Numbness and tingling during pregnancy are common causes of discomfort. These symptoms most often occur because of disruption of signal transmission along a nerve (peripheral neuropathy). Check with your doctor or midwife before starting any treatment option during your pregnancy. In some cases, the symptoms will improve or resolve after you deliver your baby.
Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is common in pregnancy and can involve one or both hands - usually your dominant hand, if only one is involved. As reviewed by the Mayo Clinic, CTS symptoms includes numbness and tingling (pins and needles), and sometimes pain, in the palm side of your thumb, index, middle and part of your ring finger, your wrist and hand. Symptoms may be worse when you awaken in the morning.
If you have CTS before pregnancy it may worsen during pregnancy. Symptoms tend to occur more often during the third trimester and usually improve soon after delivery but may take 1-2 years to resolve. The earlier in pregnancy symptoms start, the longer CTS takes to resolve.
CTS symptoms are caused by pressure on or entrapment of the median nerve as it passes under a ligament that forms the carpal tunnel at your wrist. Symptoms occur in the fingers and areas that the median nerve serves. The problem is more common in women during a second or later pregnancy and those who do repetitive motions with their hands such as typing.
The risk for the syndrome increases during pregnancy because fluid gain can cause swelling of the tissues of your wrist and hand and compress the median nerve. Diseases such as hypothyroidism, diabetes and high blood pressure that may lead to further fluid retention can also increase the chance of CTS during pregnancy.
Treatment of carpal tunnel syndrome involves reducing pressure on the median nerve. The Office on Women's Health includes the following treatment options:
- Reducing your salt intake and drinking enough fluids
- A wrist and hand splint to put your wrist in a "rest" position
- Diuretics to reduce fluid retention
- Steroid injections in your wrist to reduce swelling and inflammation
- Decrease repetitive motions of the affected wrist
- Pain medicines
Sciatica can occur before pregnancy from daily wear and tear or injuries to your back. Symptoms include numbness and tingling, burning or pain anywhere from your lower back, down your bottom and back of your leg, to the bottom of your foot and toes. Your symptoms may worsen as your pregnancy advances in the third trimester. If the problem is severe or prolonged, it can cause weakness of the leg on the involved side.
Sciatica is caused by irritation or compression of the sciatic nerve as it passes from your lower vertebrae through your pelvis and down the back of your leg. One or both sciatic nerves can be involved, though most often only one side is affected.
According to the Journal of the American Medical Association, common causes of sciatica includes herniation of a disc or arthritis in a lumbar vertebra, conditions which may be present before your pregnancy. During pregnancy other causes of pressure on the nerve include:
- Fluid retention in tissues around the nerve in the back or in pelvic tissues
- Curvature of the spine as your belly gets bigger (lumbar lordosis)
- Compression along the pelvic wall during the third trimester as the baby gets bigger and as he moves down the pelvis near term.
According to the American Academy of Orthopedic Surgeons (AAOS), sciatica can be relieved with the following options but check with your doctor first for safety during pregnancy:
- Physical therapy
- Massage therapy
- Heat or cold therapy to the back or other symptomatic areas
- Ultrasound therapy to involved areas
- Stretching exercises
- Steroids by mouth or by injection in oral the spine
- Pain medicines
The AAOS also advises against prolonged bedrest unless your doctor advises it.
Bell's palsy usually affects one side of the face, causing numbness and tingling or burning of the affected side. This is accompanied by weakness or paralysis and drooping of those facial muscles and difficulty closing your eye. Symptoms usually resolve within weeks of appearance.
Bell's palsy is caused by an inflammation of the facial (7th) nerve. According to Johns Hopkins Medicine, Bell's palsy most commonly affects pregnant women or diabetics. It might be caused by an autoimmune reaction or a viral infection of the nerve. It is more common after a viral illness or in people with diabetes or high blood pressure.
