Easing Hand Pain for Expectant Moms

June 19, 2014
Rachel Lutz

Safe, innovative ways to treat de Quervain's tenosynovitis and carpal tunnel syndrome during and after pregnancy.

A Houston Methodist medical center orthopedic surgeon recommends a safe, innovative way to treat de Quervain's tenosynovitis and carpal tunnel syndrome during and after pregnancy.

Carpal tunnel syndrome is caused by increased fluid retention in women’s hands during pregnancy. The carpal tunnel is home to several tendons and the median nerve, including the senses for most fingers and rotary movement for the thumb. De Quervain’s tenosynovitis is common among new mothers because of new hand positions used to feed and hold the baby. The tendons become inflamed due to the new hand functions, and remain inflamed because they are too irritated to heal on their own.

“Most women think pain caused by swelling in the hands is just another joy of pregnancy that they have to deal with,” Shari Liberman, MD, a Houston Methodist orthopedic surgeon and hand and upper extremity specialist, said in a press release. “In fact, there are several baby-safe options that can provide pain relief for mom.”

These types of hand pain are the 2 most common causes of hand pain among women who are expecting or have just delivered. However, there are safe and effective ways to treat this pain without harming the baby.

For carpal tunnel, Liberman recommends a splint before a woman’s due date. Once she gives birth, a woman may notice reduced fluid retention and decreased carpal tunnel syndrome symptoms.

“The carpal tunnel does not function as a balloon, so it cannot expand when a tendon becomes inflamed or if increased level of fluid is in the tunnel,” explained Liberman. “In expectant moms, the increased fluid in their hands puts pressure on the median nerve, which can cause numbness or tingling in the fingers controlled by that nerve.”

Another option that Liberman suggests is a steroid injection, though she notes many patients fear an injection may harm the baby.

De Quervain’s tenosynovitis, which Liberman calls a vicious cycle, can be treated with a steroid injection. This, Liberman suggests, provides immediate relief for women while also providing the irritated tendon some time to heal on its own. She said symptoms of de Quervain’s are resolved this way in about 90% of patients.

“When I recommend a steroid injection, many think that will hurt the baby, but it won't,” Liberman said. “Whether the baby is in utero or breastfeeding, there are steroid injections that can provide pain relief for mom without affecting the baby.”

Liberman, whose symptoms of de Quervain’s during pregnancy were resolved by splinting, recommends talking to OB/GYNs or orthopedists about options that may be the best fit for the patient and the baby.