Carpel Tunnel Syndrome

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Connective Tissue Disorders
Tests Your Doctor May Carry Out
Frozen Shoulder
Trigger Finger
Dupuytren’s Contracture
Carpel Tunnel
Stiff Man’s Syndrome [SMS] Also Known as Stiff Person’s Syndome
Diffuse idiopathic Skeletal Hyperostosis [DISH]


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Carpel Tunnel Syndrome

The carpel tunnel is a narrow, rigid passage of ligament and bones at the base of the hand that contains the median nerve [runs from the forearm to the hand] and tendons. If there is thickening of irritated tendons or other swelling the tunnel narrows and the median nerve is compressed. The symptoms often start gradually at night during sleep with burning, tingling or itching in the palm of the hand and fingers, especially the thumb and first two fingers and this can progress to daytime pain, weakness or numbness in the hand and wrist that may extend up the arm.

It is thought to be a combination of factors that put pressure on the nerve and tendons, rather than a problem with the median nerve itself. The most likely cause is congenital with some people just having a narrower tunnel but other common factors are injury to the wrist that causes swelling, over-activity of the pituitary gland, rheumatoid arthritis, and fluid retention.

Carpel tunnel problems affect three times as many women as men. People with diabetes or other metabolic disorders that can directly affect nerves are more susceptible to compression so have a higher risk of developing carpel tunnel problems.

Treatment – Obviously underlying causes such as diabetes or arthritis should be looked at first but treatment generally is resting the affected hand for two weeks, avoidance of anything that may worsen the symptoms and if necessary applying a splint to immobilise the wrist. In more severe cases drugs physiotherapy and/or surgery may be needed.

Research has found that genetics, rather than repetitive hand use, is responsible for carpal tunnel syndrome.
[American Academy of Orthopaedic Surgeons annual meeting: February 20, 2007]

However, according to the researchers genetics do not provide the whole answer. Age, genetics, obesity, diabetes, thyroid, various types of hormonal conditions, even pregnancy are predisposing factors but there are external factors that will bring on the symptoms. So the researchers suggest that a person may have a genetic or multi-factorial predisposition to carpel tunnel syndrome but something may cause the symptoms to develop. In other words, people who use their hands continuously and laboriously don’t get carpel tunnel more frequently than those who don’t.

The study authors suggest that these findings may affect disability, workers’ compensation and personal-injury claims.