The carpal tunnel syndrome in pregnancy and puerperium

The carpal tunnel syndrome, caused by compression of the median nerve at the wrist, is the most common cause of altered sensation and pain in the hands. It is common during pregnancy and tends to resolve spontaneously after delivery. About 15% of affected women have symptoms severe enough to require neurologic examination and electrophysiologic testing. Injecting methylprednisolone just proximal to the carpal tunnel often provides temporary relief, but surgical release of the transverse carpal ligament is the only effective long-term treatment. We recommend primary surgical decompression if the first electrophysiologic test shows an absent median sensory nerve action potential or if symptoms due not resolve within 4 weeks after delivery.