What is carpal tunnel syndrome?

Carpal tunnel syndrome is the name given to a condition that causes pain, tingling and stiffness in your wrist, fingers and thumb.

Carpal tunnel syndrome is a disorder of your hand. It happens when there is pressure on your median nerve where it runs through the 'carpal tunnel' in your wrist. Your carpal tunnel is a narrow passageway with just enough room for your tendons and nerves to pass through.

Carpal tunnel syndrome is common in pregnancy. Up to 1 in 2 pregnant women develop carpal tunnel syndrome.

What are the symptoms of carpal tunnel syndrome?

Common symptoms of carpal tunnel syndrome are:

• pins and needles in your hand
• pain or numbness in your hand
• weakness of your hand
• burning sensation in the fingers
• darting pain from your wrist
• pain spreading to your arm or shoulder

The parts of your hand that are most affected are your thumb, index finger and middle finger. It may affect one or both of your wrists. Your symptoms may be worse at night or early in the morning.

What causes carpal tunnel syndrome?

While pregnancy is one cause, other common causes of carpal tunnel syndrome are:

• arthritis in your wrist
• wrist fracture
• overuse of your wrist and repetitive hand movements
• diabetes

How does pregnancy cause carpal tunnel syndrome?

When you are pregnant, your hormones can cause fluid to build up in your body. Hormones also soften your ligaments, including the ligament that forms the roof of your carpal tunnel.

When there is swelling in your wrist, your median nerve can become squashed in your carpal tunnel.

Carpal tunnel syndrome is more common in the second and third trimesters of pregnancy. Symptoms often come back in future pregnancies and around the time of menopause.

In most cases, carpal tunnel syndrome during pregnancy gets better within 4 weeks of your baby being born.

When should I see my doctor?

If you have symptoms of carpal tunnel syndrome, see your doctor or midwife.

Getting treatment early helps ensure this condition is managed well and you can prepare for the birth of your baby.

How is carpal tunnel syndrome diagnosed?

Your doctor will ask about your symptoms and examine your wrist and hand. They may also look at other parts of your body, such as your neck.

You may have a nerve conduction test to see how quickly the median nerve passes messages through the carpal tunnel.

Your doctor may also request other tests, such as blood tests, to rule out other conditions.

How is carpal tunnel syndrome treated?

Treatment will aim to relieve your symptoms.

Self-care at home

You may find that your pain is reduced by avoiding certain positions and activities.

Try to:

• elevate your hands when you can
• keep your wrist in a neutral position — avoid bending it forwards or backwards
• avoid repetitive tasks
• avoid heavy lifting
• avoid sleeping with your wrist bent under your chin or sheets
• sleep on the side of your less affected hand

If you work on a computer:

• keep good wrist and arm posture
• take frequent breaks, every 20 minutes

Other things you can try are:

• applying ice (wrapped in a tea-towel) to your wrist for 20 to 30 minutes every 2 to 3 hours
• running cold water over your wrist
• wearing a compression bandage
• performing regular fluid drainage massage and gentle exercises

Fluid drainage massage encourages fluid movement towards your heart. It can help to reduce the swelling in your hand. You can do this by raising your arm up. Using your other hand, stroke from your fingertips towards your shoulder. Never stroke the other way.

Other treatment options

Your doctor may suggest that you see a physiotherapist or occupational therapist. They may give you a brace or split to wear at night or during the day. This helps to keep your wrist in a neutral position. A splint is one of the best ways to relieve your symptoms, especially when worn overnight.

They will also give you advice on changing your activities and exercise.

You doctor may arrange a corticosteroid injection to help with any pain.

If your symptoms do not get better after your baby is born, your doctor may talk with you about carpal tunnel release surgery.

There is no evidence that magnets, laser acupuncture or chiropractic treatment have any benefit.

Can carpal tunnel syndrome in pregnancy be prevented?

You can try to prevent carpal tunnel syndrome by:

• changing position often
• swapping repetitive tasks as often as possible
• getting ergonomic advice
• using an appropriate work station
• exercising and keeping fit