Q: I would like to know how to treat pregnancy induced carpal tunnel and what causes some pregnant women to get it.
I've found that many people, myself included, have had relief from carpal tunnel by doing the "crunchy" style sit ups that have the person keep their lower back flat on the floor the whole time the exercise is being done, with their arms folded across their chests. The exercise is done straight up toward bent knees as well as toward the sides (right elbow toward left knee, and vice versa). It should be done slowly, coming up to a slow count of five, holding it to a slow count of five, and going back down to a slow count of five, sitting up to the center. Each side is considered one set. Doing three sets twice a day is what seems to help the most. The woman should not remain on her back, but get up after she's finished each set. This seems to stretch the upper back and has brought relief to many women. Maybe it relieves pressure on the brachial plexus; I don't know.
I am a hand surgeon. My fiance is a homebirth midwife and asked me to respond. 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.
When pregnant moms come into my store/office and mention the problem of their wrist hurting, I ask them if they want to try a magnetic wrist band. They have all been very surprised when it doesn't hurt anymore within 10-15 minutes. But remember, magnetic therapy products are not all created equal. I only use the big name from Japan!
-PJ Jacobsen, IBCLC
Reprinted from Midwifery Today E-News (Vol 1 Issue 47, Nov 19, 1999)
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