Related topics: •  Carpal Tunnel Syndrome

Jenne Damian suspected something was wrong when pain began radiating from her wrist during pregnancy. Trained as a percussionist, Damian knew that banging on a marimba or timpani would cause her wrists and hands to ache. But she didn't realize that pregnancy would worsen her existing carpal tunnel syndrome.

"It was a constant pain that was dull, bordering on sharp. At night it was horrible. I couldn't sleep. There was no position where my hands wouldn't hurt," says Damian, 30, who lives in the Northridge area of Los Angeles.

Carpal tunnel syndrome is a common condition among people who do repetitive work all day long, punching keys on a computer or a cash register, or even pressing on the strings of a violin.

Pregnant women are also susceptible to carpal tunnel syndrome, even if they don't type or play music all day. According to some studies, as many as one out of four pregnant women complains of the syndrome, usually in the second or third trimester of pregnancy when fluid retention in the arms and hands is more likely to put pressure on the nerve that leads to the hands and fingers.

Although most women report that the syndrome goes away after delivery, some women like Damian still feel numbness and pain in her hands and fingers, even years after giving birth.

Carpal tunnel syndrome can hamper your ability to perform any number of everyday tasks: chopping, using a fork, or even holding a phone up to your ear. The pain can also spread to your arm to your shoulder and neck making hand and arm motions more painful. It can even contribute to sleep problems. Many women report their pain often worsens at night.

"It's especially a problem when you're lying down at night and the wrist is not moving for a long period of time," said Louis H. Weimer, MD, an associate clinical professor of neurology at Columbia University College of Physicians and Surgeons. "Then the wrist swells and causes pain and waking."

Some researchers believe that pregnant women are more prone to developing carpal tunnel syndrome because they retain more fluid during the later stages of their pregnancies. The more fluid you retain, the more swelling occurs, squeezing the nerves that run through the hands and fingers.

"People who tend to have more swelling often have carpal tunnel syndrome," says Michelle Sang, MD, an obstetrician in Portland, Oregon.

Breastfeeding also can prolong carpal tunnel. Holding an infant to your chest for long periods of time can keep a wrist bent in the same position, pinching off nerves in the hand, says Stacey Doyon, an occupational therapist who is also the vice president of the American Society of Hand Therapists.

Before taking an over-the-counter medication for pain, ask your doctor for advice on treating carpal tunnel syndrome. Most doctors say that using a splint, especially at night, to keep your hand from staying in a flexed position is the most effective treatment. According to a report in American Family Physician, 82 percent of women showed some relief from the pain after using a splint for only two weeks.

Although acetaminophen (Tylenol) is safe during pregnancy, nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ipubrofen (Motrin) are not, so they shouldn’t be used to treat carpal tunnel during pregnancy. NSAIDS are safe for breastfeeding moms who are not pregnant at the same time.

There are other ways to reduce the pain of carpal tunnel syndrome:

•If you use your hands to work, try to take frequent breaks. Massaging your palm and the back of your hand can also help.

•Do wrist and hand exercises to stretch the muscles in your arm and shoulders. Stretch your fingers by flexing them and rotating your wrists.

•Reduce your intake of caffeinated food and beverages. Caffeine can restrict blood vessels and reduce blood flow to your arms and wrists.

•Apply ice packs two to three times a day to your wrists to reduce inflammation.

•If you're nursing, using pillows for support can help.

•Cut down on the amount of force you use. If you type or use a cash register, touch the keys softly. Studies show that people use much more force than they need to. If you write by hand a lot, use a big pen with free-flowing ink so that you don't have to grip tightly or press hard on the paper.

Weimer, the professor of neurology at Columbia University, says women should consult a doctor to make sure their condition doesn't worsen. If not treated, carpal tunnel syndrome can eventually cause nerve damage, causing permanent loss of feeling and muscle shrinkage.

If the diagnosis is in doubt, a relatively noninvasive test called an electromyelogram may help your doctor assess your situation. If the pain doesn't subside after the delivery, some doctors may agree to treat you with injections of anti-inflammatory steroids. Your doctor may also suggest you have surgery -- preferably after you deliver -- to release the compression if the pain doesn't subside, but according to some physicians, an operation is not to be taken lightly.

"Surgery is always the last option," says Scott Herron, MD, an orthopaedic surgeon in Temecula, California. "We always try the conservative approaches first."

Damian, the Los Angeles percussionist, has avoided surgery even though she still has pain. She began a series of specialized exercises with her instruments that helped strengthen her wrist muscles and changed her performance movements so she doesn't strain herself. She also watches her diet. She's taking calcium and other supplements, all of which should help prevent water retention.

"It still hurts me. There's not a night that I don't feel pain in my arms," she says. "But the more healthy I am, the better I feel."

-- Laura Lane is a freelance health and science journalist with a master's degree in biology from Stanford University who has worked as a staff writer at The Dallas Morning News and editor at WebMD. She has also written for MayoClinic.com, Harvard Women's Health Watch, Men's Journal, Shape, CNN Interactive, the Yoga Journal, and The Scientist.

References

First published July 28, 2005
Last updated March 27, 2008
Copyright © 2005 Consumer Health Interactive

Or Find More On:

Back to top of page