Carpal tunnel syndrome, or median nerve compression, is becoming increasingly common in the US with over 3 million cases a year. Unfortunately, many carpal tunnel syndrome sufferers are not aware that it can be a symptom of an underactive thyroid.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is defined by a numbness and/or tingling sensation in the hand and arm due to a pinched nerve in the wrist. More specifically, the median nerve goes through a tunnel near the wrist bone (the carpal tunnel), allowing for sensation in the fingers. When there is swelling or irritation of the median nerve, inflammation then causes pressure to the area. This leads to the experience of pain, tingling, burning, numbness, and weakness in a number of areas (thumb, index finger, middle fingers, wrist, and forearm) as well as decreased grip strength.

Unfortunately, many carpal tunnel syndrome sufferers are not aware that it can be a symptom of an underactive thyroid.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is defined by a numbness and/or tingling sensation in the hand and arm due to a pinched nerve in the wrist. More specifically, the median nerve goes through a tunnel near the wrist bone (the carpal tunnel), allowing for sensation in the fingers. When there is swelling or irritation of the median nerve, inflammation then causes pressure to the area. This leads to the experience of pain, tingling, burning, numbness, and weakness in a number of areas (thumb, index finger, middle fingers, wrist, and forearm) as well as decreased grip strength.

Causes of Carpal Tunnel Syndrome

Carpal tunnel syndrome has a variety of potential causes and risk factors:

• Repetitive strain on the median nerve
• A wrist fracture that narrows the carpal tunnel and irritates the nerve
• Rheumatoid arthritis and subsequent inflammation
• Diabetes as it can increase the risk of nerve damage
• Medications as studies have shown a link between carpal tunnel syndrome and the use of some medications, such as anastrozole (Arimidex), a drug used to treat breast cancer.
• Obesity
• Pregnancy (carpal tunnel during pregnancy typically goes away after pregnancy)
• Workplace factors such as working with vibrating tools or any job that requires prolonged or repetitive flexing of the wrist may create harmful pressure on the median nerve.

Most of the above risk factors of carpal tunnel are fairly well-known, however, hypothyroidism’s association with the syndrome is not discussed enough as a potential cause.

Carpal Tunnel Syndrome and the Thyroid

Carpal tunnel syndrome is typically diagnosed by a hands-on examination to rule out other conditions, as well as clinical signs of the condition, which can include swelling and discoloration. A practitioner may manipulate the hand to reproduce carpal tunnel syndrome-suggestive hand positions that generate tingling or symptoms. A nerve conduction velocity test may also be conducted to measure the speed of electrical impulses as they pass through the carpal tunnel. A slowdown of the impulse can be a sign of the condition.

However, this method of diagnosis fails to consider the root cause of carpal tunnel. In the case of patients with an underactive thyroid, they often have a fluid retention issue that leads to the experience of increased pressure within the carpal tunnel, irritating the median nerve.

Treating Carpal Tunnel Syndrome

• Treating carpal tunnel syndrome involves the following:
• Eliminating repetitive stress movement triggers
• Night splints to immobilize the wrist
• Nonsteroidal anti-inflammatory drugs
• Corticosteroid injections to reduce inflammation
• Acupuncture
• Exercise
• Physical therapy
• Yoga
• Supplementation of B6

If the thyroid is the root cause of carpal tunnel, a thyroid panel should be conducted.

Learn about the symptoms of hypothyroid and consider if you may have hypothyroidism.

When asking your doctor for a thyroid panel, it is important to recognize that a panel should include Thyroid Stimulating Hormone (TSH), Free T4, Free T3, and Thyroid Peroxidase Antibodies (TPO) at minimum. Keep in mind that “your tests were normal” is not enough information from your doctor. Ask for actual numbers, and know that optimal thyroid levels are typically a TSH level below 2.0, and Free T3 in the higher end of the reference range (however, every case is individual).

Taking Action

If you are being treated for carpal tunnel syndrome and/or hypothyroidism and feel that you are not getting the care you need, it may be time to find a different doctor and treatment plan. Locating an effective and knowledgeable thyroid physician can seem daunting and unending, but there is hope!

At Holtorf Medical Group, our physicians are trained to provide you with cutting-edge testing and innovative treatments to properly diagnose and treat your thyroid condition, optimize your health, and improve your quality of life. If you have been diagnosed with hypothyroidism, but aren’t getting the treatment you need or if you have symptoms associated with thyroid dysfunction, contact us today to see how we can help you!