Hypothyroidism and Carpal Tunnel Syndrome (CTS) are believed to have a direct relationship. Do you experience tingling, numbness, and weakness in your fingers, hand, wrist, and forearm?
You might not know it, but it's likely that aside from carpal tunnel syndrome, you're also suffering from hypothyroidism. Yes, there is a connection between thyroid function and carpal tunnel syndrome, a painful nerve symptom.
What is Carpal Tunnel Syndrome
Carpal Tunnel Syndrome refers to a narrow space that is formed between the transverse carpal ligament and carpal bones where the median nerve passes, providing sensory and motor function to the first four digits of your hands and palms.
Generally, the exact explanation of how carpal tunnel develops is unclear, but many studies have associated it with hypothyroidism.
The fact is, hypothyroidism is a primary cause of nerve pain and CTS. The symptoms of carpal tunnel syndrome are usually experienced at night. Typically, the pain revolves around a person’s index finger, thumb, and the middle finger.
The pain is relieved temporarily by shaking the hands. Carpal tunnel syndrome is non-fatal, but if it is left untreated, it can lead to loss of total hand function.
Is Carpal Tunnel Syndrome a Symptom of Hypothyroidism
Carpal tunnel syndrome is considered a symptom of a thyroid disorder, including hypothyroidism. It can be a result of untreated or inadequate treatment of patients with hypothyroidism. Before even considering surgery for your CTS, it is a good idea to have your thyroid evaluated first.
The common problems of thyroid patients are excess body weight and water retention. These conditions lead to the compression of the median nerve.
The higher the body mass index and TSH, the higher is the risk of developing carpal tunnel syndrome.
Diabetes, rheumatoid arthritis, and B12 deficiency are all associated medical conditions with Hashimoto's and hypothyroidism. These conditions can cause nerve pain and other symptoms to worsen.
Is Increased BMI Responsible for CTS in Hypothyroidism
While the exact mechanism is unclear in the occurrence of neuropathy in patients with hypothyroidism, carpal tunnel syndrome in hypothyroidism can be attributed to the median nerve deposition with mucopolysaccharides or mucinous material.
In carpal tunnel syndrome, the swelling and inflammation of the synovial membrane surrounding the tendons occur in patients with uncontrolled hypothyroidism.
What Do Research Studies Show About CTS and Hypothyroidism
a. The Role of Increased BMI on the Development of CTS
In a study published online by the US National Library of Medicine, National Institutes of Health showed the relationship between hypothyroidism and carpal tunnel syndrome.
It was an observational study conducted over the course of one year in Maharashtra, India.
There were 36 patients included in the study of the clinical profile of CTS in patients suffering from primary hypothyroidism.
The clinical profile that was studied included the following factors: age, gender, duration of disease, body mass index (BMI), blood TSH level, thyroid replacement therapy, a possible cause of hypothyroidism, and previous CTS occurrence or history on patients with hypothyroidism.
The result shows that 16.7% of the patients experienced an increase in their BMI. A correlation between CTS and hypothyroidism was also found, but not with the other factors just mentioned.
The study concluded that an increased BMI is a major risk factor in the development of carpal tunnel in hypothyroidism.
b. Effects of Thyroid Replacement and Hypothyroidism in CTS
Another study conducted by the Departments of Orthopedics and Surgery in the University of California showed the relationship between thyroid replacement therapy and hypothyroidism on the development of CTS.
The study involved 26 hypothyroid patients with hypothyroidism that were examined using sensibility tests such as compression test, Semmes-Weinstein monofilaments, Phalen's test, discrimination testing (Weber 2-point test), and Tinel's sign.
Majority of patients have displayed symptoms of carpal tunnel syndrome. The symptoms of CTS are commonly seen in patients with hypothyroidism, even when they're on the state of euthyroid (normal levels of thyroid hormones).
How to Manage Carpal Tunnel Syndrome
As early as possible, you have to treat CTS once you notice the symptoms. You need to take frequent breaks by resting your hands. Avoid activities that may worsen the symptoms. To reduce swelling, you can apply cold packs to the affected area.
The other CTS treatment options are medications (ibuprofen or Naproxen Sodium), wrist splinting, and surgery. Conservative treatments, like splinting, are helpful for symptoms (mild to moderate) from 0 to 10 months. The main goal of surgery is to cut the ligament that is pressing the median nerve.
Since an increased BMI is linked to CTS, most especially for those with hypothyroidism, it also helps to lose weight if you're overweight or obese. Wearing a snug wrist splint at night also helps. You shouldn’t sleep or nap on your hands as well.
If numbness and pain are persistent, it is better to consult your doctor to rule out the root cause as soon as possible. Of course, hypothyroidism should also be addressed along with CTS to avoid recurrence.
This concludes that hypothyroidism and carpal tunnel syndrome are indeed interrelated.