Severe Carpal Tunnel During Pregnancy

The human body is designed so that it’s able to survive with a variety of conditions. For example, if there was an earthquake today, you’d be fine because your bones would absorb most of the shock. The same goes for when you’re driving on rough roads or playing sports like tennis. Your bones act as shock absorbers. But what happens when they aren’t? That’s where carpal tunnel syndrome comes into play. When nerves get pinched by bone growths called osteophytes, symptoms occur. These include tingling sensations in the hands and fingers, burning pains in the wrists and arms, numbness, weakness and even loss of function.
During pregnancy, women tend to experience more severe cases of carpal tunnel than men do. In fact, one-third of all female patients who have experienced this condition report unbearable pain [source National Institute of Neurological Disorders]. Severe carpal tunnel during pregnancy (or any time) typically occurs in two ways: increased pressure caused by swelling or hardening of ligaments at the base of the thumb, and narrowing of the space around the median nerve due to rapid changes in weight and volume. Some other possible causes include rheumatoid arthritis, diabetes and hypothyroidism.
Symptoms of carpal tunnel may begin suddenly, but usually progress over months. If you suffer from these signs, don’t worry — carpal tunnel isn’t painful enough to warrant surgery. There are several treatments available, however, including splints, braces and medication. While surgical procedures are also an option, they should only be considered after less invasive treatments fail to relieve the problem.
If you suspect you’ve got carpal tunnel, see your doctor immediately. He or she will take X-rays and possibly order additional tests to determine whether this is actually happening. Once diagnosed, doctors will try to reduce swelling through various means, such as massaging techniques and medications. If the problem doesn’t improve within a few weeks, then surgery might be necessary. Surgery involves cutting away parts of tissue surrounding the carpal tunnel and putting together new ones to create room for the nerve. Doctors often recommend steroid injections to help decrease inflammation. Steroids can be given orally or injected under the skin, while another treatment includes placing a small piece of plastic mesh between the bones and tissues surrounding the carpal tunnel.
While carpal tunnel is quite common, it does not happen equally among people. Scientists believe some people are predisposed to developing it based upon their genetics. One theory states that those with hypermobility — meaning joints move easily — are more likely to develop carpal tunnel. However, not everyone agrees with this idea. To learn more about why certain people are susceptible to carpal tunnel, read on.­
Carpal Tunnel Syndrome Causes
Treatment for Carpal Tunnel Syndrome
Carpal Tunnel Syndrome Prevention

