Carpal tunnel syndrome: Over the past couple of weeks I've been getting numbness and tingling in my hands and fingers. In addition, I have been repeatedly woken by pains shooting up my arms from my wrists.
At seven months pregnant, and with three other children to care for, I really need my sleep. Any idea what's causing this problem?
WHAT you have described are the classical symptoms of carpal tunnel syndrome. This is a painful disorder of the hand caused by pressure on the median nerve as it passes through the structures of the wrist.
A natural tunnel is formed in the wrist by a thick membrane which forms a roof over the carpal (wrist) bones.
The nerves, arteries and tendons that supply the hand pass through this arch and problems occur when the membrane becomes thickened and presses on the structures below.
When the median nerve is compressed it causes the shooting pains you describe. In addition, there is often numbness and tingling in the hands and fingers, although the little fingers are usually free of symptoms as the median nerve does not supply it.
What makes the membrane thicken?
Carpal tunnel syndrome is quite a common disorder, particularly in middle-aged women and during pregnancy. It is thought to be caused by changing hormone levels which promote swelling of the membrane and the collection of extra fluid in the tunnel. It is also seen in those who undertake regular manual work and those with other conditions such as rheumatoid arthritis.
What can I do about it?
The good news is that in cases of carpel tunnel syndrome brought on by pregnancy, the condition usually resolves spontaneously after delivery. In the meantime you might find it helpful to wear wrist splints at night to protect the nerves.
The condition can be aggravated by heat, so keep bedclothes light and the bedroom cool. Avoid putting your hands into very hot water while bathing or doing housework.
When the night symptoms occur again, it may help to hang your arm over the side of the bed, while rubbing and shaking it. In protracted cases, the pain can be relieved by an injection of cortisone into the tunnel. This is a very effective treatment, particularly when the condition is secondary to rheumatoid arthritis.
In severe cases, surgery to relieve the pressure on the nerve may be required. If untreated, long-term permanent weakness and numbness of the thumb, index and middle fingers can occur.