. Do this for 30 seconds.
4. Never stroke towards the fingertips.

What to expect after pregnancy?

 Most symptoms will resolve within 3 weeks to 3 months following delivery of your baby. If, however, symptoms continue after delivery please contact your GP for further help and guidance.