Numbness of the Hands

Why am I having numbness in my hands?

Most likely the cause is Carpal Tunnel syndrome. Women who suffer from this condition may have symptoms such as numbness, tingling or burning sensation, dull ache in the fingers, hands and wrists. Sometimes this sensation could even go up to the shoulders. It usually affects both hands and worsens during the second half of the pregnancy when you tend to retain more fluid.

What causes Carpal Tunnel Syndrome during pregnancy?

 This happens when a nerve (called ‘median’ nerve) which runs through a ‘tunnel’ in the bones of wrist (called ‘carpal tunnel’) gets compressed by the muscle tendon which runs through the same tunnel. The narrow ‘tunnel’ gets even smaller as the pregnancy advances with the increasing retention in fluid and swelling. The median nerve gives sensation to the thumb, index and half of the middle finger and is involved in movement at the base of the thumb. Hence, compression of this nerve gives rise to the symptoms associated with carpal tunnel syndrome.
 

What could I do to relieve the symptoms associated with Carpal Tunnel Syndrome?

  • If possible avoid repetitive hand movement which may aggravate the condition.
  • Those working as data processors, computer programmers and secretaries who use a lot of repetitive hand movements may consider using wrist or hand braces. Make sure to take a lot regular breaks to stretch your hands and wrists.
  • If you use computer a lot, trying adjusting your chair so that your wrist is not bending downwards while using the keyboard. Using a special ergonomic keyboard may also help.
  • Avoid sleeping on your hands at night
  • If you wake up at night with symptoms trying shaking your hand until the symptoms go away.
  • You could where splint or braces to keep your wrist in neutral position (not bend) as this makes the carpal tunnel wider. You may need to see a physiotherapist for this.
 
What treatment could be given for Carpal Tunnel Syndrome?
Pregnancy induced CTS normally is temporary, thus splinting during pregnancy using a brace rests the hands, wrists and fingers in a neutral position is most effective way of relieving the symptoms of CTS. However, those with severe symptoms may consider injection of cortisone into the wrist. Surgery is reserved for those chronic persistent symptoms where a small cut is made into the palm near the wrist to incise the ligament. This procedure could be done as an out-patient basis and you could go back to routine work within 4 – 6 weeks.
Are there any exercises that I could do to prevent the symptoms of CTS?
Yes, please refer to the diagrams below. This exercise could probably benefit those women with mild to moderate symptoms of CTS. Try doing this exercise prior to work to prevent the symptoms of CTS.1
  1. Extend and stretch both wrists and fingers, acutely for 5 seconds
  1. Straighten both wrists and relax fingers.
  1. Make a fist with both wrists for 5 seconds.
  1. Then extend both wrists downwards while still maintaining the wrist in fist position. Hold this position for 5 seconds.
  1. Straighten both wrist and relax fingers. Hold for a 5 seconds. Repeat this exercise 10 times. Then let your arms hang loosely at the side and shake your hand a few times

How long would I have the symptoms of CTS?

Most of the time if the onset of the CTS is during pregnancy, it will resolve soon after delivery. If the symptoms persists, splinting and analgesia such as ibuprofen may be suggested first then referral to an orthopaedic surgeon later on may be required if the symptoms do not resolve.
 
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REFERENCES:
 
1. Dr.Housang Seradge at the University of Oklahoma Orthopaedic & Reconstructive Research Foundation. http://ortho-ok.com/orrf/ORRF_CARPAL_TUNNEL_PREVENTION.htm

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