You’ve read all the baby books, poured over mommy blogs, delivered your precious baby, and now are left to wonder…what the heck is going on with my body?  While the pelvic and abdominal changes are certainly well known, pain in your hands are an unexpected pain in the you know what.  Let’s review two of the most bothersome new-mom problems, learn when to seek an expert opinion, and understand how to get relief and go back to taking care of the adorable source of all that pain.

Carpal tunnel syndrome is one of the most common nerve problems of pregnancy and post-partum.  Many moms start to feel numbness and tingling in their hands in the third trimester that is often resolved after giving birth.  However, over 20% of new moms continue to have carpal tunnel symptoms after having a baby.  Carpal tunnel can be a reversible issue, but there are warning signs that everyone should know about before the nerve damage becomes permanent.

5 Signs of Severe Carpal Tunnel

1. The numbness has been going on for over 3 months.
2. The numbness is constant.
3. You start developing weakness in the hand.
4. You start to drop objects and feel clumsy using the hand.
5. The muscles in the thumb start to atrophy, or wither away.

The time to seek an expert opinion is before you develop any of these symptoms, when the numbness is intermittent (usually at night).

Treatment options depend on how severe your symptoms are.  For mild, intermittent carpal tunnel symptoms, wearing a nighttime wrist brace is the first thing you can do on your own and pick up at any drugstore or order from Amazon.  For more severe carpal tunnel syndrome that causes painful numbness (called paresthesias) a local cortisone injection is a direct way to decrease inflammation surrounding the nerve.  For even more severe cases that don’t respond to conservative treatment, a surgery to release the ligament that overlies the nerve is an outpatient, same day procedure that takes less than 30 minutes to perform, and typically requires a few weeks for the wound to heal before you’re back to lifting your little bowling ball.

The second painful hand issue is called DeQuervain’s tenosynovitis, or “Mommy Wrist”.  DeQuervain’s is a very painful problem over the thumb side of the wrist that affects the tendons that move your thumb.  Repetitively lifting the baby up and down is often the culprit.  The pain can be severe, often sending a jolt of pain throughout the hand.  You may see some swelling over the thumb side of the wrist as well.

This is a problem that can be easily addressed; you do not need to play the superhero and push through the pain!  Go see a hand specialist when the symptoms start.  Picking up a wrist brace with a thumb extension (called a thumb spica wrist brace) helps to immobilize the wrist and thumb, limiting the motion of the thumb tendons.  However, this brace can be quite clunky and makes it difficult to hold the baby comfortably.  A cortisone injection will offer you the biggest bang for your buck in terms of pain relief.  When the pain is not relieved with multiple rounds of cortisone injections, a small procedure that releases the thumb tendons can be a permanent solution.

So, the takeaways are:

• Post-partum hand problems can cause serious and permanent problems.
• There are simple and conservative treatments for the most common issues.
• See a specialist early-on to get the correct diagnosis and pain relief.

***One special note about cortisone injections and pregnancy/breastfeeding.  While local cortisone injections do get absorbed by the bloodstream and can be passed along while pregnant or through breastfeeding (like other medications taken by mouth), multiple, large studies have shown no significant increased risk to the fetus/newborn.  Always discuss the pros and cons of receiving a cortisone injection with your doctor before undergoing any treatment.***

Erin Nance, MD, is a board-certified orthopedic hand surgeon practicing in New York, NY www.NanceMD.com.  You can follow her @the_hand_doctor and be reached at enance@hands-on-media.com.