Friday, December 11, 2009

Carpal Tunnel Syndrome and Hypothyroidism

Hypothyroidism May Be the Cause of Many Carpal Tunnel Cases

August 1998 -- Until recently, despite much research on the subject, many doctors and endocrinologists have not been generally aware of the connection between carpal tunnel syndrome (CTS) and hypothyroidism. CTS is a repetitive strain injury (RSI) that manifests itself as pain, achiness or numbness in the wrist, fingers or forearm. It is due to swelling of membranes that compress a nerve in the forearm, and is more common in people with hypothyroidism.

In writing to me, many people have reported that their CTS cleared up after being diagnosed and treated for hypothyroidism. In addition, some patients on thyroid hormone replacement but with high-normal TSH values have also reported that they continue to suffer from an existing case of CTS, or even develop new cases. I speculate that this is due to the fact that their hypothyroidism is undertreated. [Bold emphasis is that of the author of this blog.]

The medical research has for more than 15 years shown a strong relationship between CTS/other RSIs and hypothyroidism. However, the July 27, 1998 Archives of Internal Medicine published by the American Medical Association, has just reported on a research study that found that many people with CTS may have unrecognized medical diseases, including hypothyroidism, as the cause of their CTS.

In the article, titled "Concurrent Medical Disease in Work-Related Carpal Tunnel Syndrome", it was reported that in a third of all the patients studied, other illnesses -- mainly hypothyroidism, diabetes and joint disease -- were present that could be the cause of the CTS.

The researchers concluded that at minimum, doctors first need to determine if a case of CTS is due to a treatable medical problem such as hypothyroidism.

If you have CTS and hypothyroidism, my recommendation would be to make sure you are receiving proper treatment, and proper management of your TSH level, in order to make sure that your thyroid problem is under full control to minimize your symptoms.. Remember, the normal range is a range, not an absolute number. You might have symptoms -- including CTS problems - - at a TSH of 4.5, but not at a TSH of 2, for example. So if you are potentially what I refer to as undertreated, get in and discuss this with your doctor as soon as possible!

If you have CTS but have not been diagnosed with or tested for thyroid disease, clearly, these new findings would suggest that your doctor should order a thyroid function test for you before starting on any other treatments for your CTS.

After testing for and treating underlying diseases, the various treatments for CTS include:

* a wrist brace, worn at night and sometimes throughout the day, to keep the wrist in an unbent position to minimize nerve compression
* anti-inflammatory drugs to minimize swelling
* exercises
* changes in your office ergonomics
* cortisone injections
* surgery

In addition, some alternative practitioners are having success with alternative medicine treatments for CTS. Several years before being diagnosed with hypothyroidism, I had a painful bout of CTS (primarily due to working 12 hour days on the computer, I think, and probably not due to my thyroid at that point.) I couldn't even hold a glass in my right hand, it hurt so much. My doctors, who are osteopathic physicians, were reluctant to go to drugs or surgery as first course of action. So I had osteopathic manipulation and a few acupuncture treatments, and it took care of the problem. Last year, when I was pregnant, I had it again, this time due to the fluid retention and swelling of pregnancy. I went to a myotherapist for trigger point massage that helped relieve it. So I'll add osteopathy, acupuncture, and myotherapy to the lineup of treatment options. It appears that chiropractors are also claiming to offer good treatments, but I don't know anyone who's done this, so I can't say for sure, but chiropractic does operate on similar principles as osteopathy.

Author: Mary Shomon, Guide


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