Diagnosis Carpal tunnel syndrome is most accurately diagnosed using a medical history, the patient's descriptions of symptoms, a physical examination, and electrodiagnostic tests that measure nerve conduction through the hand. Diagnosing CTS, however, is not straightforward. Only a small fraction of patients exhibit all three factors necessary for a clear diagnosis: Classic CTS symptoms Specific physical findings Abnormal electrodiagnostic test results Many people have abnormal electrodiagnostic test results without classic symptoms or any symptoms at all. Furthermore, about 15% of the population has symptoms that are consistent with CTS, but in most of these people, test results do not indicate the disorder. MRI, CT scans, and other imaging tests are not useful for diagnosing carpal tunnel syndrome. Symptom Description and Severity Many cases of CTS result from a medical problem that is worsened by repetitive stress factors at work. The patient should give the doctor a detailed history and de...
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.
As the story was unfolding in Part One , I shared that my neurologist had referred me to a hand surgeon to be evaluated for treatment of Carpal Tunnel Syndrome. The hand surgeon injected steroids into each wrist which relieved the swelling, pain, and dysfunction. He stated that when/if the pain returned that my next step would be Carpal Tunnel Release surgery, a procedure I was greatly fearful of and didn’t want to undergo. However, he also referred me to a rheumatologist to be evaluated.
My first appointment with the rheumatologist was exactly two years ago. I brought to the appointment: x-rays of the swollen (and immobile) finger, a note detailing my symptoms and attempted treatments, and a history of blood work. The rheumatologist used a nifty ultrasound machine to detect inflammation around the joints and possible erosion of the bones in the joints due to arthritis. The evidence seen on ultrasound combined with the examination, my hi...
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