Topic Overview

Tingling, numbness, and pain in the hands are common during pregnancy, especially in the last trimester. These problems are usually caused by carpal tunnel syndrome, and they usually go away after pregnancy.

Carpal tunnel syndrome is a specific group of symptoms that can include tingling, numbness, weakness, or pain in the fingers, thumb, hand, and occasionally in the arm. These symptoms occur when there is pressure on the median nerve within the wrist.

The carpal tunnel is a small space or "tunnel" in the wrist formed by the wrist bones (carpal bones) and a ligament (transverse carpal ligament). The median nerve and several tendons pass through the carpal tunnel from the forearm to the hand. The median nerve controls some movements of the thumb, and this nerve supplies feeling to most of the thumb and to the index finger, middle finger, and part of the ring finger.

Carpal tunnel syndrome occurs when a combination of health conditions and activities puts pressure on the median nerve as it passes through the carpal tunnel in your wrist. Anything that decreases the amount of space in the carpal tunnel increases the amount of tissue in the tunnel, or increases the sensitivity of the median nerve can lead to carpal tunnel syndrome.

The swelling that is common in pregnancy can crowd structures in the tunnel and lead to carpal tunnel syndrome, especially when combined with forceful or repetitive hand and finger movement or the use of vibrating equipment.

If your symptoms are not severe, expect your health professional to recommend nonsurgical treatment to see whether symptoms improve. Nonsurgical treatment includes:

• Changing or avoiding activities that may be causing symptoms, and taking frequent breaks from repetitive tasks.
• Wearing a wrist splint to keep your wrist straight, usually just at night. See an illustration of a wrist splint.
• Doing exercises to stretch and strengthen the muscles in the hand and arm.
• Learning ways to protect your joints as you go through your daily activities.

Unless carpal tunnel symptoms become intolerable, a pregnant woman should delay surgery until after childbirth. After delivery, symptoms often disappear without treatment when pregnancy-related fluid buildup is relieved.