Carpal Tunnel Syndrome Causes
One way to understand how carpal tunnel develops is to look at how our bodies grow throughout life. As we age, our cartilage begins to break down, and bones become brittle. Bones lose flexibility and start to form thicker layers of gristle known as periosteum. Our muscles die and fat cells shrink, resulting in overall reduced size. All these things combine to make us older, fatter and slower.
As we get older, we also put more stress on our bones, especially those in the hands and legs. Those bones need to withstand greater amounts of force and support larger muscle groups. When we bend, lift weights or walk up stairs, the bones must endure more strain than normal. They also need to keep up strength to maintain healthy joints. Unfortunately, bones are not always built to handle long-term use. Because of this, they build thicker layers of tissue called osteophytes. Osteophytes are essentially bone spurs, which can increase pressure inside the joint cavity.
This process of building osteophytes is very important for preventing injury, but it could also lead to carpal tunnel syndrome. People who work jobs that require repetitive motions or those who spend hours each day typing on computers are particularly vulnerable to this type of condition.
People who have carpal tunnel syndrome develop thickened tissue around the carpal tunnel. This increases the amount of pressure on the median nerve, which runs through the tunnel. Also, since the area has been narrowed, blood vessels that supply oxygen and nutrients to the hand are squeezed out, depriving them of oxygen and fluids. Eventually, the nerve fibers die. Carpal tunnel syndrome is believed to affect approximately 2 million Americans every year, though some reports estimate its frequency at 10 percent of the population.
In addition to taking longer to heal, injuries involving the carpal tunnel result in higher rates of recurrence. Women are more prone to both types of carpal tunnel than men are, but men are more likely to have recurring problems. Recurrences are much more common in people who have had previous operations on the carpal tunnel, or those whose occupations involve heavy lifting or repetitive motion.
So far, scientists haven’t pinpointed exactly why this happens, although many theories exist. It appears that hormones play a role in the development of carpal tunnel, although the exact reason remains unknown. Researchers think that estrogen plays a part, since women are generally more susceptible to carpal tunnel. Estrogen is thought to speed up production of collagen, which helps connect the bones of the wrist. And it slows the breakdown of proteins that produce hyaluronan, which lubricates joints.
Researchers also believe that genes may contribute to the occurrence of carpal tunnel. A group of genes called Hox genes appear to influence the formation of osteophytes. Another study showed that mice with mutations in three different Hox genes were resistant to developing osteoarthritis. These findings suggest that carpal tunnel may be related to genetic factors.
Next, we’ll discuss treatments for carpal tunnel syndrome. ­
Treatment for Carpal Tunnel Syndrome
There are a number of treatment options available for carpal tunnel syndrome. Most of these methods focus on relieving the pressure that results from swelling and narrowing the carpal tunnel.
Medications can provide relief from mild symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen sodium, ibuprofen and aspirin, can help reduce swelling. Topical creams containing capsaicin, menthol and eucalyptus oil can also offer temporary relief from the pain associated with carpal tunnel syndrome. Ibuprofen works best when taken regularly for pain, rather than just when needed. Patients should avoid using corticosteroid injections, since prolonged use can weaken the immune system.
Splints and braces can be used to stabilize the bones surrounding the carpal tunnel. Wrist supports, such as soft splints, bracelets and night splints can hold the wrist in a neutral position or flexion position. Casts can allow the patient to wear his or her own splint or cast. Night splints prevent movement of the wrist, which can alleviate pain. Braces limit movement of the forearm, stabilizing the wrist.
Surgery is rarely recommended unless noninterventional measures fail to relieve the symptoms. Surgical intervention is performed to remove the bony buildup and restore proper alignment of the bones surrounding the carpal tunnel.
Once the pressure is relieved, the blood flow returns to the hand, helping nourish the nerve endings. The return of circulation improves the chance of recovery from the disease.
With improved circulation, nerve sensitivity decreases, and the likelihood of recurrence becomes lower. With no surgery required, physical therapy can be done without worrying about scarring or infection.
To learn more about treating carpal tunnel syndrome, head to the links on the next page. ­
Since carpal tunnel tends to occur more frequently in women, researchers want to know why. One theory relates to sex hormones such as estrogen and progesterone. Both of these hormones encourage cell division. However, too much cell division can damage DNA. Therefore, it’s theorized that excessive cell division in females occurs only when high levels of estrogens are present.
Preventing Carpal Tunnel Syndrome
Because carpal tunnel is more prevalent in women, it makes sense that prevention efforts would focus on women. Several steps can be taken to minimize the risk of experiencing carpal tunnel.
First, limiting exposure to harmful chemicals can help prevent carpal tunnel. Chemicals linked to the development of carpal tunnel include pesticides, solvents and metals. Workplace exposures include fumes, dust and poor ventilation. Limit contact with these substances by wearing gloves and protective eyewear. Avoid eating foods grown near soil contaminated with chemical residues, since toxins can seep through the skin.
Regular exercise can help strengthen the muscles surrounding the carpal tunnel. Good posture can also help protect against carpal tunnel. By sitting upright and keeping the back straight, the neck and shoulders won’t be pulled forward, compressing the carpal tunnel.
Finally, consider avoiding unnecessary activities that put extra stress on the wrist and hand. Swimming, golfing, bowling and skiing all place undue strain on the wrist. So, before beginning any of these activities, take note of whether your occupation puts you at risk for carpal tunnel.

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