Unexpected… Pregnancy Related Hand & Wrist Problems, Part 2

Last month we discussed several unexpected hand and wrist conditions associated with pregnancy – the first in a series of blogs on this subject.

We focused first on one of the most common pregnancy related hand and wrist conditions, Carpal Tunnel Syndrome – discussing the symptoms and common treatment options available to expectant moms.Pregnancy related hand conditions

This month we’re discussing another common hand and wrist condition women may experience during pregnancy and following childbirth, deQuervain’s Tendonitis.  Like Carpal Tunnel Syndrome, deQuervain’s can develop as a result of the musculoskeletal changes, hormonal fluctuations, pregnancy related fluid retention and nursing – all of which can place stresses on the tendons.

DeQuervain’s Tendonitis affects the tendons around the base of the thumb and results when these tendons become irritated – causing the lining around the tendon, known as synovium, to become inflamed.  Tendonitis actually means “swelling of the tendons.”  Tendons are responsible for attaching muscle to bone.

The main symptom of deQuervain’s Tendonitis is pain and tenderness along the thumb side of the wrist, which may radiate down the thumb or up the forearm when rotating the wrist, grasping things or gripping.  The swelling may also place pressure on nearby nerves, causing numbness in the thumb and index finger.  The pain may be gradual or arise suddenly.

DeQuervain’s Tendonitis is generally easily diagnosed in the physicians office after a physical examination and discussion of patient history.  Patients are then asked to perform a series of hand movements and discuss the level of discomfort and area of pain and tenderness.Parts of the hand and wrist affected by deQuervain's Tendonitis

Treating deQuervain’s Tendonitis
Treatment for deQuervain’s Tendonitis is generally nonsurgical and may include:

  • Resting the thumb and wrist with the support of a splint
  • Anti-inflammatory medication 
  • A steroid injection into the tendon compartment
Look for the final part of this series on Unexpected Pregnancy Related Hand & Wrist problems next month when we talk about Trigger Finger.

Unexpected… Pregnancy Related Hand & Wrist Problems

Pregnancy, while one of the most exciting times of a woman’s life, can also present a few physical challenges – affecting parts of the body new moms-to-be may not expect.

During pregnancy women are not only adjusting to changes in the body necessary to create new life, but also other less expected changes resulting from the musculoskeletal challenges and overall physical demands pregnancy places on body function.  These demands come from added weight of carrying the baby as well as the reallocation of nutrients from mom to baby, hormonal changes and pregnancy-related fluid retention.  

It is this type of physical impact to seemingly unrelated areas of the body like the hands, wrist and elbow that takes most expectant women by surprise.

While problems in these areas might be expected after the baby is born – as extended holding in unusual positions, feeding positions, pushing of strollers and other unusual hand and upper extremity movements place stress on the hands, wrist and elbow – there are actually a number of hand and upper extremity pregnancy-related conditions women may experience.

Such conditions include carpal tunnel syndrome, deQuervain’s tendonitis, trigger finger and general swelling and tingling in the hands and upper extremity.

This article is one in a series focusing on pregnancy related conditions, beginning with carpal tunnel syndrome, as it is one of the most common hand and wrist conditions affecting pregnant women.  While often categorized as a “repetitive stress” condition – which affects those performing a repetitive tasks resulting in irritation and inflammation – it is often also commonly associated with pregnancy.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is the compression of the median nerve passing through the narrow carpal tunnel of the wrist.  Increased fluid generated during pregnancy can cause the same inflammatory/compressive effect of repetitive stress generally associated with carpal tunnel syndrome. 

Carpal tunnel syndrome is most often experienced in the third trimester when fluid retention is at its highest.

Symptoms of carpal tunnel syndrome may include pain, tingling and numbness in one or both hands. It is traditionally addressed nonsurgically with behavior modification, rehabilitation exercises and bracing.  If bracing and activity modification do not alleviate the problem, a steroid injection may be given and usually resolves the problem within a day or two.  Patients infrequently will need surgery if the carpal tunnel syndrome is related to pregnancy.