The gist: What is carpal tunnel syndrome?
Also known as: "My hand burns", numbness and tingling in your fingers, "I feel like I can't pick up or use a pen"
Carpal tunnel syndrome is the pain, numbness and tingly, or weakness of your fingers and hand due to the compression of your median nerve in your wrist. It can occur on one or both sides.
If you have carpal tunnel syndrome, your hand will feel numb and tingly. Symptoms may only be present during certain times of the day or constant in more severe cases. You may also experience weakness and muscle wasting of the muscles at the base of your thumb. You may have difficulty gripping, holding, or pinching your fingers together when trying to handle small objects.
The anatomy of carpal tunnel syndrome
The carpal tunnel is exactly what it sounds like. It is a tunnel in your wrist composed of the carpal bones and the transverse carpal ligament through which nerves, tendons, and blood vessels pass. One of the nerves that passes through your carpal tunnel is the median nerve, which provides neural input to portions of all your fingers except your pinky. When there is increased pressure on the carpal tunnel, it causes pressure on the nerves and vessels that pass through it causing symptoms.
Who gets carpal tunnel syndrome? When does it occur?
During pregnancy, some women retain more fluid. This increased fluid in the body can put more pressure on the carpal tunnel, causing carpal tunnel syndrome. It typically presents or worsens later in pregnancy during the third trimester. It typically goes away after delivery when your fluid levels and swelling decrease.
The Origin Way: Physical therapy for carpal tunnel syndrome?
Because the pregnancy related swelling is the typical cause of Carpal Tunnel Syndrome during pregnancy, we treat the whole body to decrease fluid levels in the limbs. Our treatment plans include cardiovascular exercise to promote fluid retention, manual therapy techniques to the wrist and hand to improve mobility, as well as strengthening and neural mobility exercises to maintain wrist and hand strength.
Your Physical Therapist may also use taping techniques or recommend wrist braces to address the swelling and decrease pressure put on the carpal tunnel when you bend your wrist. Your PT will also give you movement strategies that decrease the pressure going through your wrist when doing everyday tasks, like typing, writing, or even brushing your teeth.
How long will treatment take?
During pregnancy, management of symptoms and maintaining the function of your hand are the main goals. Sometimes, but not always, it will resolve completely before delivery, but you can get moderate to significant symptom relief to help keep your hand functioning until delivery.
What to expect in the future
Typically, your symptoms will resolve after delivery. Sometimes, symptoms will persist postpartum, but you will have the stretches and exercises to address it. Some physical therapy may be required postpartum to address continued muscle and wrist tightness.
Sources and additional reading
Stolp-Smith, Kathryn A., et al. "Carpal Tunnel Syndrome in Pregnancy: Frequency, Severity, and Prognosis." Archives of Physical Medicine and Rehabilitation, W.B. Saunders, 25 May 2004, www.sciencedirect.com/science/article/abs/pii/S0003999398902763
Turgut, F., et al. "The Management of Carpal Tunnel Syndrome in Pregnancy." Journal of Clinical Neuroscience, Churchill Livingstone, 25 May 2002, www.sciencedirect.com/science/article/abs/pii/S0967586800907616
Padua, L., et al. "Symptoms and Neurophysiological Picture of Carpal Tunnel Syndrome in Pregnancy." Clinical Neurophysiology, Elsevier, 6 Sept. 2001, www.sciencedirect.com/science/article/abs/pii/S138824570100637X