Carpal tunnel syndrome & De Quervain’s

Carpal tunnel and De Quervain’s syndromes are common complaints amongst both my pregnant and postnatal clients, so I thought it might be helpful to write a short blog explaining what they are and the exercise and lifestyle considerations that come with them.

(As you know I’m not a GP, physio or other healthcare professional, so please do consult appropriately. My knowledge has been acquired in my capacity as a personal trainer and massage therapist serving this population of women and by continually studying the female body with some of the best educational providers out there.)

What is carpal tunnel syndrome?

Put simply, it is pressure on one of the major nerves serving the hand (the median nerve) which passes through the same space as the tendons that bend the fingers and the wrist. Hence why those with carpal tunnel syndrome typically report aching, tingling, numbness or pain/burning in the fingers, hand or arm and/or a weakened grip. (And often more at night.)

What causes it?

Lots of factors can cause the swelling that compresses the nerve (like your weight, genetics, high blood pressure, diabetes, thyroid dysfunction, etc.) but:

  • water retention (both in pregnancy and postnatally) and
  • regularly overextending the wrist whilst looking after little one

…are two very common ones.

How can I be sure that what I’m experiencing is carpal tunnel?

As always, consult an appropriate healthcare professional for a formal diagnosis, but the video below shows three tests which will give you an idea if what you’re experiencing is likely to be carpel tunnel syndrome.

How do I make it better?

As always, people tend to talk about the most dramatic options when sharing stories, and surgery is an option in more severe cases, but there are lots of conservative measures to explore first.

  • Focusing on good wrist alignment whilst using your hands (& exercising), avoiding painful positions (which quite often can include exercising on all fours as the hands are flexed) and resting as needed. Soldiering through and ignoring will likely only make it worse!
  • Massage can be a great way to release restrictions along the length of the nerve (so focusing not only on the hand, wrist and forearm, but also the biceps, shoulders & chest because the relevant nerve starts at the spinal cord in the neck and travels all the way down the arm)
  • Ice can be helpful for reducing swelling, as can elevating the wrist.
  • Wrist splints that hold your hand in a neutral position, particularly at night (as many people curl their wrists or clench their hands whilst sleeping). And to save splints from getting sweaty, consider putting some tubigrip underneath it, which you can wash as needed.
  • Kinesiology taping has been shown to be helpful in reducing pain, swelling and inflammation by gently lifting the skin, thereby reducing pressure on the underlying structures. And unlike many braces and supports, it allows for full movement of the wrist and hand. (This is something that we can cover in a massage session or something that you can do with your physio).
  • Your physio / GP / massage therapist might give you specific exercises to practice at home.
  • Appropriately prescribed medication to help with the pain and to reduce inflammation. This may ultimately involve steroid injections into the area to reduce inflammation.
  • Treating any underlying condition that might be causing this, like diabetes or arthritis.

How does this compare to De Quervain’s syndrome?

De Quervain’s syndrome (sometimes referred to as “mummy thumb”) is swelling in the sheath that surrounds the two tendons that move the thumb specifically and pain is typically felt (particularly at the base of the thumb / the thumb side of the wrist) when doing things like pinching, wringing or grasping.

It is common in women after pregnancy (hence the nickname), but can also be due to repetitive movements (get off your smart phone!) or a strain.

So the two are similar in terms of being inflammation of the tendons involving the thumb, but carpel tunnel affects more than just the thumb – it affects the other fingers too, just not the little ones.

Similar treatments are advised to that of carpal tunnel syndrome (typically avoiding an L-shaped grip helps) and whilst it should again be formally diagnosed, the video below will give you an idea if this is what you’re currently experiencing.

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