Carpal tunnnel syndrome in pregnancy

Carpal Tunnel syndrome is due to the compression of median nerve at wrist leading to pain, sensory disturbance and sometimes motor weakness.
Clinical features
(i)Paraesthesiae & numbness in the thumb,index and half of middle finger
(ii) Tinel's sign




(iii) Phalen's sign


Causes
(i)Arthritis
(ii) hypothyroidism
(iii)pregnancy
(iv)diabetes
(v)acromegaly



There is an increased incidence of carpal tunnel syndrome in pregnancy and the possible reasons are

(I) water retention

(II) relaxin

(III)Musculoskeletal changes



Conservative treatments

• physical therapy
• wrist splints-Nocturnal splinting of the wrist in mid position is effective.
• non-steroidal anti-inflammatory agents(may not be safe in pregnancy)
• a low salt diet
• hydrocortisone injections
• surgery is indicated if there is progression to weakness of abductor pollicis brevis.

How to manage carpal tunnel syndrome in pregnancy?

Answer from TRIP data base

(i)Splints (ii)analgesia (iii)corticosteroid injections (iv) rarely surgery.

Sources

(I) The management of carpal tunnel syndrome
in pregnancy
F.Turgut1 MD, M. Çetins¸ahin1 MD, M.Turgut2 MD, O. Bölükbas¸i3 MD
1Department of Gynecology and Obstetrics, Aydin Maternity Hospital, and Departments of 2Neurosurgery and 3Neurology, Adnan Menderes University Hospital
(II)Nelson-Piercy C. Handbook of obstetric medicine. Taylor & Francis; 2002.