Diabetes and Your Hands
While it’s common knowledge that diabetes involves an elevation of a person’s blood sugar, it is not well known why diabetes can cause stiffness of the hands, shoulders, and other joints and how exactly it plays a role in diseases like trigger finger and Dupuytren’s contracture.
Diabetes Stiff Hand Syndrome
Diabetes can cause stiffness of the hands in a condition known both as diabetic stiff hand syndrome or diabetic cheiroarthropathy. It is an uncommon condition in which a person’s finger movement becomes decreased and the hands take on a thickened and waxy appearance.
As it turns out, people with both type 1 diabetes and type 2 diabetes can both get the disorder. People who keep their blood sugars under good control and partake in physical therapy usually can overcome the condition.
Diabetes stiff hand syndrome is found in 8 to 50 percent of type 1 diabetic patients. Lesser numbers of type 2 diabetic patients will come down with the disease. The longer a person has diabetes and the worse control of the diabetes the person has, the greater is the chance of getting diabetic cheiroarthropathy. People who have diabetes that results in diabetic neuropathy have a greater chance of having stiff hands when compared to diabetics who don’t have diabetic neuropathy.
Common symptoms of diabetic stiff hand syndrome include an inability to move the joints very much, which winds up causing limitations in the function of the hand. Usually the stiffness starts in the smallest fingers of the hands and progresses so that eventually all of the fingers are affected.
In the most severe cases, the individual with stiff hand syndrome are unable to clench the hands at all and the fingers stick straight out, unable to hold onto anything with any degree of strength. The skin is also affected so that the backs of the hands develop thick, tight skin that has a waxy appearance.
There are many possible causes of diabetic stiff hand syndrome. Some experts believe that the problem occurs when high glucose levels cause binding of glucose onto the collagen of the hands, which makes up a portion of the connective tissue of the hands. Some studies have shown that the collagen of individuals with diabetic stiff hand syndrome is different from the collagen of normal people.
It is also believed that small vessel disease so common in diabetes and diabetic neuropathy also contribute to getting diabetic stiff hand syndrome. This means that you may be able to prevent this complication by keeping the blood sugars in good control at all times.
Diabetic stiff hand syndrome can be diagnosed by putting the hands together in a praying position. If there is any gap between the palms and the joints of the fingers when the hands are put together, it means that the joints are stiff and you likely have stiff hand syndrome. This is the time you need to talk to your doctor about ways to keep the hands more supple.
No one knows exactly what causes a person to develop diabetic stiff hand syndrome. It is believed, however, that keeping the blood sugar levels under the best of control may prevent the condition from occurring. Once you have the disease, there are exercises you can do in physical therapy that can loosen the stiffness of the hands. Stretching is an important part of this physical therapy regimen.
Diabetes and Carpal Tunnel Syndrome
Being a diabetic is another risk factor for carpal tunnel syndrome. Carpal tunnel syndrome occurs when there is swelling and inflammation of the connective tissue that makes up the carpal tunnel of the wrist. Inside the carpal tunnel is the median nerve, which controls movement and sensation of the palm of the hand, the thumb, the index finger, the middle finger, and half of the ring finger.
Common symptoms of carpal tunnel syndrome include parasthesias (tingling sensation) of the hands, numbness of the hands, and decreased grip strength of the hands to that it is common to drop things as the pincher grip is diminished. Only the small finger of the hand is spared in carpal tunnel syndrome.
No one knows why diabetics are at an increased risk for developing carpal tunnel syndrome. Most research studies point to the elevation of blood sugar as being the root cause of inflammation of the connective tissue in the wrist that pinches off the nerve leading to the hand. Poor circulation in diabetic patients may also play a role in the development of the syndrome.
Carpal tunnel syndrome strikes about 2-3 percent of individuals but it seems to be more prevalent in certain conditions. Diabetics who also have problems with low thyroid conditions, high blood pressure, or autoimmune syndromes also seem to have a higher risk of developing the syndrome.
Altogether, it has been found that diabetics have a 15 times greater risk of developing carpal tunnel syndrome when compared to people who do not have diabetics. In fact, about 20 percent of diabetics will eventually come down with carpal tunnel syndrome.
Carpal tunnel syndrome may actually be used to screen people with diabetes. A research study showed that people who had carpal tunnel syndrome had a 36 percent incidence of later developing type 2 diabetes, even if they had no other risk factors for the disease. While the two conditions seem to be related, it is not believed that either one causes the other disease to occur.
There doesn’t seem to be a relationship between carpal tunnel syndrome and the length of time the person has diabetes nor does it seem to be related to blood sugar levels or the degree of blood vessel disease in diabetics. It is possible that carpal tunnel syndrome and diabetes just share the same demographics and aren’t actually related to one another.
Studies have also shown that type 1 diabetics have a higher risk of developing carpal tunnel syndrome. They don’t, however, develop the most severe form of carpal tunnel syndrome. People with metabolic syndrome, on the other hand, have a higher risk of both diabetes and carpal tunnel syndrome, and they generally get a severe form of carpal tunnel syndrome.
Diabetes and Trigger Finger
Trigger finger happens when one or more fingers of the hand get stuck and are unable to straighten. There may be a clicking sensation when the joint locks up. The problem is usually worse in the morning hours and can be painful. People with diabetes seem to have an increased risk of developing a trigger finger for reasons that aren’t completely clear.
Diabetes and Dupuytren’s Contracture
Dupuytren’s contracture starts with a thickening of the palm of the hand with the eventual development of a lump beneath the skin on the palm side of the hand. It usually affects the base of the little finger or the base of the ring finger.
The lumps eventually coalesce into a thick cord that extends along the palms and into the fingers. The cords shorten so that the sufferer is unable to completely extend the fingers. It limits the movement of the hand and the ability to use the hand in activities of daily living.
Diabetics have a greater incidence of Dupuytren’s contracture for reasons that are not completely clear. Once the condition develops, however, physical therapy and stretching exercises can help reduce the contracture of the hands. If physical therapy doesn’t work, surgery can be done to cut the ligaments that have become contracted. The hand may still have a loss of functioning as the surgery doesn’t leave the hands with functioning ligaments.
- Diabetic stiff hand syndrome. http://www.diabetes.co.uk/diabetes-complications/stiff-hand-syndrome.html. Accessed 5/10/16.
- Diabetes and Carpal Tunnel Syndrome. The 411. http://www.healthline.com/diabetesmine/the-411-on-carpal-tunnel-syndrome-diabetes#1. Accessed 5/10/16.
- Diabetes and the hands. http://www.diabetesselfmanagement.com/blog/diabetes-and-your-hands/. Accessed 5/10/16.
- Dupuytren’s Contracture Risk Factors.http://www.webmd.com/a-to-z-guides/features/dupuytrens-contracture-causes. Accessed 5/10/16.