Carpal tunnel syndrome in pregnancy, how to ease your discomfort
Many are the discomfort that pregnant women go through and several problems that cause pain in women. Among all of them, the Carpal tunnel caused by the compression of the median nerve in the carpal tunnel, which is manifested by alterations in the sensory and eventually motor function of this nerve, as indicated by the Hospital Clínico Universidad de Chile.
In pregnant women, the presence of the Carpal tunnel it increases considerably, going from 31 to 62% when the diagnosis is made by clinic and from 7 to 43% if electrodiagnosis is used. When compared with the general population, pregnant mothers have a 2 to 3 times greater risk of developing this problem. As the pregnancy progresses, the possibilities increase.
Causes of this syndrome in pregnancy
The cause of the increased frequency of carpal tunnel syndrome in pregnancy is unknown. However, there are some theories that point to local edema caused by the hormonal change of pregnancy. These alterations cause an increase of the maternal vascular volume, if to this is added the compression of the inferior vena cava by the gravid uterus, makes this situation appear.
As the pregnancy progresses, the edema increases, producing an increase in pressure in the carpal tunnel, compressing the medium nerve and generating the clinical picture. The high pressure generates a focal demyelination and with it a blockage of nerve conduction. If compression continues, the blood flow of the endoneural capillary system is altered, leading to alterations of the blood-nerve barrier and endoneural edema.
To all this, we must add that pregnancy by itself could predispose women to greater hypersensitivity of the peripheral nervous system, making it more susceptible to this group to manifest the symptomatology of carpal tunnel syndrome. Nor should we forget that other conditions of the pregnant that make it susceptible to develop neuropathies, such as diabetes mellitus, hypertension, preeclampsia, smoking, among others.
Treatment
Depending on the severity of the situation, there are different therapeutic options. The pharmacological treatment of neuropathic pain includes opioids and neuromodulators. Since most of these drugs are contraindicated in pregnancy, this therapeutic option is eliminated.
In pregnant patients with mild carpal tunnel syndrome, treatment based on the use of night splints, postural reeducation and physical therapy is recommended. It is described that more than 80% of the patients manifest symptomatic relief.
Damián Montero
