What is the most common cause of hand and wrist pain in pregnancy?

• A. Carpal tunnel
• B. De Quervain's tenosynovitis
• C. Tendonitis of the thumb
• D. Trigger finger

Answer: (A)

During pregnancy, fluid retention and hormonal changes can increase pressure inside the carpal tunnel of the wrist. This swelling narrows the tunnel and compresses the median nerve, leading to numbness, tingling, and sometimes pain in the thumb, index, and middle fingers—often worse at night. This combination of symptoms and the clear link to edema makes carpal tunnel syndrome the most common cause of hand and wrist pain in pregnancy, and it typically improves after delivery when the swelling subsides.

Other conditions listed can occur in pregnancy but are less common. De Quervain’s tenosynovitis causes pain at the base of the thumb with thumb movement. Trigger finger involves catching or locking of a finger due to thickening of the flexor tendon sheath. General tendonitis of the thumb is also possible but less typical than median nerve compression. The key distinction is that CTS reflects nerve compression from edema, which is a frequent pregnancy-related change. Management is usually conservative: wrist splints in a neutral position, activity modification, and measures safe in pregnancy; symptoms often resolve postpartum, with more advanced treatment considered only if necessary.