Why do I often feel pain, tingling and numbness in my hands?
Pain, tingling and numbness in your hands during pregnancy is likely to be caused by carpal tunnel syndrome.
The carpal tunnel is a small tunnel that runs from the bottom of your wrist to your lower palm. Feeling and movement in your hand is controlled by the median nerve, which passes through the carpal tunnel (NHS 2011).
Most pregnant women have mild swelling in their hands during pregnancy. This is caused by a build-up of fluid, called oedema, in the tissues (PRODIGY 2008). The swelling places pressure on the median nerve, compressing it and causing tingling and numbness in your hands and fingers (Ashworth 2010, NHS 2011).
Carpal tunnel syndrome is fairly common in pregnancy. Up to 60 per cent of mums-to-be suffer from it (Ashworth 2010, NCCWCH 2008:113). Symptoms can appear at any time but tend to begin in the second and third trimesters (Shepherd et al 2004:274). That's when you may also get swelling in your hands.
If you do experience carpel tunnel syndrome, it's likely to be mild and temporary, disappearing soon after your baby is born (Ashworth 2010, PRODIGY 2008, NHS 2010). But for some mums it can be severe and last for several months or longer.
The carpal tunnel is a small tunnel that runs from the bottom of your wrist to your lower palm. Feeling and movement in your hand is controlled by the median nerve, which passes through the carpal tunnel (NHS 2011).
Most pregnant women have mild swelling in their hands during pregnancy. This is caused by a build-up of fluid, called oedema, in the tissues (PRODIGY 2008). The swelling places pressure on the median nerve, compressing it and causing tingling and numbness in your hands and fingers (Ashworth 2010, NHS 2011).
Carpal tunnel syndrome is fairly common in pregnancy. Up to 60 per cent of mums-to-be suffer from it (Ashworth 2010, NCCWCH 2008:113). Symptoms can appear at any time but tend to begin in the second and third trimesters (Shepherd et al 2004:274). That's when you may also get swelling in your hands.
If you do experience carpel tunnel syndrome, it's likely to be mild and temporary, disappearing soon after your baby is born (Ashworth 2010, PRODIGY 2008, NHS 2010). But for some mums it can be severe and last for several months or longer.
What other tell-tale symptoms are there?
Symptoms of carpal tunnel syndrome are often worse at night but can affect your daily activities, too. They include:
- Pins and needles and a tingling or burning sensation in your thumb, index finger, middle finger, and the side of your ring finger nearest to your thumb. But you may experience these symptoms in your whole hand (PRODIGY 2008).
- Pain in your fingers and thumb (PRODIGY 2008).
- Aching in your hand, forearm and upper arm (PRODIGY 2008).
- A weakened grip, particularly in your thumb.
- Dry skin or swelling in your affected fingers or thumb (PRODIGY 2008).
- Numbness in your affected fingers or your palm as the condition gets worse (PRODIGY 2008).
What can I do to relieve the pain?
You may find that your symptoms are worse at night and that they wake you up (Patient UK 2011, PRODIGY 2008). When you feel twinges, shifting your sleeping position may make you more comfortable.
Other steps you can take to reduce your pain:
Other steps you can take to reduce your pain:
- Try not to sleep on your hands.
- If you feel pain while in bed, try shaking your hands until the tingling reduces (NHS 2010).
- Try not to keep your arm or hand in the same position for long periods of time.
- Flex your wrists and fingers regularly throughout the day. See if it works for you - for some women the flexing motion makes the condition worse (PRODIGY 2008).
- Try not to do tasks requiring repetitive hand movements as this may make your symptoms worse (Lee and Thomas 2009, PRODIGY 2008).
Vitamin B6 supplements may help, but check with your doctor before you take any supplements in pregnancy. And gentle exercise, such as a yoga with a trained instructor may also help to reduce your pain, as may chiropractic treatment on your wrist. Ultrasound therapy is another method which may lessen your symptoms.
Do bear in mind that there is a lack of research into these types of treatment for carpal tunnel syndrome. So you may need to try a few before you find the right one for you (Ashworth 2010, PRODIGY 2008, Patient UK 2011). Before you visit a complementary therapist, check that they are fully qualified and experienced in treating pregnant women.
