I'm seven months pregnant with my third child. I've had carpal tunnel syndrome with each pregnancy. The symptoms seem to get worse each time. I can hardly manage to take care of my family. What can I do about this?

Pressure on the median nerve in the wrist can cause carpal tunnel syndrome (CTS). Pregnancy can cause CTS for two reasons. The hormonal changes can affect the nerve directly. Increased fluid volume from pregnancy can put greater pressure on the nerve. There isn't a lot of room in the carpal tunnel area of the wrist where the tendons and nerves pass through to the fingers and hand. The added fluid may be just enough to trigger CTS in some women.

The condition often goes away after the baby is born. For this reason, most pregnant women don't want to have surgery. There are some other options that work well for many people. The wrist can be splinted in a neutral position. Pressure on the nerve is reduced this way. The splint can be worn at night for patients who can't get their job tasks done with splints on during the day.

Heat wraps and nerve and tendon gliding exercises have also been found effective. The patient should avoid strong, gripping and pinching motions. Such activities can increase pressure in the carpal tunnel.

Finally, you may want to consider a steroid injection into the wrist. This reduces the swelling without affecting the fetus.