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August 7, 2007

Carpal Tunnel Syndrome During Pregnancy

A reader asks for information about carpal tunnel syndrome during pregnancy.

According to my reading, fluid retention during pregnancy may be responsible for carpal tunnel syndrome during pregnancy. The narrow opening through the wrist has limited space for nerves and tendons to pass through it. Add excess fluid retention which is common in pregnancy and those structures are crowded further. Luckily, symptoms usually resolve following delivery.

According to a hand surgeon:
One must first confirm the diagnosis of carpal tunnel syndrome. Not all numbness or pain is indeed carpal tunnel syndrome. The diagnosis is usually confirmed by the history and physical exam. Occasionally, a nerve test may be required. Treatment may depend on whether the symptoms are only at night or occur during the day with activities. If only at night, a splint and anti-inflammatory medication may be helpful. One should avoid anti-inflammatory medication during the first trimester. If symptoms occur during the day, the best initial treatment is often an injection into the carpal tunnel with a steroid preparation (I use depomedrol combined with lidocaine). The injection is minimally painful (really !) and often can eliminate the symptoms entirely. The steroid is a very small dose and given once has effectively no side effects or risks. Most of the time, but not all the time, the symptoms will go away after the person delivers. Occasionally, the symptoms persist and further treatment, even surgery may be required. One should therefore try to delay surgical treatment until after delivery since surgery may not be necessary. This response is general information--you should consult your doctor for specifics for yourself.

I would have expected to find a connection between carpal tunnel syndrome and the softening of connective tissue during pregnancy that allows for flexibility of the pelvic bones during delivery of the baby. However, this does not seem to be the case. Also included is good general information about things people can do to avoid getting carpal tunnel syndrome.

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Posted by linda at August 7, 2007 6:59 AM

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