Carpal Tunnel Syndrome After Pregnancy " Judy a 42-year-old corporate lawyer "

Case study ( 2818 views as of November 24, 2017 )

Judy is a 42-year-old corporate lawyer who visits her doctor complaining of bilateral hand and wrist pain, in her palms as well as the index and middle fingers, along with some tingling and numbness. She just recently had a baby, and is back to work 6 weeks later. She had this issue beginning in pregnancy. She feels her hands are somewhat weak. She types a great deal all day.

On exam, she’s 5’2” tall. She has a positive Tinel’s sign and Phalen’s sign on both sides, with some complaint of numbness on testing sensation in the palm side of her index and middle fingers on both sides. Her neck exam is normal.

Judy would benefit from a consultation with a physiotherapist to work on stretching and posture. She likely requires an ergonomic assessment, given that she types a lot and also is in the lower end of the height bell curve. Most equipment fits people between 5’5” and 5’10”, at best. She may require wrist splints for nighttime as well; this reduces pressure on the median nerves, the nerves that are compressed in carpal tunnel syndrome.

Judy may also wish to consider consulting with a massage therapist and/or a chiropractor for additional treatment options that could help relieve her carpal tunnel pain.

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Conversation based on: Carpal Tunnel Syndrome After Pregnancy " Judy a 42-year-old corporate lawyer "

Carpal Tunnel Syndrome After Pregnancy " Judy a 42-year-old corporate lawyer "

  • With a positive Tinel sign, the patient feels tingling when the area is tapped lightly as a result of irritated nerves. A positive Phalen sign is when the back of both hands are pressed together with fingers pointing to the floor and numbness develops. This indicates excessive pressure to the wrist nerves. Since carpal tunnel syndrome is directly related to pressure on the nerves in this area, positive tests on both sides means Judy has carpal tunnel syndrome in both wrists.
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    • For the Tinel sign, the patient would have the inside of their wrist tapped, just below the palm of their hand.
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    • Thanks @AllieS. Do you know where on the wrist they would "tap" the tinel sign in a carpel tunnel assessment ?
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  • What does it mean that she has a positive Tinel’s sign and Phalen’s sign on both sides ? How is that diagnosed ?
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  • What is the correlation between pregnancy and carpal tunnel syndrome?
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    • While your pregnant your body produces more blood and fluid. The excess fluid can cause compression of the nerves in areas that otherwise wouldn't be affected and result in carpel tunnel. It's the same reason that some women find their shoe size increases a full size
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  • I was not diagnosed with Carpel Tunnel syndrome after pregnancy but did have complete numbness of my right hand and fingers for several months postpartum. It was recommended to me to do some stretches of the hand and arm/shoulder (went to a physiotherapist) and to wear splints at night. I couldn't really wear the splints because my baby was always waking up and I couldn't properly care for him with the splints on, so, perhaps that is why my symptoms lasted longer. I really feel for others that are going through this! Adjusting to motherhood is challenging on its own without having this experience as well.
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    • I developed carpel tunnel while pregnant and it lasted about 6 weeks postpartum. I wonder if her symptoms have lasted longer because she returned to work so early
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  • This lady would benefit from having Acupuncture to open up the joints. Especially when women give birth, they use a lot of blood during the birthing process so their extremities get starved for fresh blood. Acupuncture helps to relieve congestion/inflammation so that blood can move into the area smoothy. Possibly she has not had enough rest to rejuvenate her body either and is now doing double duty with a job and a new baby at home to look after. She would also benefit from having Cupping Therapy. Cupping Therapy on the back would help to promote circulation and fortify her blood and promote her immune system functions better.
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    • I probably could have benefitted greatly from acupuncture to relieve the hand numbness and Carpel Tunnel Syndrome symptoms I experienced. I should remember to keep it in mind and tell other new moms about this option.
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    • I find this interesting. My acupuncturist actually recommended the opposite. She doesn't like to do acupuncture until 6 weeks post partum
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    • @julianne that is really interesting to know. Would having acupuncture right after giving birth helped this patient avoid Carpel Tunnel Syndrome?
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  • I often wake in the night up with numbness and tingling in my small finger and ring fingers. It goes away once I more my fingers around. Could this be the beginning of carpel tunnel syndrome?
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    • Do you sleep on your side? You may be laying on your arm and cutting off blood circulation to your fingers. I do that sometimes!
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  • Is sleeping with a wrist splint recommended to assist with the pain while sleeping ? How does this actually help the injury for the rest of the day, or is the pain more prominent at night ?
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  • I had what was thought to be carpel tunnel a few months after the birth of my son. I was 37 yrs old at the time. A friend read an article, & suggested I see a plastic surgeon. I did, as the pain was excruciating. The plastic surgeon said it was tendinitis..advising it was commonly misdiagnosed as carpel tunnel. He did a quick surgery in the hospital, removing the scar tissue in my wrists. It is now 17 years later, & I have never hd the pain again. I would strongly recommend anyone diagnosed with carpel tunnel go see a plastic surgeon to have it looked at.
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  • Carpal tunnel is so painful. I feel for everyone who has to live with the pain. From what I was told by my Orthopedic Surgeon carpal tunnel isn't caused by pregnancy but by the make up of your wrists. If pregnancy brings on the symptoms, you were predisposed to it and became symptomatic because of pregnancy (or job related reasons). It runs in families as well, usually the people with like body make up will share something like this.
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    • @carrle, what strategies helped relieve your pain? Did you try a chiropractor or physiotherapist?
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  • I had carpal tunnel surgery while pregnant and until about 8 weeks post partum. Mine was caused by fluid retention causing pinching of the nerves. Wearing braces helped considerably
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    • How do the braces help to ease the fluid retention?
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    • This was exactly my situation. I retained so much fluid that it was causing pinching of the nerves. It took about 8 weeks for all of the fluid to go away
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    • I am not a doctor, but often during pregnancy we retain more fluid so that is one reason. When the "tunnel" is narrowed from swelling or pressure the nerve can get pinched.
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    • I am not a doctor, but often during pregnancy we retain more fluid so that is one reason. When the "tunnel" is narrowed from swelling or pressure the nerve can get pinched.
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    • @drwade, what is the connection between carpel tunnel syndrome and pregnancy?
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  • If you think you have carpal tunnel syndrome or have other questions, you could consult a physiotherapist, your family doctor, or a sports medicine physician.
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    • Is that the nerve conductivity test ?
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    • I was referred to Neurologist who did an electrode type test on my carpal tunnel syndrome.
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  • The typical treatment for carpal tunnel syndrome would include splinting
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    • I have heard that B6 supplements can also benefit. Do you have any information on that?
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  • The carpal tunnel is the area through which the median nerve, which is a nerve that comes from the forearm and goes into the hand, the carpal tunnel is right here. It’s formed by a band or a retinaculum on the top of the wrist.
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