Symptoms Symptoms of carpal tunnel syndrome usually progress gradually over weeks and months, or sometimes years. Anyone with recurrent or persistent pain, numbness and tingling, or weakness of the hand should consult a doctor for a diagnosis. Symptoms often develop as follows: Initial symptoms include pain in the wrist and palm side of the hand. Problems commonly occur in both hands. (Even when only one hand is painful, the other hand often shows signs of nerve conduction abnormalities when tested.) Early on, the patient also usually reports numbness, tingling, burning, or some combination of symptoms on the palm side of the index, middle, and ring fingers. (Typically the fifth finger has no symptoms.) Such sensations may radiate to the forearm or shoulder. Over time, the hand may become numb, and patients may lose the ability to feel heat and cold. Patients may experience a sense of weakness and a tendency to drop things. Patients may feel that their hands are swollen even though there i...
In the previous post, we discussed different types of surgeries which are used in patients with rheumatoid arthritis . This week I’d like to talk more about surgeries involving soft-tissue, specifically synovectomy, tendon repair, and carpal tunnel release.
What is a Synovectomy?
The synonium is a membrane surrounded a joint, usually only one or two cell layers thick, which produces synovial fluid to help lubricate the joint. In rheumatoid arthritis, the synovium becomes inflamed and may grow excessively, producing too much synovial fluid containing an enzyme that can eat away at the cartilage on the joint surface. Disease-modifying anti-rheumatic drugs (DMARDs) are used to control the abnormal growth of synovium.
If DMARDs do not work, a patient’s rheumatologist may suggest steroid injections into a joint or a needle aspiration of excess synovial fluid. If these strategies do not work, then the patient may be referred to an orth...
I just saw the following question:
I recently had carpal tunnel surgery on both hands at the beginning of June. It's now late July and my blood sugar levels are still in the 230s. I take Lantus twice a day. What can I do? I have a constant headache, jaw pain, teeth hurt; can this be making my level stay high?
Something doesn’t quite fit together here. As I understand it, you have had elevated blood glucose levels continuously since hand surgery that was done almost two months ago.
Surgery certainly can cause pain, and pain is a stressor that can raise blood sugar levels. Plus, after most surgical procedures, there’s decreased physical activity for a while, which also would contribute to high sugar levels. With that in mind, I think people with diabetes who are on insulin shots or pumps should be given explicit instructions on what target ranges to aim for post-operatively, and how to adjust their insulin to meet these targets.
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