Diabetes And Carpal Tunnel Syndrome
The tingling, burning pain of carpal tunnel syndrome (CTS) is more common in people with diabetes—a whopping 15 times more common. About 20 percent of people with diabetes will one day develop CTS.
There is such a strong correlation between CTS and diabetes that researchers used to think that CTS was an independent risk factor for an eventual type 2 diabetes diagnosis (CTS is linked to type 1 diabetes as well). The two conditions are correlated because they share similar risk factors and the populations overlap, but CTS does not seem to be an independent risk factor for diabetes, though diabetes can exacerbate the symptoms of CTS. It’s a complicated relationship.
But let’s back up…
What is carpal tunnel syndrome?
Carpal tunnel syndrome is caused when the median nerve that runs from the forearm to the hand gets pinched or compressed. The carpal tunnel is a narrow passageway that is shared by tendons and nerves. The median nerve can become compressed when ligaments or other nerves that share the carpal tunnel become swollen or harden.
The median nerve provides feeling to the thumb, pointer, and middle finger as well as part of the ring finger. Those with CTS will experience symptoms ranging from numbness or tingling to overwhelming pain and compromised mobility. Since feeling in the pinky finger is provided by other nerves, it may be unaffected by CTS.
Essentially, the median nerve needs to slide easily through the carpal tunnel in order to provide feeling and strength to the fingers. But when things get too cramped, the pinched nerve compromises movement and causes pain.
What causes carpal tunnel syndrome?
The underlying cause of carpal tunnel is unknown, but high glucose levels are thought to contribute (you’re not surprised, are you?). Excess glucose molecules can stick to tendons causing inflammation and hardening. Diabetic neuropathy is distinct from CTS, though it can cause similar symptoms. It’s important that a diagnosis clarify the underlying condition, as CTS and diabetic neuropathy have different treatments.
Repetitive motions that involve the hand and wrist, such as typing or playing the piano, were once thought to cause CTS. But recent research has debunked that theory. These activities can trigger and exacerbate the condition, but they don’t cause it.
Symptoms usually begin with tingling or numbness around the thumb, pointer, and middle fingers and progress with time. Pain can travel up the arm and make things like holding a phone or steering a car nearly impossible. Loss of grip strength and general weakness are common, and pain from CTS often keeps those affected from being able to sleep. The syndrome can affect one or both hands/arms.
CTS affects about 2 to 3 percent of the general population, and it’s more common in those with thyroid conditions, high blood pressure, autoimmune disorders, and diabetes.
Risk factors for the syndrome include:
- Having a small carpal tunnel. Pinching is more likely in those with smaller carpal tunnels, which helps explain why CTS is more common in women.
- Genetics. If you have a family history of carpal tunnel, you’re more likely to deal with it.
- A deformation in the small bones of the wrist due to arthritis or a fracture or dislocation.
- Inflammatory conditions like rheumatoid arthritis.
- Environmental factors. Those who use their hand and wrists a lot (such as people who type all day) are more likely to trigger CTS.
If you have diabetes, managing blood sugar to the best of your ability is key to reducing risk for nerve damage that could contribute to CTS. Other strategies include:
- Relaxing your grip. Reduce pressure on the median nerve by typing with soft strokes, using a large pen when writing, and gripping things gently.
- Taking breaks. When you get up from sitting (which you should do often), gently stretch and bend the hands and wrists.
- Keeping your wrists neutral. Avoid positions that force you to keep your wrists bent up or down. Yes, this means keeping those keyboards at elbow height!
There are a range of treatment options for CTS including rest, splints, medication, physical therapy, and surgery. Often avoiding activities that irritate the wrist, using a splint, and taking ibuprofen are sufficient to manage symptoms. In more severe cases, a doctor may recommend icing, physical therapy, or corticosteroid injections.
We rely on our hands so much that we rarely think about them until they give us trouble. And people often don’t think CTS sounds that serious… until it happens to them. The good news is that most cases are treatable. Talk to your doctor about your concerns, and keep those hands healthy!