Hand Pain During Pregnancy: Causes and Concerns

Pregnancy

At 30 weeks pregnant, starting from Sunday, I noticed that upon waking up, the joints in my palms become sore and painful whenever I make a fist, and my entire palm feels tight.
However, there is no swelling or edema, and my blood pressure is normal.
Since I work in education and frequently use my hands, I'm concerned that the pain might be due to my job or if there could be other underlying causes.
Could you please provide some insight, doctor?

Xinshou Mama, 20~29 year old female. Ask Date: 2009/03/11

Dr. Chen Changfu reply Obstetrics and Gynecology

In late pregnancy, due to naturally lower protein levels in the blood, fluid in the blood vessels can easily shift out due to osmotic pressure, leading to tissue edema (which may not necessarily be visible as swelling).
Additionally, the wrist joint is surrounded by a circular ligament that encases the blood vessels, nerves, ligaments, and soft tissues.
When soft tissue edema occurs, it increases the internal pressure within the circular ligament, resulting in varying degrees of compression symptoms affecting the blood vessels, nerves, and ligaments: symptoms may include pain when making a fist, a tight feeling in the entire palm, and numbness in the palm.
After a night of lying flat and resting, fluid redistribution occurs throughout the body, including the arms, resembling surgical carpal tunnel syndrome.
During the day, when upright, gravity causes further fluid redistribution, leading to noticeable swelling in the lower extremities by the afternoon or evening, while the tightness in the hands may lessen or disappear.
As long as blood pressure remains normal and there are no significant signs of body edema, and by avoiding high-salt foods, there is no need for concern.

Reply Date: 2009/03/11

More Info

Experiencing hand pain during pregnancy, especially as you approach the 30-week mark, is a common concern among expectant mothers. The discomfort you describe—pain in the joints of your hands, particularly when making a fist—can be attributed to several factors that are often exacerbated by the physiological changes that occur during pregnancy.

Causes of Hand Pain During Pregnancy:
1. Hormonal Changes: During pregnancy, your body produces higher levels of hormones such as relaxin, which helps to loosen ligaments in preparation for childbirth. This can lead to increased joint laxity and discomfort, particularly in the hands and wrists.

2. Fluid Retention: Although you mentioned that you do not have swelling or edema, fluid retention is still a common issue during pregnancy. Even slight swelling can lead to increased pressure on nerves, particularly in the wrists, which can cause pain and discomfort.

3. Carpal Tunnel Syndrome: This condition is prevalent among pregnant women and is characterized by numbness, tingling, or pain in the hand and fingers. It occurs when the median nerve, which runs through the wrist, becomes compressed. Symptoms often worsen at night or with repetitive hand movements, which could be relevant given your teaching profession.

4. Postural Changes: As your body changes to accommodate the growing fetus, your posture may also change. This can lead to muscle strain in the shoulders and arms, contributing to hand pain.

5. Overuse or Repetitive Strain: If your job involves frequent use of your hands—such as writing, typing, or other manual tasks—this could lead to overuse injuries. The repetitive motion can cause strain on the muscles and tendons in your hands, leading to discomfort.

Management and Relief:
1. Rest and Modification of Activities: It’s essential to take breaks and modify your activities to reduce strain on your hands. Consider alternating tasks that require heavy use of your hands with lighter activities.

2. Ergonomic Adjustments: Evaluate your workspace to ensure that it is ergonomically friendly. This may involve adjusting the height of your desk, using supportive tools, or changing your grip on writing instruments.

3. Stretching and Strengthening Exercises: Gentle stretching and strengthening exercises for the hands and wrists can help alleviate discomfort. Simple stretches, such as extending your fingers and rotating your wrists, can be beneficial.

4. Warm Compresses: Applying warm compresses to your hands can help relax the muscles and alleviate pain. Heat therapy can be particularly soothing before bedtime.

5. Consulting a Healthcare Provider: If your symptoms persist or worsen, it is crucial to consult with your healthcare provider. They may recommend physical therapy or further evaluation to rule out conditions such as carpal tunnel syndrome or other underlying issues.

6. Monitoring Symptoms: Keep track of when the pain occurs and any associated activities. This information can be helpful for your healthcare provider in diagnosing the issue.

In conclusion, while hand pain during pregnancy can be concerning, it is often manageable with appropriate care and lifestyle adjustments. It is essential to listen to your body and seek medical advice if you have any doubts or if the pain significantly impacts your daily activities. Remember that your health and comfort during pregnancy are paramount, and addressing these concerns early can lead to better outcomes for both you and your baby.

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