Pregnancy-Related Carpal Tunnel Syndrome

TL;DR

Pregnancy-related carpal tunnel syndrome is a common condition that often resolves after childbirth and is typically managed with conservative treatments.

Contribution

This review provides updated insights into conservative treatment options for carpal tunnel syndrome during pregnancy.

Findings

Conservative treatments like wrist immobilization and anti-edema therapies are first-line for managing PRCTS.

Pharmacologic treatment during pregnancy requires careful consideration due to potential risks.

Surgery is rarely needed and reserved for severe cases unresponsive to conservative measures.

Abstract

Carpal tunnel syndrome (CTS) is a common musculoskeletal disorder during pregnancy. Symptoms are often mild, and only a minority of affected women seek medical attention. Although symptoms typically resolve after delivery, they may persist through breastfeeding or beyond in some cases. Given this course, conservative management is recommended. This article aims to review pregnancy-related carpal tunnel syndrome (PRCTS), with particular emphasis on indications for available conservative treatment modalities. In this narrative review, a computer-based search was conducted on PubMed, Scopus, The Cochrane Library, and Web of Science databases for the relevant literature. Studies published between 2005 and 2025 were included. The search strategy included a combination of the following search terms: carpal tunnel syndrome, pregnancy, conservative treatment, hand, and pain. No specific limitations were imposed on study selection criteria. In PRCTS, the primary treatment goal is to reduce intracarpal pressure. First-line measures include wrist immobilization, pharmacologic and anti-edema therapies, and techniques to mobilize or stretch the transverse carpal ligament. Initiation of pharmacologic treatment during pregnancy should be carefully weighed because of potential maternal and fetal adverse effects. Commonly used physiotherapy procedures in the treatment of CTS, including high-intensity laser therapy and extracorporeal shock wave therapy, are contraindicated during pregnancy. Therapeutic ultrasound and phonophoresis are generally avoided or used only with caution. Surgical intervention is infrequently required and is reserved for cases with severe symptoms and functional impairment, failure of nonsurgical measures, and electrophysiological evidence of marked nerve compression.

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