Carpal tunnel syndrome (CTS) is caused by swelling and inflammation of the nerves that line the carpal tunnel cavity of the wrist, located in each wrist. CTS is common during pregnancy due to edema, a buildup of fluid in body tissues. According to estimates, about 60% of pregnant women can experience carpal tunnel syndrome of varying intensity. Common symptoms of CTS include pain, numbness, difficulty holding things, and tingling in the hands, palms, and fingers. Although carpal tunnel syndrome usually subsides by the end of pregnancy, it is possible for symptoms to persist for up to six months after delivery. Knowing how to treat your symptoms early so they don't get worse can help reduce pain and allow you to move freely again.
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Part 1 of 3: Relieving Pain from CTS
Step 1. Compress the wrist with ice
Ice therapy is very effective for pain relief and is anti-inflammatory because it helps to numb the throbbing pain very quickly. Ice can also reduce inflammation by slowing blood flow to the injured area.
- Use an ice pack, or wrap a few ice cubes in a clean napkin. You can also put your wrist under a faucet and run cold water for 10 minutes at a time.
- Do not apply the ice pack for more than 20 minutes at a time. Remove the ice pack for at least 10 minutes before reapplying it.
- Some people find that alternating cold and heat therapy is also effective in reducing carpal tunnel pain. How to do this is to apply an ice pack and a hot compress alternately for one minute each, and do it for 5-6 minutes. With this method, you can repeat the treatment three to four times each day.
Step 2. Use a splint for the wrist
According to many people using a wrist splint can help reduce wrist movement if CTS symptoms persist. The use of a splint makes the wrist relatively stable so that it can help healing.
- Most drugstores usually sell splints without a prescription. Your doctor may recommend a special splint for you, depending on how severe the CTS is.
- Many people with CTS use a splint at night to prevent involuntary painful movements, such as turning over during sleep.
Step 3. Get enough rest
Rest plays an important role in the recovery process from injury because it gives the body a chance to heal itself. Especially on the parts of the body that are used the most, such as the hands and wrists.
Reduce or eliminate unnecessary activities. As much as possible, avoid doing anything too heavy with your hand or wrist while trying to recover from CTS
Step 4. Raise your hands
When resting, it is best if the arm and hand (or both if CTS affects both wrists) are raised. Elevating the injured body part can help reduce swelling and inflammation by slowing blood flow to the area.
To elevate your hands, use a pillow or a clean, rolled-up towel
Step 5. Get used to sleeping with the right posture
The best sleeping position for pregnant women is on their side or on their back. Make sure your hands are relaxed and neutral, not clenched into fists. If you choose a sideways position, use pillows to support your hands to keep them in a neutral position. If you wake up at night and your hand feels numb or tingling, try shaking your hand until the pain goes away. Make sure that your wrists are not bent when you sleep, or that they are resting on your body. The use of a splint can help keep the wrist in a straight position.
Part 2 of 3: Doing Exercises to Relieve CTS
Step 1. Flex your wrist up and down
Carpal tunnel syndrome reduces mobility in the wrist, making it difficult for you to perform even the most basic manual functions. One way to strengthen your wrist is to build strength by performing gentle, repetitive movements. Flexing the wrist up and down can help increase mobility and rebuild the range of motion that the hand can perform.
- Straighten your fingers and stretch your arms out in front of you.
- Bend your wrists forwards and backwards, lifting your hands up and down in alternating gentle motions.
- If you have trouble doing this exercise with your arms outstretched, you can extend your arms on a table or chair with your wrists hanging off the ends.
- Repeat this exercise 10 times every day.
Step 2. Practice moving your fingers
In addition to reduced wrist mobility, many people with carpal tunnel syndrome complain of difficulty moving their fingers or clenching their fists. In addition to wrist exercises, building strength and mobility in the fingers and hands is equally important.
- Make a fist, and tighten the fist as hard as you can without causing pain.
- Hold this position for 5 or 10 seconds before straightening your fingers back to their original position.
