Diabetics can be vulnerable to a number of nerve-related conditions. Although these conditions are more common in the feet and lower legs, other parts of the body can also be affected such as the hands and wrists. Conditions such as Dupuytren’s contracture and carpal tunnel syndrome are more common in people with diabetes and can cause symptoms such as weakness, numbness, and loss of function in the hand and arm, which may require expert care from an orthopedic surgeon.
Diabetes is a disease that causes levels of glucose (a type of sugar) in the blood to become elevated. This is caused by insufficient or defective insulin production made by the pancreas. Insulin moves glucose from the bloodstream into the cells of the body to give us energy. If the body can’t process it properly, or make enough of it, glucose doesn’t reach the cells and stays in the bloodstream, which can cause medical complications such as circulatory and nerve damage.
Diabetic Neuropathy
People with diabetes often have high blood sugar levels, which if not managed correctly can damage the nerves throughout the body and lead to a condition known as diabetic neuropathy. There are three types of diabetic neuropathy, including peripheral neuropathy, autonomic neuropathy, and focal neuropathy.
Peripheral neuropathy is damage to the peripheral nerves that sense pain, touch, heat and cold, and control muscles. It develops when the nerves in the body’s extremities, such as the hands, arms, legs, and feet, are damaged. However, it most commonly affects the nerves in the feet and lower legs, which can lead to serious foot problems.
Autonomic neuropathy is when there is damage to the autonomic nerves that control things like blood pressure, heartbeat, digestion, and sexual function.
Focal neuropathy affects only one nerve usually in the wrist, hand, upper leg, or foot. There are many types of focal neuropathies that can affect people with diabetes, but the most common type are entrapment syndromes, which occur when nerves become compressed or trapped in areas where they pass through narrow passages between tissues and bones. The most common type of entrapment syndrome is carpal tunnel syndrome which occurs in the wrist.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is caused when pressure is put on the median nerve as it passes through the wrist. The median nerve runs from the forearm, through the carpal tunnel in the wrist, and to the hand. It carries signals for muscle movement and sensation. If the nerve becomes compressed or entrapped, it isn’t able to function properly and can lead to symptoms such as numbness, tingling, and weakness in the hand, wrist, and arm. This can make certain activities, such as those involving grasping and gripping actions, difficult. An orthopedic surgeon can usually treat carpal tunnel syndrome successfully with nonsurgical treatment methods such as rest, pain relief, and wearing a splint at night to support the wrist in a neutral position. If nonsurgical options do not work effectively or if the condition becomes worse, carpal tunnel release surgery may be recommended.
Dupuytren’s Contracture
Dupuytren’s contracture is a condition that appears to be more prevalent in people with diabetes. The condition causes the connective tissue beneath the surface of the skin in the palm of the hand to thicken and knot, which over time, creates strong cords. These cords can then contract, which pulls the fingers (usually the two fingers farthest from the thumb), so they become bent towards the palm and cannot be straightened completely. This can make simple everyday activities, such as grasping large objects, difficult. Although Dupuytren’s contracture is not usually painful, it can affect movement and function in the hand.
An orthopedic surgeon may be recommended if you are unable to extend your fingers. Treatments such as enzyme injections may help relieve symptoms, but surgery, such as a fasciotomy, may be recommended if the fingers become flexed enough to restrict hand function.
Hand and Wrist Care in Greater Chesapeake
If you have numbness, weakness, or limited function in your hand or wrist, speak to Greater Chesapeake Hand to Shoulder. Our Maryland surgeons use a variety of nonsurgical and surgical treatments to effectively treat a broad range of conditions affecting the hand, wrist, elbow and shoulder. For more information or to book a consultation, call us at (410) 296-6232 or you can request an appointment online at one of our offices throughout Maryland.
