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Carpal Tunnel Syndrome During Pregnancy
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Carpal Tunnel Syndrome During Pregnancy: Tips & Tricks to Ease the Pain

International Journal of Childbirth Education, March 2010

by Heather Jeffcoat, DPT

Carpal Tunnel Syndrome (CTS) during pregnancy is a commonly overlooked problem by healthcare practitioners. It presents as mild to severe pain, numbness, and sometimes weakness in the hands, wrists and forearms along the distribution of the median nerve. At times, the muscles in the forearm ache due to compensations in movement or activity that may result.

The pain can occur at night, further disrupting sleep patterns. These symptoms may arise due to postural changes, increased edema, occupational stressors, or a combination of these. Often patients are told their symptoms will resolve after delivery. Although this is usually the case, patients can perform a few simple exercises that may ease or even eliminate this pregnancy complaint.

When Carpal Tunnel Syndrome occurs in the general population, it is most often associated with the stresses of repetitive motion such as typing, using a computer mouse, work related tasks, or even hobbies as diverse as cooking, knitting, bowling, or tennis (it can also manifest in the elbow as "tennis elbow").

Pregnancy and Carpal Tunnel Syndrome

When manifesting during pregnancy, CTS due to edema tends to worsen in the third trimester, and it often occurs bilaterally. (Turgut, et al 2001). Since edema worsens when the upper extremity is placed in a gravity dependent position, instructing your patient to elevate her arms is a good place to start. Rolling an ice cube over the wrist, called ice massage, can also reduce local swelling.

Exercises to improve flexibility may provide additional relief. Specific areas to include are the postural muscles as well as wrist and elbow.

Doorway Stretch:

Doorway Stretch

Hold onto doorframe as pictured above for 30 seconds. Perform 3 repetitions 2-3 times daily.

Wrist flexor stretch:

Wrist Flexor Stretch

Pull fingers back as shown. Hold a gentle stretch for 30 seconds. Perform 3 repetitions, 2-3 times daily.

Resting posture of the wrists should also be given consideration. At night, some women have the tendency to curl their wrists into a flexed position. Since they are sleeping, the best way to ensure their wrists stay in a neutral position is through the use of wrist splints. The ideal splint would have stays to keep the wrist from moving into flexion or extension, thereby keeping it in a neutral position. As an inexpensive alternative, some women are able to prevent the flexed wrist posture by sleeping with a pillow between their hands.

If a patient's symptoms do not improve with the above techniques and exercises or if the symptoms are severe, additional intervention may be required. Presence of numbness and tingling warrants follow-up with a physician immediately to rule out more severe causes of her symptoms. A women's health physical therapist may then be recommended to provide a directed treatment plan. If you don't know of one in your area, contact the American Physical Therapy Association Section of Women's Health at This email address is being protected from spambots. You need JavaScript enabled to view it. or (800) 999-APTA, extension 3229.

References

Stephenson, R., O'Connor, L. 2000. Obstetric and Gynecologic Care in Physical Therapy. New Jersey: Slack, Inc.

Turgut, F., Cetinsahinahin, M., Turgut, M., Bolukbasi, O. 2001. The management of carpal tunnel syndrome in pregnancy. Journal of Clinical Neuroscience 8:4 332-334.

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I had tried Pelvic Floor Physical Therapy before (with another PT) and I had a really bad (painful) experience. A friend of mine and fellow patient, told me about Heather, Laureen and Femina PT (née Fusion Wellness & Physical Therapy) and I decided to try again. I am so happy I did! Femina PT have, literally, changed my life. I was able to do again things I couldn't do for over 10 years!! Their bedside manners are impeccable, their knowledge and understanding make me feel comfortable to recommend this place to anyone in pain. Specially if you have Endometriosis. 100% recommended!!

-- Carolina J., 12/28/16 via Yelp!

Testimonial by Carolina J.

I had tried Pelvic Floor Physical Therapy before (with another PT) and I had a really bad (painful) experience. A friend of mine and fellow patient, told me about Heather, Laureen and Femina PT (née Fusion Wellness & Physical Therapy) and I decided to try again. I am so happy I did! Femina PT have, literally, changed my life. I was able to do again things I couldn't do for over 10 years!! Their bedside manners are impeccable, their knowledge and understanding make me feel comfortable to recommend this place to anyone in pain. Specially if you have Endometriosis. 100% recommended!!

-- Carolina J., 12/28/16 via Yelp!

Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

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Heather has affected my life in the MOST POSITIVE way and I am forever grateful. My husband refers to her as the "sex doctor" so you can only imagine how happy he is with my therapy outcome.

After the birth of my son I suffered from "Vaginismus", however, at the time I just thought I was broken. My "broken vagina" affected me physically but it was an emotional struggle as well. Many women in my life also suffered with pain from sex after their babies were born so I knew I wasn't alone. They told me they "just got used to it" but I couldn't see myself living that way.

Sex wasn't just painful, it was literally impossible - IT DIDNT FIT!

Read more: Testimonial by Rosanna R.,...

Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

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