Until symptoms resolve, it is important to protect the affected eye with eye drops and an eye patch. Other treatment considerations include the following only as a doctor allows:
- Steroids by mouth or injection
- Application of moist heat to the face
- An antiviral medicine
- Pain medicine
Meralgia paresthetica refers to numbness, tingling and burning along the front outer side of your thigh, as reviewed by the American Association of Orthopedic Surgeons. The syndrome is more common in the third trimester of pregnancy. Unless there is damage to the nerve from trauma or other causes, symptoms are expected to improve after delivery.
Meralgia paresthetica is caused by compression of the lateral femoral cutaneous in the groin. According to the Mayo Clinic, pregnancy puts more pressure on your groin tissues as your belly grows. The nerve can also be affected by gaining a lot of weight or wearing tight clothing during pregnancy, or from inflammation.
In addition, compression of the nerve can also happen from prolonged pushing with your thighs flexed on your belly during a long second stage at delivery.
With guidance from your doctor or midwife, management of your symptoms can include:
- Taking pressure off your groin as much as possible including wearing looser clothing
- Managing your pregnancy weight gain
- Massage and ice or cold therapy to the affected areas
- Pain medicine
- Steroid injections
Women with a history of diabetes are at risk for symptoms of diabetic peripheral neuropathy (DPN). Symptoms include numbness, tingling and burning, especially in the legs, feet and hands. These symptoms may have been present before pregnancy and may become more noticeable during pregnancy. Fluid retention, especially in women with diabetic kidney disease, could make the numbness and tingling more pronounced.
Diabetes can cause damage and generalized dysfunction of peripheral nerves. Damage to small blood vessels and inflammation of nerve fibers because of high blood sugar may be involved, according to the Mayo Clinic. The longer you have diabetes, especially if not well-treated, the greater your risk for DPN.
You can reduce your risk for DPN before pregnancy by keeping blood sugar under good control. Talk to your doctor about treatments that might be safe during pregnancy. According to the National Institute of Diabetes and Digestive and Kidney Disease, medicines that may relieve symptoms include:
- Anti-seizure medicines
- Opiate pain medicines
- Creams or patches applied to the feet to relieve pain
Because of decreased sensation, continue to protect your hands from and feet from trauma and extreme temperatures and follow proper diabetic foot care during your pregnancy.
Vitamin B12 Deficiency
Vitamin B12 is the most common B vitamin deficiency and can cause numbness and tingling in hands and feet during pregnancy. This is because vitamin B12 and other B vitamins are essentially for normal nerve growth and function.
Deficiency in vitamin B12 can occur if you don't eat any or enough animal foods and don't take a vitamin supplement during your pregnancy. Other common causes include prolonged vomiting, poor absorption of nutrients, autoimmune diseases such as pernicious anemia and other bowel diseases, according to the University of Chicago.
Prevention and treatment of Vitamin B12 deficiency during pregnancy includes adding sources of the vitamin to your diet, such as red meat, fish and poultry or taking a prenatal vitamin that contains Vitamin B12. Severe deficiency may require B12 shots.
Electrolyte imbalances can cause numbness and tingling during pregnancy, especially around your mouth, fingers and toes. Causes can occur throughout pregnancy. Check with your doctor for correct management if you have any of the following problems which could lead to an electrolyte imbalance:
- Recurrent vomiting which can cause sodium and potassium loss
- Recurrent diarrhea which can lead to primarily to potassium loss
- Loss of fluids from dehydration
- Low calcium from not enough dairy products in your diet
- Diuretics for fluid retention or high blood pressure
- Kidney disease from problems such as diabetes or high blood pressure
- Hyperventilation triggered by anxiety
Don't hesitate to consult with your doctor especially if these conditions are accompanied by light-headedness and dizziness.
In general, it is helpful to assess your health, your medical history and your risk factors for neuropathy before you get pregnant. This will keep you aware of symptoms to watch out for and how to manage them. If you have numbness and tingling in your extremities, lower back pain, or any chronic disorders that might put you at risk for worsening peripheral nerve dysfunction during pregnancy, discuss your situation in detail with your doctor ahead of pregnancy.