Pregnancy related Hand and Wrist Injuries
In-Clinic or Telehealth consultations are very effective and available to help you manage these conditions.
Pregnancy is such an exciting time filled with anticipation and wonder for what’s to come. I always have so much admiration for the female body, transforming, creating, shifting and nourishing to create new life. As part of a new blog series covering some of these changes and challenges women experience, we will look at carpal tunnel and ‘baby wrist’ today. I personally experienced a very painful wrist on my left from carrying and holding my newborn daughter in “all the positions” to feed, rock to sleep, to hold and to cuddle. It started off as a mild discomfort but before long I could hardly use my left hand!
Below is some information if your wrists are also giving you grief during pregnancy or beyond, and what you can do to manage it.
Carpal tunnel syndrome
WHAT IS IT?
Median nerve related neuropathy affecting the first three and a half fingers. It results in pain, pins and needles, numbness, a weaker grip and if severe can result in muscle bulk loss.
The carpal tunnel symptoms experienced during pregnancy is largely due to an increase in fluid retention throughout a woman’s arms, compressing the median nerve.
Carpal tunnel symptoms after pregnancy e.g. fourth trimester, is most commonly a result of wrist positioning and prolonged flexion while holding, breast feeding and caring for a newborn babe.
Lets tackle carpal tunnel during pregnancy first…
Pregnancy-related Carpal Tunnel
Normally you will experience symptoms in both arms, and you’re likely to notice swelling (peripheral oedema). Do you notice that your rings now fit uncomfortably on your fingers, or you have to remove them completely?
Looking at a ‘normal day’ your symptoms tend to be worse in the morning and evening, but eases during the middle of the day. Night time can be pain with increased sensations of pins and needles or pain, especially if you curl your wrists into a flexed position while you sleep.
It often gets worse as your pregnancy progresses
Clinical tests performed by your physiotherapist will be able to confirm your diagnosis of carpal tunnel.
Things we can do to help:
Wrist orthoses and advice. Based on a study in 2006 with 30 women, 83% had a reduction in symptoms after only three weeks. Winning.
Ways to manage the swelling such as soft tissue work, compression and positioning might be helpful on an individual basis.
The good news? Carpal tunnel syndrome after pregnancy tends to go away relatively quickly. A small number of women are likely to suffer in the long run based on how severe their symptoms were during pregnancy, how soon it started and if they scored high on the Endenburg Depression Scales after giving birth.
Carpal Tunnel in the Fourth Trimester
Here symptoms are associated with prolonged wrist postures whilst breastfeeding. Often wrist flexion postures are needed for hours on end and as a result, symptoms can start within two weeks of breastfeeding.
The symptoms lasts around five to six months therefore, it is important to get an assessment and treatment as soon as possible. Advice and a few home exercises can go a long way to help with spinal mobility, neural mobility, posture, pain and other symptoms.
If symptoms become more serious with associated weakness and numbness it increases the risk of the mother dropping her baby... we do not want that, so please get in touch sooner rather than later.
“Baby Wrist” aka De Quervains
WHAT IS IT?
Baby Wrist is also known as De Quervains Tenosynovitis.
It affects women (and men) post-natally due to repetitive lifting of your baby.
‘Baby wrist’ is caused by an injury to two of the tendons that attach into the thumb. As a result they struggle to slide and glide during normal range of movement.
Symptoms include pain, swelling and tenderness around the base of the thumb down to the wrist.
What can we do to help?
Good news is that 75-95% of mild cases can be treated conservatively by your physiotherapist! Lifting advice, ice massage, splinting and taping have been proven to be very effective.
If the symptoms do not subside with the above treatment, a corticosteroid injection may be considered.
TFCC - Triangular Fibrocartilage Complex Injury
In my case, my wrist pain was on the side of my pinky, just above my ‘wrist bone’ where my TFCC is located. It is less commonly injured during pregnancy and post-natally in comparison to others, however, if it does occur it is helpful to know a bit more about it.
WHAT IS IT?
Your TFCC is a small cartilage disc located between the end of your ulna, and some of the smaller bones within your wrist (carpal bones). The TFCC helps to stabilise your wrist, and allows your wrist to move like it should. When injured the area is painful and often swollen, it can also ‘click’ or feel ‘stuck’. For example, in my case, it was very painful to rotate my hand, wrist or forearm, any weight bearing positions was also a big no for me.
Once I realised that something had to give, I took my own advice (and that of my husband!) and changed how I handled my daughter, I iced, massaged, tape and mobilised the area.
Furthermore, due to breastfeeding 24/7, I became a bit ‘hunched’ with reduced movement through my upper back. Reduced thoracic spine mobility directly affects the biomechanics of the shoulder girdle and arm, further increasing the load through my wrist.
See below for three stretches that I used to improve my upper back mobility during pregnancy and in the fourth trimester.
You’re welcome.
Exercises to improve your upper back mobility:
Whether you suffer from carpal tunnel irritation, or de quervains - these three exercises will allow your thoracic spine to move more freely, reducing the load through your arm and wrist.
Thread the Needle
Take three breaths at the end of the movement. Repeat x 5 each side. Thank me later.
Thoracic Extension
Hold for 30-60 seconds. Move the roller down your back to work on different spinal segments. It does get easier trust me.
Modified Childs-pose Stretch
This one targets your Lats. Hold for 60 seconds each side. Breathe deeply into your lower ribcage.
If you are suffering from any hand or wrist pain or stiffness while pregnant or while keeping a little human alive, please reach out for help!
We have physiotherapists who have an interest in women’s health and can help you now. Whether you are local to our practice, or distant to us, we can help with both in-rooms or Telehealth consultations