Everybody experiences hypothyroidism and autoimmune Hashimoto’s disease differently because symptoms vary considerably. Often we don’t even realize that some of our symptoms are actually thyroid related.
Despite a significant amount of research it comes as a big surprise to many thyroid patients that painful tingling sensations, numbness or burning in their hands, wrists, elbows and arms can be due to a thyroid imbalance.
In fact, hypothyroidism is one of the main causes of nerve pain and a condition called Carpal tunnel syndrome which is prevalent in hypothyroid patients at about 28.5%.
The good news is that hypothyroidism related nerve pain and carpal tunnel syndrome can be alleviated without surgery in most cases and today I am going to show you how.
What Is Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is a combination of signs and symptoms that develop due to compression of the median nerve (a nerve supplying muscles and skin of the hand) within the carpal tunnel which is a space between the carpal bones of the hand.
CTS as such is not a disease but only a manifestation of other underlying conditions or trauma and this is the reason why its called a syndrome.
Symptoms And Signs Of Carpal Tunnel Syndrome:
- Numbness, tingling, weakness, pain and abnormal sensations in the area of your hand and wrist due to pressure on the median nerve in your wrist.
- Objective or subjective weakness of certain muscles of the hand.
- Symptoms of CTS most often occur in the thumb, index finger, middle finger and half of the ring finger because their muscles are controlled by the median nerve. The little finger is supplied by a different nerve so it doesn’t get affected.
- You may first notice symptoms at night.
- You may be able to get relief by shaking your hand in the early stages.
- Swelling and inflammation of the connective tissue around the nerve due to a prolonged strain and repeated use of muscles of the hand.
- Nerve damage and nerve injury or neuropathy when a long term swelling and fibrosis leads to a thickening and excessive pressure on the nerve.
While Carpal tunnel syndrome is a nonfatal condition it can cause severe median nerve damage leading to the loss of hand function if left untreated.
If you are a thyroid patient it is very important to know that
Compression of the median nerve in the forearm leading to Carpal Tunnel Syndrome is more common in people with hypothyroidism.
2 Ways How Hypothyroidism Can Cause Carpal Tunnel Syndrome
- In hypothyroidism an excess deposition of glycosaminoglycans, hyalauronic acid and some mucopolyssacharides in subcutaneous tissues causes dermal oedema. In the narrow space of carpal tunnel, deposition of pseudo mucinous substances on the median nerve sheath leads to compression of the nerve and results in Carpal tunnel syndrome.
- Common problems among thyroid patients such as water retention and excess body weight create a median nerve compression. The higher the TSH, Body Mass Index (BMI) and more overweight you are, the higher your risk is to develop Carpal tunnel syndrome.
Besides hypothyroidism there other factors causing and contributing to CTS including:
- Medical conditions including diabetes, B12 deficiency anemia and rheumatoid arthritis. All three are associated conditions with hypothyroidism and Hashimoto’s and can make symptoms and nerve pain even worse.
- Repetitive hand movements especially those associated with modern lifestyles such as typing on mobile phones, computers and scrolling on a computer mouse.
All these factors need to be considered when making a diagnosis and choosing a treatment for CTS.
Carpal Tunnel Syndrome Check Up
Here is how to go about carpal tunnel syndrome diagnosis:
- Your doctor will ask if you have any health problems such as arthritis or diabetes or if you are pregnant.
- He or she will ask if you recently hurt your wrist, arm, or neck.
- The doctor will also need to know about your daily work and routine.
- While performing a physical, your doctor will check the strength and external appearance of your neck, shoulders, arms, wrists, and hands.
- You may also need to undergo tests – blood tests or nerve function and nerve conduction studies.
- Screening for B12 deficiency anemia that can cause many similar symptoms as CTS
- Sometimes you may need to undergo an Electromyography test and even an MRI scan of hands or shoulder.
- Screening for thyroid disease is well warranted. One of the goals is to determine if CTS is due to a treatable medical problem such as hypothyroidism before starting on any other treatments for your CTS. Many patients have reported improvement in symptoms of carpal tunnel syndrome after their thyroid imbalance was treated.