- Repeat this exercise 10 times every day.
Step 3. Expand the range of motion of the hand
Comprehensive carpal tunnel exercises can strengthen the entire hand and wrist. Each finger may have a decreased range of motion, so it's also important to train each finger.
- Place your index finger with your thumb so that it forms an “O” (like the “okay” symbol).
- Lower your hand, then attach each other finger with your thumb one at a time.
- Repeat this exercise 10 times, gluing each finger in turn from top to bottom and then back up again.
Part 3 of 3: Dealing with CTS After Childbirth
Step 1. Know when to see a doctor
Most cases of pregnancy-induced carpal tunnel syndrome tend to go away on their own within a few weeks after the baby is born. However, a number of pregnancy-related CTS cases persist for up to six months after delivery. If CTS is treated early, it is often easy to manage the symptoms until the pain goes away on its own. However, if CTS is simply ignored, the symptoms will continue and cause more extensive damage.
In severe cases when CTS is not treated properly, surgery or therapy may be required
Step 2. Take the medicine
Your doctor may not recommend that you take painkillers, including nonsteroidal anti-inflammatory drugs (NSAIDs) while pregnant. However, after the baby is born, your doctor may recommend that you take medication to relieve pain.
- It is important to ask your doctor whether certain medicines can affect your child through breast milk, if you plan to breastfeed your baby.
- Common pain relievers include NSAIDs, such as ibuprofen and acetaminophen. For more serious pain, your doctor may suggest stronger over-the-counter pain relievers.
Step 3. Ask your doctor about corticosteroids
Your doctor may suggest corticosteroid injections, but that depends on the severity of your carpal tunnel syndrome. Corticosteroids, such as cortisone, can help reduce swelling and inflammation, and will eventually reduce pressure on the nerves in the wrist.
Corticosteroids taken by mouth do not work as effectively as injections in treating CTS
Step 4. Consider surgical options
Most cases of CTS caused by pregnancy do not require surgery. However, if you are prone to pain from carpal tunnel syndrome and these symptoms do not go away after the birth of the baby, your doctor may suggest surgery as an option. Surgery carries risks, including the risk of nerve or vascular injury that can permanently limit range of motion. However, surgical options are usually safe, and may be an effective solution for long-term pain relief.
- Endoscopic surgery is a CTS procedure. In this procedure the surgeon uses an endoscope (a long, thin telescopic instrument) to enter the carpal tunnel and cut the ligaments causing pain and inflammation. Endoscopic surgery is generally considered less painful than open surgery.
- In open surgery, the surgeon makes a relatively larger incision in the palm of the hand. The surgeon then enters the wrist through the incision and cuts the ligaments to free the nerves. The procedure is the same as endoscopic surgery, but is much more invasive, and consequently takes longer to heal.
Step 5. Try rehabilitation therapy
Some people with long-term carpal tunnel pain may need physical and occupational therapy to regain a wider range of motion in the wrist and hand. Certain rehabilitation therapy techniques can help relieve pain and strengthen muscles in the hands and wrists.
In addition to physical and occupational therapy, some people choose high-intensity ultrasound therapy to help restore the condition of the wrist. This treatment involves raising the temperature in and around the wrist to reduce pain and improve blood circulation so the injury can be healed
Step 6. Perform strengthening exercises once your wrists are strong enough
Strengthening exercises can be performed once the pain has subsided. Start with the isometric exercise as follows: Keep your wrist in a neutral position with your palm facing down, and place your other hand on top of your wrist. With your fist slightly closed, try to stretch your wrist back, while at the same time providing enough resistance with your other hand to keep your wrist from moving. Hold this position for 10 seconds and repeat 5 to 10 times.
- Do this exercise three times per week.
- You can now reposition your hands so that your palms are facing up, with your hands in a comfortable closed position. Place the other hand on top of the closed hand and try to flex the wrist, applying enough resistance with the other hand so that the wrist doesn't move. Hold this position for 10 seconds and repeat five times.
