Ask the Doctor Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

"What is the relationship between hypothyroidism and carpel tunnel syndrome? A published answer would be greatly appreciated." -- MT, Buckingham, VA

Carpal tunnel syndrome is due to compression of the median nerve at the wrist. It results in pain, tingling, and weakness of the wrist with symptoms most prominent in the thumb and the adjacent three fingers. Risk factors include repetitive trauma to, or use of, the wrist joint (especially in workers on an assembly line), as well as hypothyroidism and acromegaly (growth hormone excess).

Hypothyroidism may be associated with carpal tunnel syndrome because hypothyroid patients tend to retain fluid in connective tissues due to an accumulation of mucopolysaccarides, a substance that accumulates abnormally in hypothyroidism. This exacerbates the swelling and worsens the compression of the median nerve as it passes under the connective tissues overlying the wrist.

When hypothyroidism is treated, the symptoms of carpal tunnel syndrome may improve. Therefore, unless there is evidence of severe nerve injury, hypothyroid patients with carpal tunnel syndrome should wait for a few months after their hypothyroidism is corrected before considering surgery to release the pressure on the median nerve. Conservative measures such as a splint, and non-steroidal anti-inflammatory medications such as ibuprofen may be useful while waiting for hypothyroidism to resolve.