Numb/Swollen Hands

[secretwave101]

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Have a patient who is 35w pregnant with numb and swollen hands. Numbness wakes her up and is getting more and more uncomfortable. 1+ ankle edema also.


BP fine. Trace dip protein. No glucose. Moderate wt. gain.


Anything I should be doing? Just reassure her? Any ideas for sx. relief for her?

 

[primadonna22274]

Carpal tunnel syndrome is very common in late pregnancy due to swelling and compression on median nerves. Did you check Phalen's & Tinel's signs? (Easy.) Obviously you don't want to give her NSAIDs but carpal tunnel braces especially at night and tylenol, ice are helpful. It will likely get better after delivery. Unlikely you would have to refer to neuro for nerve conduction studies (I'm not sure if they would even do them in pregnancy).
Good luck
Lisa PA-C

 

[maxheadroom]

Tylenol won't help any of the symptoms of carpal tunnel. The nighttime splinting is a good idea. If her symptoms don't improve within about a month of delivery, she should probably get an EMG/NCS.