Outline of carpal tunnel syndromeThe pregnant mother’s musculoskeletal system changes in response to hormones, weight gain, and the growing fetus. These changes may affect the patient’s gait, posture, and comfort. In addition, increased maternal metabolism creates the need for greater calcium intake. If the patient ingests insufficient calcium, hypocalcemia and muscle cramps may occur.
In the third trimester, carpal tunnel syndrome may occur when the median nerve of the carpal tunnel of the wrist is compressed by edematous surrounding tissue. The pregnant mother may notice tingling and burning in the dominant hand, possibly radiating to the elbow and upper arm. Numbness or tingling in the hands also may result from pregnancy-related postural changes such as slumped shoulders that pull on the brachial plexus.
The symptoms of carpal tunnel syndromeAbout 20 to 50% of pregnant mother may experience the numbness of their wrist. Most of them may complain about feeling of needles and pins which are present in their hand during pregnancy. The carpal tunnel syndrome is manifested with several associative signs such as carpal tunnel pain, weakness felt in the fingers and wrist, less common in the palm area.
The pain is exacerbated when the pregnant mother uses her hand or wrist. It occurs severely when the wrist is used to grip an object. The manifestations diminish few days after the delivery of the baby. Therefore, the carpal tunnel pain is not considered as a serious problem unless the pain prolongs for a longer period of time.
Various carpal tunnel syndrome exercisesThe American Academy of Orthopedic Surgeons (AAOS) provided a prescribed exercise as carpal tunnel treatment for pregnant mother. This exercise is done within few minutes and it is recommended for pregnant mother who are suffering from intense carpal tunnel pain:
- Stretch and extend the fingers and wrist in an acute manner. Execute this by assuming a standing hand position. Hold this manner for at least 5 seconds.
- Next is to straighten your wrist and relax the fingers.
- Using your hands, form a fist and hold it for at least 2 seconds.
- Bend your two wrists down. Make sure to keep your fist. Hold this for another 5 seconds.
- Afterwards, straighten your two wrists and relax the fingers for the second time then hold it for 5 seconds.
This carpal tunnel treatment through exercise must be done repeatedly for 10 times. Allow your arms to hang loosely at each side and shake them properly for a few seconds.
Last resort: the carpal tunnel syndrome surgeryIn some cases that the carpal tunnel pain is too severe and it can’t be treated with exercises and other natural remedies, then surgery may be used as an option. This type of carpal tunnel treatment is done by removing the compressed median nerve. The surgeon will make a small incision in the transverse carpal ligament to release the compressed median nerve. The mini-open approach which utilizes small incision is the type of surgery used for treating carpal tunnel syndrome. The surgeon usually incised an inch length of opening to view the area using an endoscope (instrument used to visualize the internal part of the body). This procedure has quick recovery period. However, the same with other surgical procedures, the mini-open approach has its risks for complication.
The common complications that can arise during and after the operation are as follows:
- Damage of nerve with numbness and tingling sensation (temporary manifestation);
- Possible infection;
- Scarring of skin tissue;
- Occurrence of pain (mild to moderate);
- Stiffness of the wrist.
1/3 of patients who undergone this procedure may have 10% chance of losing wrist strength. However, this will improve as the recovery progresses. There are cases of this surgery fails to treat the condition. If the pain persist and other symptoms of carpal tunnel resumes then the procedure will be repeated.
Management for causes of carpal tunnel syndromeThe management of this condition involves proper health education. Most pregnant women must identify the common cause of CTS. This condition is brought by the edema or prolonged use of wrist. As the pregnancy progresses, the weight also changes. It includes the physiologic changes in the musculoskeletal system. Another important key is to provide health teaching about what is carpal tunnel syndrome. This is very important because most pregnant women are not aware of the common manifestations. They might think this as part of the pregnancy but they are not aware of the common factors that can cause this condition. Awareness about what is carpal tunnel syndrome including the importance of management and preventive measures can help them to identify the possible and potential intervention that can help them to avoid the occurrence of CTS. Most importantly, the family must be included in the management of this condition. Most especially if the pregnant women consider surgery as an option.
The key to early diagnosis of CTS is to determine the background of the pregnant women. This will be realized if the health care practitioner is able to provide education about what is carpal tunnel syndrome for the pregnant mother during consultation.
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