Pregnancy often accompanies these various discomforts, and carpal tunnel syndrome is also common. This article lists some ways to relieve carpal tunnel syndrome.
Carpal Tunnel Syndrome (CTS)
Carpal Tunnel Syndrome (CTS) is common during pregnancy and causes numbness and tingling in the fingers and sometimes wrist pain. In my experience as an occupational therapist, carpal tunnel syndrome associated with pregnancy is different from CTS not associated with pregnancy. The presentation is slightly different; therefore, the strategy is slightly different. The good news is that CTS during pregnancy is relatively easy to treat, and I'll share my secrets with you here.
What exactly is carpal tunnel?
Carpal tunnel syndrome (CTS) usually causes numbness or tingling in the thumb half of the thumb, index finger, middle finger, and ring finger. CTS sometimes progresses and causes wrist pain that radiates to the hand. Symptoms often wake clients at night and appear while driving and doing desk work. Symptoms may also be related to grasping and prolonged activity.
What causes these symptoms?
The muscles that flex and straighten the fingers are located on the forearm. If you turn your arm so that your palm is facing up, you will see the flexor surface of the arm. The muscles of the forearm are the fingers and wrist flexion. The muscular belly tapers into a rope. The chordae tendineae of the finger and thumb benders pass through the wrist and through the palm to the fingers and thumb.
There is a wide band, called the flexor retinaculum or transverse carpal ligament, at the bottom of the hand. This ligament keeps the flexor tendons flush with the carpal bones so they don't pull the strings when the muscles contract. The transverse carpal ligament forms the top of the carpal tunnel, and the carpal bones form the floor. Tunnel through 9 tendons and their protective sheaths and median nerve.
The bones and ligaments that border the carpal tunnel do not have any "give". If the tendon sheath is inflamed and swollen, or if the wrist is generally swollen, the tunnel may become tighter and the median nerve pinched. Compression of the median nerve can cause carpal tunnel symptoms.
But what causes inflammation?
The prevailing idea is that repetitive movements such as factory work, scanning purchases and typing can cause tendon sheaths to become inflamed and swollen. This is totally overrated. Despite numerous well-known studies to the contrary, this mythological idea continues to spread.
Carpal tunnel is more prevalent than the "normal" population in conditions such as diabetes, rheumatoid arthritis, thyroid disease and pregnancy. This is highly suggestive of a systemic process, possibly hormonally driven, rather than the prevailing assumption of biomechanical causes. Further complicating the situation is severe overdiagnosis, declaring that almost all symptoms in the arms and hands are carpal tunnel syndrome.
It's not always carpal tunnel!
As an occupational therapist for nearly 25 years, I have had many clients, pregnant and others who have been referred to me for carpal tunnel syndrome. However, I rarely agree that clients actually have carpal tunnel. Symptoms are often more consistent with vascular origin than nerve.
In my professional opinion, the "carpal tunnel" of pregnancy has a huge vascular component. As pregnancy progresses, many women retain more and more fluid throughout their body, including their wrists, putting pressure on the median nerve. Hormones may also play a role.
This is an important part of most clients, including pregnant women. The main cause of compression is posture and posture, such as the overhead or forward position of the arms.
Examples of overhead poses that compress neurovascular bundles are changing light bulbs and washing or styling hair. The arms often feel heavy or tired while performing these tasks, which are vascular symptoms. Sleeping with your arms over your head can also compress the nerve trunks and major blood vessels in your arms. Compression of neurovascular bundles can cause not only a heavy feeling in the arm, but also a variety of pain, numbness, or tingling sensations in the arm or hand.
monitor your posture
One of the easiest and most effective strategies for relieving assumed carpal tunnel for anyone, including pregnant women, is to improve your posture. The further forward your shoulders are, the more your chest muscles are in a shortened position. Then, as your arms are in different positions, the muscles shorten and tighten. The tight muscles compress the large nerves and blood vessels in the upper chest area. This compression can cause various arm and hand symptoms.
Try aligning your shoulders with your ear holes. Do this in as many activities as possible throughout the day. It's a process. It won't happen overnight. Align your shoulders with your ear holes when working at your desk. Your elbows should be at your sides. As you extend your elbows out of your body, your shoulders follow, putting your chest muscles in a shortened position.
Sleeping position is another key contributor to arm and hand pain, numbness, and tingling. Most of us call ourselves side sleepers when in fact we are left and right front recumbents. This position is more like sleeping on your stomach than sleeping on your side, and also compresses the neurovascular bundles in your upper chest. We can then feel pain consistent with any nerve distribution, including the median nerve. We may also have vascular symptoms, such as numbness in the hands or numbness in the hands and arms. Finger numbness from vascular compression usually goes away quickly after the arm is repositioned, while numbness from nerve compression tends to take longer. Clients often describe regaining sensation by shaking or rubbing their hands.
Sleep on your back or stacked on one side. If you're stacked, your shoulders won't be forward, and an imaginary pole going through both shoulders will be perpendicular to the floor.
In addition, we also tend to sleep with our hands over our faces. If you sleep with your wrists bent, or your head resting on your hands, this can lead to compression not only on your upper chest, but also on your flexed elbows and wrists. A wrist rest can help keep your wrist neutral. Reverse elbow pads or socks with soft balls at the elbows (or another rolled-up sock) can keep your arms from bending enough to keep your hands close to your face.
Wrist braces are a staple in relieving carpal tunnel symptoms and are very effective. While occupational therapy clinics can make custom splints, there are many good over-the-counter (OTC) or off-the-shelf wrist braces. Unfortunately, there's a lot of pure junk out there too.
The purpose of a wrist brace is to minimize or eliminate wrist movement and allow inflammation to subside. While full cast-like immobilization is not necessarily what we want to accomplish, the brace should significantly limit and nearly immobilize wrist motion. If the wristband allows you to do everything you've done before, why would anything (like your symptoms) change? !
Choose a good wristband
A good wrist rest will have a flat metal stand on the palm side of the arm. The stand should be made of thick canvas material, two thick fabrics with padding in between, or some other material of considerable thickness and weight. The brace should fit nicely on the wrist and the bottom of the hand, supporting the wrist in a slightly extended functional position. Many sources specify that wrist should be neutral, but I compromise for compliance. We need to stretch a little because this is the natural position for writing, grabbing clothes, holding a fork, etc.
Another feature of a good wrist rest is that it should be 2/3 to 3/4 the length of your forearm. This is basic biomechanics. A ridiculously short splint doesn't provide enough support to stabilize the wrist.
Wrist rest wearing schedule
How often should you wear a wrist rest? It depends on the frequency, duration and intensity of symptoms. Be sure to sleep with braces on, not only because most clients experience symptoms while sleeping, but also to give your wrists a rest. Most clients report that it only takes a few nights to get used to the splint, so why not give your wrist a full rest when you don't need to use your hands.
If you work at a desk and you always have symptoms while working at the desk, wear your braces while working at the desk. Don't make excuses -- it's absolutely possible to wear a wrist splint and type, mouse, and do other office tasks. If your symptoms persist, then you should wear braces frequently, at least initially, until your symptoms begin to subside.