While carpal tunnel syndrome (CTS) is usually characterized as a repetitive stress injury, it can also be caused by pregnancy. In fact, CTS is a common complaint among pregnant women due to an increase in fluid build-up in the tissues, including those in the forearms and wrist. Edema is the technical term for fluid build-up, and it is hard to avoid during pregnancy. This swelling results in increased pressure on the median nerve that originates in the neck, travels through the shoulder, into the arm, through the wrist to innervates the thumb, index, third, and half of the fourth finger. The “usual” initial symptoms include a “half-asleep“ sensation in the fingertips prompting the sufferer to shake and “flick” the fingers in attempt to “…wake them up.” These symptoms (with or without pregnancy) commonly occur at night, as many tend to sleep with wrists in bent positions. When we bend our wrist in any direction, the pressure inside the carpal tunnel will double.
This can happen even more if there is edema or swelling present from the hormonal shift that occurs during pregnancy. This is why chiropractors will frequently fit CTS patients with a “cock up splint,” which is to be used primarily at night, as it often gets in the way during routine daytime activities. However, there may be times when the cock-up splint can be quite beneficial, such as when driving and holding onto the steering wheel. Grip strength may also be affected by CTS, making buttoning shirts and opening jars difficult. CTS may only affect your dominant hand, but it can also affect both. It is less common that CTS only impacts the non-dominant hand. There is an increased likelihood of developing CTS if you had it previously and/or if other family members have had CTS. Also, if you’ve had problems with your neck, back, or shoulder, such as an old whiplash injury, slipped disk in the neck, or broken collar bone, you are also at greater risk of developing CTS. If you were obese before the pregnancy and/or put on too much weight during the pregnancy, this too will increase the risk.
Besides the splint, other forms of care to treat CTS during pregnancy include: 1) EAT A BALANCED DIET. Include small amounts of lean protein (meat, poultry, eggs, beans) with each meal. Reduce the amount of salt, sugar, and fat you eat and drink PLENTY OF WATER! Eat at least five portions of fruit and veggies EVERY DAY! 2) VITAMIN B6. Pyridoxine or B6 has been reported to help CTS sufferers, and it is good for the nervous system. Foods rich in B6 include sunflower and sesame seeds, dark green vegetables (like broccoli), garlic, hazelnuts, lean meat, avocados, and fish (salmon and cod especially). Consider a B6 supplement, but DON’T exceed 150mg/day. 3) MATERNITY BRA. Be sure to wear a good fitting maternity bra with straps that don’t dig into your shoulders and neck. Wear it early on, as this can reduce the weight off your neck, rib cage, and shoulders and can help avoid compression of the median nerve. 4) Herbs such as chamomile tea, ginger, turmeric, and others that fight inflammation can be effective – your doctor can guide you on the dose! 5) Wrist exercises, wrist manipulation/mobilization, traction, and muscle release work can ALL be VERY effective and can be provided by your doctor of chiropractic.