AAOS News: Gestational Carpal Tunnel Syndrome Found to be Persistent in Women After Pregnancy

New research presented this week at the 2019 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) titled, “Prospective Evaluation of the Incidence and Persistence of Gestational Carpal Tunnel Syndrome” studied women who experienced gestational carpal tunnel syndrome (GCTS) during the third trimester of pregnancy to determine how long it takes for GCTS to dissipate after childbirth and how commonly symptoms persist.
 
GCTS can cause pain, numbness, and tingling in the hand and arm. While the exact cause of GCTS is unknown, it’s hypothesized that fluid retention, weight gain, and hormones are contributing factors.
 
“Conventional medical wisdom has been that GCTS simply goes away after pregnancy, and for many women this is true,” said lead author, Philip E. Blazar, M.D., chief, Hand and Upper Extremity Service at Brigham and Women’s Hospital in Boston, Mass. “However, in our practice this wasn’t always the case, and it warranted additional analysis to help educate physicians, advise patients with persistent carpal tunnel syndrome (CTS) and continue research in this field.”
 
Dr. Blazar and his team prospectively administered a survey, Boston Carpal Tunnel Questionnaire (BCTQ) to women in their third trimester of pregnancy. A total of 368 patients in their third trimester with GCTS and no prior history of CTS were studied. The women were then asked to complete additional questionnaires at two to six weeks, three months, six months and 12 months postpartum or until symptoms were resolved or they underwent surgical treatment.
 
Among the findings of the research:

• Approximately 28 percent of previously asymptomatic patients will have GCTS in their third trimester.
• An overwhelming majority of symptomatic patients, 84.8 percent (n=56), will have resolution by six weeks postpartum.
• One month after delivery, 15.2 percent (n=10), of patients still had persistent symptoms of CTS.
• For women who didn’t have resolution three months postpartum, symptoms persisted and worsened over time.
• Some demographic and comorbid conditions increased the likelihood of developing GCT including non-Caucasian, higher BMI, history of smoking and preeclampsia.

With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. The AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level best treat patients in their daily practices. The AAOS is the source for information on bone and joint conditions, treatments and related musculoskeletal health care issues and it leads the health care discussion on advancing quality.