|Miami Experts - Mommy Health|
Are you pregnant or a new mommy and all of a sudden your hands hurt? Hand problems aren't uncommon in new mommies or mommies-to-be. Dr. Roberto Augusto Miki, a local orthopaedic hand surgeon at The Miami Hand Center, describes common hand problems and what can be done to help you.
Hand problems are extremely common amongst pregnant women and women who have recently delivered a baby. These problems usually begin as pain or numbness in the hand and if left untreated can progress. Women with infants often feel this pain when trying to handle their infant. Carpal tunnel syndrome, trigger fingers and DeQuervain’s are the most common of these problems. This article reviews some of the most common symptoms to look for and the common treatment options for each problem.
Carpal tunnel syndrome is caused by excessive pressure or compression of the median nerve in the wrist. This nerve provides sensation or feeling to the fingers of the hand. Common symptoms or signs of carpal tunnel include numbness, tingling, weakness, and night time pain in the hand.
The initial treatment for carpal tunnel is bracing. Options after bracing has failed or if symptoms are very severe include injections of steroids and surgery. The surgery involves releasing a ligament over the median nerve. By cutting the ligament, this releases the pressure on the nerve. The procedure can be done in several ways but the two general categories are open and endoscopic. An open carpal tunnel release entails a 2 to 3 inch incision on the palm with a cut directly over the ligament. The endoscopic carpal tunnel release is peformed using a camera to aid in the cutting of the ligament. With the camera the surgery can be preformed using a smaller incision. There is no difference in the outcomes of the two surgeries long term. There is some evidence that in the short term patients with an endoscopic release return to work faster.
Trigger fingers are caused by a swelling in the tendons that bend the fingers which leads to a painful catching or locking of the finger in a flexed or bent position. The condition is often painful and often worse in the morning. The treatment options include splinting, injections of steroids and surgery. Splinting and injections can be helpful but have a significant failure rate. In general injections should be tried first prior to surgery. Surgery can be done percutaneously or open. Both surgeries involve cutting the ligament overlying the tendon allowing the tendon to move freely.
DeQuervain’s is an inflammation of some of the tendons that move the thumb. This leads to pain with motion of the wrist and thumb. The pain can be severe especially when trying to place an infant in and out of a crib. The thumb side of the wrist is often swollen and tender to touch. The treatment includes bracing, activity modifications, injections of steroids and surgery. Bracing can be an effective treatment option but it is often not practical with a small child because the brace is hard. Injections of steroids are extremely successful with this condition. Unfortunately, mothers who are breast feeding are not eligible for injections of steroids because of transfer to the infant. Surgery is truly a treatment of last resort because of the risk of injury to the radial nerve.
A physician is the only person who can diagnose these problems and recommend treatments for your problem. If you have symptoms similar to these problems, please see a physician.
Written by Roberto Augusto Miki, M.D.
The Miami Hand Center