However, keep in mind that hypothyroidism is not always easily detected because standard thyroid tests such as TSH and T4 are often unreliable and are not designed to make a Hashimoto’s diagnosis.
Subclinical hypothyroidism when a person has normal thyroid hormone levels but mildly elevated TSH is another risk for CTS. As a result, an untreated or under-treated hypothyroidism can be the underlying not so obvious cause of this distressing condition.
In addition, an overactive thyroid gland and excessive thyroid hormone replacement therapy can also affect the median nerve and cause peripheral neuropathy by other mechanisms so even an overzealous treatment of hypothyroidism can cause symptoms of CTS.
It is not clear how many people may have undergone unnecessary surgeries for CTS who were not diagnosed with hypothyroidism which was in fact a treatable underlying condition. However, medical options should be explored fully before taking the decision to have surgery.
How To Recover From Carpal Tunnel Syndrome
Mild symptoms and a starting phase of Carpal Tunnel Syndrome can be treated with home care. You can try icing your wrist for 10 to 15 minutes 1 or 2 times an hour. However, many hypothyroidism patients have cold hands and feet and feel that icing is aggravating this even more.
After testing for and treating underlying diseases, the various treatments for CTS include:
- wrist braces used to optimize the wrist joint position which reduces nerve compression to a minimum
- anti-inflammatory drugs to minimize swelling
- changes in your office ergonomics
- cortisone injections
- osteopathic, yogic and acupuncture treatments have also found some success
Treatment of peripheral neuropathy due to hypothyroidism is directed at correcting the underlying thyroid imbalance and treating the resulting symptoms. This may include:
- Thyroid drugs
- Use turmeric for thyroid the right way to support your thyroid and decrease inflammation and swelling. I recommend this specific turmeric supplement to achieve better results
- Weight loss and maintenance of a healthy weight. This is possible even if you have hypothyroidism. Check out here how to lose weight by balancing thyroid and other hormones
- Refrain from smoking
- Use effective B12 supplement
The earlier you start on with a proper thyroid therapy, the better your chances of stopping symptoms and preventing long-term damage to the nerve.
Studies show that an increase in the median nerve compression caused by hypothyroidism can be fully reversible after achieving target levels of TSH and free T4 with an optimal thyroid treatment.
In general, if you are concerned about developing CTS you can try to take good care of your wrists and hands:
- Try to keep your wrist in a neutral position.
- Stop activities that cause numbness and pain. Rest your wrist longer between activities.
- Use your whole hand instead of just your fingers to hold
- When you type, keep your wrists straight, with the hands a little higher than your wrists. Relax your shoulders when your arms are at your sides.
- Switch hands from right to left or vice versa when doing repeated movements.
- Do stretching exercises often because they would be especially useful since they focus on a lot of stretching, improving flexibility, strength and relaxation of muscles and joints
- For many, alleviating the compression of the median nerve using natural methods can help to avoid surgery, reverse CTS and other causes of hand numbness. Consider this alternative carpal tunnel treatment created by a licensed massage therapist with 23 years of practice before undergoing a surgery.
You need to make sure that your thyroid is properly diagnosed and optimally treated since this alone would in many cases improve or resolve completely symptoms of Carpal Tunnel Syndrome.
P.S. Like want you read and want to get more? Get access to our FREE online Hypothyroidism Seminar: The Right And Wrong Ways To Heal here
Cross-sectional area of the median nerve is increased in primary autoimmune hypothyroidism and decreases upon treatment with thyroxine. Eur J Endocrinol. 2016 Oct;175(4):265-71.
Carpal Tunnel Syndrome in Hypothyroidism. Clin Diagn Res. 2016 Feb;10(2):OC36-8.
Diagnostic value of median nerve ultrasonography for screening of carpal tunnel syndrome in hypothyroid patients: A cross-sectional study. J Neurol. 2016 Apr 3;15(2):70-4.