If your symptoms seem to be getting worse, contact your GP, midwife or ask to be referred to a physiotherapist.
Do bear in mind that there is a lack of research into these types of treatment for carpal tunnel syndrome. So you may need to try a few before you find the right one for you (Ashworth 2010, PRODIGY 2008, Patient UK 2011). Before you visit a complementary therapist, check that they are fully qualified and experienced in treating pregnant women.
If your symptoms seem to be getting worse, contact your GP, midwife or ask to be referred to a physiotherapist.
When should I contact my doctor or midwife?
See your doctor, midwife or a physiotherapist if the pain and numbness interferes with your sleep or daily life (Lee and Thomas 2011).
Contact your doctor if you have constant numbness in any part of your hand, or if you have any weakness in the muscles near your thumb. This may mean that the nerve is not working well and there's a risk of permanent damage (Patient UK 2011). But rest assured that this is unlikely to happen during pregnancy.
If self-help measures don't work, your doctor or midwife may suggest wearing a wrist splint during the night and possibly the day (NCCWCH 2008, Patient UK 2011, PRODIGY 2008). A splint keeps your wrists in a straight position which maximises the space in the carpal tunnel (Patient UK 2011, PRODIGY 2008).
You should begin to notice an improvement in your symptoms within eight weeks of wearing the splint (NHS 2010, Patient UK 2011).
Contact your doctor if you have constant numbness in any part of your hand, or if you have any weakness in the muscles near your thumb. This may mean that the nerve is not working well and there's a risk of permanent damage (Patient UK 2011). But rest assured that this is unlikely to happen during pregnancy.
If self-help measures don't work, your doctor or midwife may suggest wearing a wrist splint during the night and possibly the day (NCCWCH 2008, Patient UK 2011, PRODIGY 2008). A splint keeps your wrists in a straight position which maximises the space in the carpal tunnel (Patient UK 2011, PRODIGY 2008).
You should begin to notice an improvement in your symptoms within eight weeks of wearing the splint (NHS 2010, Patient UK 2011).
What happens if I still have carpal tunnel syndrome after my baby is born?
Carpal tunnel syndrome symptoms often disappear, along with the swelling, within a year of your baby being born (NHS 2010, Padua et al 2010, Patient UK 2011, PRODIGY 2008).
However, some mums find that their symptoms continue for longer than this (Padua et al 2010). If pain and other symptoms continue after your baby is born, you may need treatment.
If wrist splints haven't helped, an injection of a steroid (corticosteroid) into your wrist (NCCWCH 2008, NHS 2010) is an option. This reduces inflammation and relieves the pressure on your median nerve, which runs down your arm and into your hand (Ashworth 2010, Patient UK 2011).
As a last resort it may be recommended that you have simple surgery on your hand. This involves the surgeon cutting the ligaments to relieve the pressure on your meridian nerve. You'll probably only need a local anaesthetic while the surgeon carries out the procedure (NHS 2010, Patient UK 2011).
Fortunately, for most women, carpal tunnel syndrome is another pregnancy niggle that simply disappears, and they'll never need surgery to correct it (NHS 2010).
http://www.babycentre.co.uk/a234/carpal-tunnel-syndrome-in-pregnancy#ixzz2zaT3e0W2
However, some mums find that their symptoms continue for longer than this (Padua et al 2010). If pain and other symptoms continue after your baby is born, you may need treatment.
If wrist splints haven't helped, an injection of a steroid (corticosteroid) into your wrist (NCCWCH 2008, NHS 2010) is an option. This reduces inflammation and relieves the pressure on your median nerve, which runs down your arm and into your hand (Ashworth 2010, Patient UK 2011).
As a last resort it may be recommended that you have simple surgery on your hand. This involves the surgeon cutting the ligaments to relieve the pressure on your meridian nerve. You'll probably only need a local anaesthetic while the surgeon carries out the procedure (NHS 2010, Patient UK 2011).
Fortunately, for most women, carpal tunnel syndrome is another pregnancy niggle that simply disappears, and they'll never need surgery to correct it (NHS 2010).
http://www.babycentre.co.uk/a234/carpal-tunnel-syndrome-in-pregnancy#ixzz2zaT3e0W2
