Introduction

The physiology of pregnancy is complex and poses several challenges to physicians who are caring for the musculoskeletal health of pregnant women. Fluid changes, hormonal fluctuations, and increased weight gain all stress the muscular system and predispose patients to a plethora of orthopedic issues. One of the most common pregnancy-related ailments is carpal tunnel syndrome (CTS).

In the general population, the prevalence of CTS ranges from 0.7% to 9.2% among women and 0.4% to 2.1% among men. These patients typically present with numbness in the median nerve distribution of the hand, wrist pain, nocturnal awakenings, decreased 2-point discrimination, and, in later stages, thenar muscle atrophy and weakness. In pregnant patients, CTS presents similarly. Most pregnant patients present with bilateral symptoms and most commonly in their third trimester, yet patients can present as early as the first few months of pregnancy and with unilateral symptoms. The incidence of CTS in pregnancy has been reported to be as high as 62%; however, it varies widely in the literature. For instance, the incidence of clinically diagnosed pregnancy-related CTS ranges from 31% to 62%, whereas the incidence of electrodiagnostically confirmed pregnancy-related CTS ranges from 7% to 43%. Variations in study designs, specifically diagnostic criteria and methods, account for this wide distribution of incidence in the literature, and thus, the true incidence of pregnancy-related CTS is still unknown.