by Jodie Isle | Merakai Massage
With the increased fluid and changes to your body posture most women experience new aches and pains during pregnancy. Some women will develop pain in their wrist(s), which may radiate down to their thumb/fingers and be accompanied by numbness, or pins and needles. If you are experiencing this you may* have symptoms of Carpal Tunnel Syndrome.
What is the Carpal Tunnel?
The Carpal Tunnel is a narrow passageway on the palm side of your wrist made up of bones and ligaments. The tunnel has a fibrous band arching over your bones, called the Flexor Retinaculim. The median nerve, which controls sensation and movement in your wrist, runs through this passageway, or ‘tunnel’, along with blood vessels and tendons to the fingers and thumb.
What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome is a painful condition of the hand caused by pressure to your Median Nerve. Symptoms begin when the pressure in the tunnel becomes too high, resulting in the median nerve being compressed. It will be compressed because the space becomes restricted; or because the nerve, blood vessels and tendons enlarge within the space.
What are the symptoms?
Quite often the pain is worse at night, and the strength of your grip will weaken as the condition progresses. Typically, you may experience pain in the thumb, index and middle fingers and the associated path in the palm to the wrist from these fingers.
You may experience the following symptoms:
- Hand pain or aching
- Pins and needles to your hand and fingers
- Numbness
- Burning sensation
- Weakness or cramping to wrist and fingers
- Swelling
Can I only get this during Pregnancy?
No. Carpal Tunnel Syndrome may be experienced by men or women of any age. There may an increased chance during pregnancy due to the nature of the increased fluid and pressure to the passageway.
What causes Carpal Tunnel Syndrome?
You may experience Carpal Tunnel Syndrome due to a number of reasons such as long term, or high strain to the arms, hands or wrist; repetitive movements; arthritis; Pregnancy or any condition which causes increased fluid to occur in the body.
Is this pain always from Carpal Tunnel Syndrome?
No. The symptoms are not always Carpal Tunnel Syndrome, so you should not be quick to self-diagnose this condition. The Median nerve originates from your neck, and runs down the bicep side of your arm to your thumb/fingers as mentioned above. Symptoms similar to Carpal Tunnel Syndrome may occur where the nerve is compressed along its path. Most often the compression occurs in your neck.
Why is it worse during pregnancy?
Approximately 30-50% of women may experience Carpal Tunnel Syndrome during their pregnancy. During pregnancy the hormones cause retention of fluid, and the hormone relaxin causes softening of the ligaments that form the root of the tunnel. When this happens, the median nerve is ‘squashed’.
Postural changes during pregnancy where your shoulders rotate forward and your head is sitting forward may also cause compression where the median nerve originates.
What can you do to manage the symptoms?
- Avoid any positions or activities that make the symptoms worse
- Avoid heavy lifting
- Avoid repetitive tasks
- Elevate hand, or hands.
- Sit on chairs with arm rests that enable you to keep your wrist(s) flat and elevated
- Avoid sleeping on the side of the most affected hand
- Try to keep your wrist in a neutral position
- Avoid movements that cause full extension or flexion of your wrist
- Apply ice (wrapped in a cloth) over wrist for 10-15 min every couple of hours
- Wear a compression bandage
- Wear a wrist splint or brace, especially at night, to keep your wrist straight
- Perform regular fluid drainage massage and gentle exercises as directed by your physiotherapist
Will it go away when I have had my baby?
Quite often once the increased fluid reduces, and the ligaments are not as soft the pain will ease. However, a number of women may continue to have Carpal Tunnel Syndrome postnatally, or some who have had no pain during their pregnancy may develop symptoms postnatally. This is often due to combination of oedema still being present, poor biomechanics of holding the baby, or your hand position whilst feeding.
Exercises, stretches and tips to prevent CTS
During pregnancy try raising your arms above heart level a few times a day to encourage excess fluid to pump back through the lymphatic system. Massage, physiotherapy and exercises can all assist during pregnancy. Postnatally try to keep your wrist and fingers in line with your forearm when lifting your baby. Avoid letting your wrist flex forward or to the side when lifting your baby or small child.
Acupuncture may also assist in alleviating the symptoms and pain.
NECK RETRACTION …
I talk a lot about this with my clients. A lot of clients come in with a “protruded chin” (i.e. their chins/head poke forward like a chicken), mainly due to posture. Try to tuck your chin in and down to lengthen your neck, hold this position for a count of ten.’
Common posture of protruded chin
Tuck chin in and down to stretch your neck
CHICKEN STRETCH …
Tuck your chin in, lengthening out your neck, then with your elbows bent and wrists straight, open up your chest (like you are holding onto a doorway). Hold for a count of 10.
“REVERSE” CHICKEN STRETCH …
This is the same position as the chicken stretch but tilt your head to the ceiling and hold for a count of 10.
MEDIAN NERVE GLIDE …
Sit on a fitball or chair with your back straight, raise both arms to shoulder level with palms facing forward. The hands are extended backwards as far as possible and released. Repeat 10 times.
RADIAL NERVE GLIDE …
Sit on a fitball or chair with your back straight, raise both arms to shoulder level with palms now facing backwards. Grasp your fingers around both thumbs to form a fist. Flex the wrist back and forth 10 times.
ULNAR NERVE GLIDE …
Remember making those “finger” glasses as a child? Make the ok sign with thumbs and index finger. Now flip the OK sign upside down so your fingers rest on your cheeks and ok circles are placed over your eyes. Push elbows as far back as possible. Hold for a count of ten.
Proper Assessment *
If you are experiencing symptoms of Carpal Tunnel Syndrome you should be assessed properly by your Physiotherapist, Osteopath or Chiropractor and ensure you perform the correct exercises under their guidance. See our Useful Links page to find specialists we recommend.
INFORMATION SOURCES
Prenatal Massage, Elaine Sillerman. New York: Mosby Elsevier 2008
Pregnancy and Childbirth, Suzanne Yates. Sydney: Churchill Livingstone Elsevier, 2013
Pregnancy Massage Australia – NurtureLife® Practitioner training