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January 4, 2006

Aches and Pains, Other Illnesses

Question from Plymouth, New Hampshire, USA:

I am a 21 year old female and I've had type 1 diabetes for about eleven years. I have been using an insulin pump for around five years. I take Synthroid for a hypoactive thyroid. I am in decent control and good overall health. For a little over two years, I have been suffering severe symptoms of carpal tunnel syndrome. Because of my young age and the fact that I have no typical reason for suffering CTS, it took my primary care physician, endocrinologist, and eventually a neurologist, a long time and multiple MRIs to diagnosis the problem. I take massive amounts of naproxen and ibuprofen to help with the pain and can rarely sleep for more than a few hours at a time. I have had to learn how to write with my left hand because I can no longer grip a pencil. My doctors have been little help, mostly just suggesting surgery. I was just wondering if you know of any connection between diabetes and/or thyroid problems with carpal tunnel syndrome. I know that thyroid problems can aggravate CTS, but that's about all I know. Could this be a side effect of somewhat poor control over the past few years?

Answer:

Carpal tunnel syndrome is associated with diabetes. It turns out that the nerve that become compressed with carpal tunnel syndrome is pinched as a result of the connective tissue expanding around the nerve. The connective tissue expands as a result of elevated glucose levels attaching to the connective tissue. Over time, the compression becomes worse and is markedly worsened by repeat movements. Surgery is relatively easy and can be curative. If the nerve is pinched too long, there is a time of no return where surgery, even if performed, may not help.

JTL