Risk factors
In order to be able to make a detailed diagnosis, it is important that the patient explains all his or her complaints to the doctor. Questions about accompanying diseases, such as diabetes mellitus (“diabetes”), malfunctions of the thyroid gland or fractures in the area of the wrists are also important.
Course of the disease
In the course of the disease, it is not only the nightly pain and discomfort that remains. Increasingly, the symptoms also occur during the day. Patients often report “clumsiness” and sudden “weakness” of the hand.
The sensitivity of the skin on the thumb, index, middle and ring fingers is increasingly reduced. In the subsequent stages, the thumb ball muscles may be lost. Fortunately, the complete loss of skin sensitivity in the hand occurs very rarely today.
Gender distribution
The gender distribution is about 75 : 25 (female : male), mostly the primary working hand is affected. In the majority of cases both hands are affected. This does not mean that carpal tunnel syndrome must occur simultaneously in both hands.
Often the disease in the other hand occurs only after years. During pregnancy, the woman’s body is exposed to a special hormonal situation. Especially in the last trimester (third) of pregnancy the body stores more water.
The stored water leads to swelling of the body tissues and compression of structures such as nerves, especially at anatomical narrow points. The carpal tunnel is such an anatomical constriction. This leads to a compression of the median nerve and to the typical symptoms of carpal tunnel syndrome.
Pain in the affected hand dominates, which can radiate into the arm and is particularly distressing at night. As a result, a lack of sleep and nocturnal restlessness develops. In addition, the middle finger and index finger in particular feel numb.
How should carpal tunnel syndrome be treated during pregnancy? In principle, unnecessary interventions during pregnancy should be avoided.However, thanks to modern anaesthetic procedures, carpal tunnel syndrome can also be operated on during pregnancy. However, it is not necessarily sensible to do this.
In most cases, the syndrome recedes as soon as the cause no longer exists. This means that after birth and possibly breastfeeding, the symptoms subside completely in about 50% of those affected. It should therefore be tried to wait for the birth.
Especially in case of pain at night, a night splint can be worn. This is intended to relieve the symptoms so that the pregnant woman can sleep as free of complaints as possible. The splint relieves pressure in the carpal tunnel.
Above all, waiting for the operation prevents an infection during pregnancy. Even if the risk is quite low, an infection can occur during the operation, the treatment of which can be considerably complicated by the pregnancy. This is because not all medications may be given during pregnancy, which means that they are contraindicated.
After weaning, an operation can be performed at any time. However, it should be ensured that someone takes care of the baby for the first 2-3 weeks after the operation. This includes changing diapers and bathing the child.
During these activities, the fresh surgical wound can possibly be contaminated with germs. This causes inflammations and infections. This should be avoided in any case.
