Swelling during pregnancy may squeeze on the nerve that runs through the wrist, causing carpal tunnel syndrome. Tingling, pain, and numb hands may be the first signs.

The carpal tunnel is a passageway in the wrist. Finger muscle tendons and the median nerve pass through this tunnel. The median nerve enables the fingers to bend and grip and gives sensation to the majority of the fingers.

Any condition that increases the pressure in the carpal tunnel or compresses the median nerve can cause carpal tunnel syndrome (CTS).

CTS is the most common type of entrapment neuropathy. This condition affects about 5% of the general population. It is common during pregnancy and occurs in around 1 in 4 pregnant people.

This article explores CTS during pregnancy and how long it lasts, the causes and potential risk factors, symptoms, and treatments.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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During pregnancy, the volume of blood in a person’s body doubles. Hormones trigger fluid retention (edema), which increases pressure and swelling in the blood vessels throughout the body. This can occur in particularly tight spaces, such as the carpal tunnel area of the wrist.

Another possible cause of CTS during pregnancy is the hormone the body secretes called relaxin. The ovaries produce this hormone when a person is pregnant. Relaxin causes pelvic and cervical expansion and blood vessel dilatation. It can also induce inflammatory changes to the transverse carpal ligament in the wrist, causing it to relax. This arched ligament may flatten and compress the nerve.

Conditions that alter the amount of fluid in the body can also increase a pregnant person’s risk of having CTS. These conditions include:

Alternatively, certain conditions may affect the nerve without increasing the pressure in the tunnel in a pregnant person. These include:

  • diabetes
  • vitamin deficiency or toxicity
  • exposure to toxins

A 2021 study found that obesity and diabetes are independent risk factors for CTS.

Certain factors can also put a person at higher risk of CTS. These include:

Compression of the median nerve may cause symptoms to range in intensity from mild discomfort to severe pain.

Symptoms often affect both hands, but affect the dominant hand more. However, some people may only have symptoms on one hand.

Common symptoms include:

  • numbness, burning, and pain, primarily in the thumb and index, middle, and ring fingers
  • occasional shock-like sensations that radiate to the thumb and index, middle, and ring fingers
  • pain or tingling that travels up the forearm
  • weakness in the hand

Pain occurring at night is very common. Symptoms can often occur during the day when holding something for a prolonged period of time. For example, if the wrist is bent forward or backward when using a phone or driving.

During pregnancy

Most pregnant people notice symptoms during their third trimester since edema and swelling are more common in this stage.

A 2021 study found that CTS is most common in the third trimester (40%), followed by the second trimester (35%), then the first trimester (25%).

After pregnancy

Most symptoms resolve weeks or months after delivery as the swelling and edema subside.

However, 1 in 6 people will still have symptoms a year after pregnancy, particularly in people who had severe CTS in the earlier stages.

Hormonal changes during lactation and repetitive motions and positions during breastfeeding may cause pregnancy-related CTS after delivery.

Researchers have also associated higher postpartum depression scores with long lasting CTS symptoms.

Most doctors recommend the following treatments:

  • Splinting: This involves immobilizing the wrist in a neutral position for at least 3 weeks to reduce swelling and allow the nerve to heal. Doctors recommend wearing the splint while sleeping.
  • Therapy: A physical or occupational therapist can create a program to reduce swelling, improve circulation and range of motion, and strengthen weak finger muscles.
  • Medications: Pain relievers are generally safe for pregnant people. Doctors recommend paracetamol as the first choice of pain reliever. However, high doses will not be recommended by doctors, as these may affect circulation in the fetus. Topical numbing agents may also relieve symptoms.
  • Steroid injections: A doctor may inject steroids into the carpal tunnel to reduce inflammation. Since doctors administer it locally, there is minimal risk to the pregnant person and fetus.

People who have severe CTS usually require surgical decompression. Doctors only recommend surgery in individuals with persistent symptoms, who find no relief with other treatments, or who present with worsening motor and sensory symptoms.

Home remedies can also help ease symptoms. These include:

  • taking frequent breaks
  • elevating the hands when not using them or while resting
  • maintaining a good arm, hand, and wrist posture while doing activities
  • applying an ice pack to the inner wrist
  • doing a contrast bath to improve circulation (dip the hand in cold water for a minute, then warm water for another minute)
  • reducing activities that require repetitive or excessive use of wrists and fingers, such as typing

Read more about hand exercises for CTS here.

To diagnose CTS, doctors will ask questions about the symptoms a person is experiencing. These will include when they occur, their frequency, and certain activities they perform that lead to the symptoms. They will also ask about a person’s habits, routines, and work.

Doctors will obtain a thorough medical history. This will determine if there are any conditions that may predispose a person to have CTS.

A physical assessment of the person’s hand is an important part of diagnosing CTS. For example, abrasions on the wrist and hands may indicate damage to the tissue, which could also suggest harm to the median nerve.

The initial medical tests for CTS include the Tinel’s signs and Phalen’s maneuver. Tinel’s sign involves tapping the median nerve to see if a person feels numbness or tingling in their fingers. During Phalen’s maneuver, a person flexes the wrist 90 degrees to see if symptoms occur.

Doctors may also perform sensory testing and grip strength tests to assess the severity of the symptoms.

A medical professional may also request electromyography to check for nerve damage. By inserting a fine needle into the muscle, they can determine how severe the damage is.

Read more for other diagnostic tests used for CTS.

CTS is a common condition affecting pregnant people. While symptoms typically resolve within a year after delivery, some may last longer.

Many people benefit from conventional treatments, but depending on the severity of the condition, some may require surgery. Individuals experiencing symptoms may wish to consider talking with their doctors for safe options to manage their condition.