Table of Contents
Medical Conditions
Several medical conditions increase the risk for, or even cause CTS. The main conditions associated with CTS are diabetes, hypothyroidism, rheumatoid arthritis, osteoarthritis, obesity, and pregnancy. Many of the underlying diseases that contribute to the development of CTS are also associated with more severe forms of CTS.
Diabetes. CTS is a very common feature of diabetic neuropathy, one of the major complications of diabetes. Neuropathy is decreased or distorted nerve function; it particularly affects sensation. Symptoms include numbness, tingling, weakness, and burning sensations, usually starting in the fingers and toes and moving up to the arms and legs. About 6% of patients with CTS have diabetes. Up to 85% of patients with type 1 diabetes develop CTS. The development of CTS symptoms is related to the patient's age, and the length of time that he or she has had diabetes.
Autoimmune Diseases. In autoimmune diseases, the body's immune system abnormally attacks its own tissue, causing widespread inflammation, which, in many cases, affects the carpal tunnel of the hand. Such autoimmune diseases include rheumatoid arthritis, systemic lupus erythematosus, and thyroiditis, which can lead to hypothyroidism. Some experts believe that CTS may actually be one of the first symptoms in a number of these diseases. Studies also suggest that CTS patients with these disorders are more likely to have severe CTS that requires surgery.
Diseases that Affect Muscle and Bones. Arthritis, gout, and other medical conditions that damage the muscles, joints, or bones in the hand may cause changes that lead to CTS.
Structural Abnormalities. Inborn abnormalities in the bones of the hand, wrist, or forearm may contribute to CTS.
Chronic Kidney Insufficiency. People who have hemodialysis for chronic kidney damage often experience a buildup of a certain type of protein, called beta 2-microglobulin, in the hand. This buildup can result in CTS. The longer the person has been receiving hemodialysis, the greater the risk of CTS. Certain drugs and procedures (particularly a procedure called hemodiafiltration) may be able to reduce microglobulin build-up.
Other Diseases. Other medical conditions may cause or increase susceptibility to CTS:
- Down syndrome
- Amyloidosis (a progressive disorder of the connective tissues)
- Acromegaly (a disease that leads to abnormally large hands and feet due to excessive growth hormone)
- Tumor on the median nerve (removing the tumor often successfully treats CTS in these cases)
Medications. According to case reports, many other medications may increase the risk for temporary CTS. They include certain medications that affect the immune system (such as interleukin-2) and anticlotting drugs (such as warfarin). The evidence is conflicting as to whether corticosteroids and hormone replacement therapy may increase the risk of CTS. More research is needed before a cause-and-effect association can be established.
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Review Date: 02/17/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
