What Came First—the Chicken or the Egg? Carpal Tunnel Syndrome and Pregnancy

Pflibsen, Lacey R; McCormick, Brittney A; Noland, Shelley S.; Kouloumberis, Pelagia

doi:10.1089/jwh.2020.8471

Cited by 5 publications

(5 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CTS generally becomes symptomatic during the third trimester and commonly resolves after delivery, possibly after rapid reduction of pregnancy edema. 34,[37][38][39][40][41] In two different studies including 30 and 40 pregnant women with typical CTS symptoms, the authors reported the resolution of symptoms two weeks post-partum. 38,39 We think that MN-CSA values might have been affected by reduction of pregnancy edema during those two weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Second, we did not analyze CTS presence in the first and second trimesters because the third trimester is most commonly associated with CTS. 4,5,8,10,25,34,[37][38][39] We suggest future studies that undertake sonographic measurements of the MN-CSA in successive trimesters and that correlate these measurements with the emergence of CTS.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasonography for carpal tunnel syndrome in pregnancy: A prospective cross-sectional study

Ayhan,

Caglar

et al. 2024

Preprint

View full text Add to dashboard Cite

Objective: To analyze the ultrasonography (USG) values of median nerve cross sectional area (MN-CSA) in pregnant women with and without clinically diagnosed carpal tunnel syndrome (CTS). Design: Prospective cross-sectional study. Setting: Third trimester pregnant women during their routine office visits. Methods: USG was performed by a perinatologist and the MN-CSA at the carpal tunnel inlet was measured. Then, the participants were asked about the presence of typical CTS symptoms. Participants with typical clinical symptoms were assigned to the CTS group. Remaining participants were assigned to the Control group. Main outcome measures: The groups were compared according to MN-CSA. Results: Of the 89 pregnant women, 25 participants were grouped in CTS group and the remaining 64 participants were grouped in Control group. The MN-CSA was higher in the CTS group (9.44 ± 2.68) than in the Control group (7.20 ± 1.99), p = 0.00004. There was a statistically significant linear trend, p = 0.003, with higher MN-CSA associated with a higher proportion of patients diagnosed as CTS. Conclusions: USG measurement of MN-CSA at the wrist appears as a convenient method to confirm CTS diagnosis in pregnant women. Further research is necessary to determine a clear cut-off value for MN-CSA. Obstetricians can measure MN-CSA to confirm CTS diagnosis and consequently can offer conservative management, which is the widely accepted treatment modality in this cohort.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Ultrasonography for carpal tunnel syndrome in pregnancy: A prospective cross-sectional study

Ayhan,

Caglar

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…The test group showed faster and stable improvement. Hence, vascular hypothesis formation and fibroblastic hypothesis need to be taken into account [14].…”

