Prise en charge thérapeutique du syndrome du canal carpien chez la femme enceinte : une revue de la littérature

Abstract : Introduction: Carpal tunnel syndrome (CTS) is the second most common rheumatological manifestation during pregnancy after low back pain. Usually the CTS decreases after childbirth, even if it persists beyond 3 years in 30% of cases. Life quality is affected by nocturnal neuropathic pain as well as a decreased sensibility, grip and pinch forces. In the absence of new recommendations, the objective of our study was to update the knowledge of analgesic therapies available to treat pregnant CTS. Methods: A literature review was conducted until January 31, 2019. The MEDLINE, COCHRANE and EMBASE databases have been consulted. The inclusion criteria was the management of CTS during pregnancy. Results : 5 articles have been selected. The thermoformed wrist splint showed significant results on the improvement of pinch, grip (p<0.0001) and clinical symptoms (p<0.0001) after one week of treatment. Corticosteroid infiltration resulted in a significant improvement in the Boston Symptom Severity Scale, of hand strength (p<0.01) and electromyogram results (p<0.001). Bioptron light therapy significantly reduced pain and paresthesia. It also increased hand strength up to one month after treatment. Early carpal tunnel surgery should be considered only when clinical severity criteria are reached. Conclusion: Treatment of pregnant CTS by splint or infiltration appears to be the most acceptable. The general practitioner has an essential primary role in the management and referral of pregnant women with CTS. Further studies are necessary to improve the recommendations.
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Emmanuelle Dupe. Prise en charge thérapeutique du syndrome du canal carpien chez la femme enceinte : une revue de la littérature. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02114425⟩

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