Section: Discussionmentioning

confidence: 99%

Frequency of Local Treatment in Carpal Tunnel Syndrome during Pregnancy

Hussain¹,

Saqib²,

Khan³

et al. 2021

PJMHS

View full text Add to dashboard Cite

Background and Aim: The most common entrapment neuropathy is carpal tunnel syndrome (CTS). Carpal tunnel syndrome is caused by median nerve compression at the wrist joint. Idiopathic carpal tunnel syndrome is the most common cause. Among the other physiologic causes of carpal tunnel syndrome (wrist trauma, diabetes, hypothyroidism, rheumatoid arthritis, occupation, contraception, and pregnancy), pregnancy is the most common. The objective of the present study was to determine the frequency of local treatment in carpal tunnel syndrome during pregnancy. Materials and Methods: This cross-sectional study was carried out on 45 pregnant women with carpal tunnel syndrome in the departments of Neurology and Gynaecology, Ayub Teaching Hospital, Abbottabad from May 2020 to April 2021. Individuals who met the inclusioncriteria were enrolled in this study. Ethical approval and consent forms were taken from the participants. All the patients were treated with local treatment (dexamethasone acetate 4 mg and lidocaine 0.5 ml) under the carpal tunnel syndrome. Before and after 3 weeks of local injection, median nerve electro physiologic parameters through sensory nerve conduction velocity (SNCV), sensory latency (DSL), pain intensity (visual analog scale or VAS) and distal motor latency (DML) were all noted. Results: The mean age of the patients was 29± 5.3 years while mean weight gain was 13.2 ± 4.9 kg. The third trimester was the mostfrequent pregnancy trimester with carpal tunnel syndrome. Before and after 3weeks, the average pain score of injected dexamethasone acetate was 8.65 ±0.89 and 4.29 ± 0.74 respectively (p-value < 0.005). Additionally, the median nerve SNCV transcarpalwas 32.9 ±7.1 and 25.1 ± 7.2 m/s (p-value = 0.001); while DSL median nerve was4.87±0.81 ms and 4.1±0.62. Lastly, the DML of the median nerve before and after 3weeks of local treatment was 5.2±1.03 and 4.69±0.54 ms respectively. Conclusion: Pain intensity and electrophysiological factors were considerablyimproved after local treatment dexamethasone acetate injection. Encouraging results have been offered for carpal tunnel syndrome with minimum invasive treatment in pregnant women. Keywords: Carpal tunnel syndrome, Pain intensity, local treatment

show abstract

“…Orthopedic and neurological concerns that are common during and after pregnancy include pelvic girdle pain, low back pain, carpal tunnel syndrome, and thoracic outlet syndrome. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] In addition, ligamentous laxity and an increase in inter-recti distance (IRD) are common during and after pregnancy. 30,31 Increased IRD is associated with impaired strength and fatigability of the trunk muscles and may contribute to musculoskeletal impairments due to impaired load transfer between the trunk and lower extremity.…”

Section: Introductionmentioning

confidence: 99%

“…Additional considerations after childbirth include mode of delivery, infant feeding method, and body mechanics with childcare activities. Orthopedic and neurological concerns that are common during and after pregnancy include pelvic girdle pain, low back pain, carpal tunnel syndrome, and thoracic outlet syndrome 15–29. In addition, ligamentous laxity and an increase in inter-recti distance (IRD) are common during and after pregnancy 30,31.…”

Section: Introductionmentioning

confidence: 99%

Addressing the Kinetic Chain in a Postpartum Multisport Athlete: A Case Report

Piropato¹,

Deering

2023

Journal of Women's Health Physical Therapy

View full text Add to dashboard Cite

Background: Physiological and biomechanical changes must be considered when evaluating and treating musculoskeletal impairments in a perinatal female athlete, whether or not these impairments are directly related to their pregnant or postpartum state. Case Description: This case report describes a 34-year-old woman active in high-intensity functional conditioning, recreational volleyball, and running, seeking care for shoulder and thoracic back pain from birth to 1 year postpartum. Her primary complaint of shoulder pain was exacerbated by overhead activities. She also presented with a secondary complaint of "weakness" through her core, preventing return to sport. Treatment focused on joint mobilizations, neuromuscular reeducation, and core strength using biotensegrity principles throughout the postpartum journey of return to sport. Outcomes: The patient was highly motivated and met her desired goals to (1) compete in recreational sand and indoor volleyball starting at 6 weeks postpartum, (2) participate in a relay trail race at desired pace, and (3) compete in a weightlifting competition at 8 months postpartum without an increase in shoulder pain. Discussion: This case demonstrates the importance of addressing the entire kinetic chain in the postpartum athlete while addressing what may be considered a "straightforward" orthopedic condition. Understanding birth and postpartum healing is essential for physical therapists working with active mothers. Knowledge of the physiological and biomechanical changes during and after pregnancy is essential to appropriate treatment of these patients.

show abstract

What Came First—the Chicken or the Egg? Carpal Tunnel Syndrome and Pregnancy

Cited by 5 publications

References 14 publications

Ultrasonography for carpal tunnel syndrome in pregnancy: A prospective cross-sectional study

Ultrasonography for carpal tunnel syndrome in pregnancy: A prospective cross-sectional study

Frequency of Local Treatment in Carpal Tunnel Syndrome during Pregnancy

Addressing the Kinetic Chain in a Postpartum Multisport Athlete: A Case Report

Contact Info

Product

Resources

About