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The Difference Between Carpal Tunnel and Diabetic Neuropathy

A male doctor shows a female patient an X-ray of her hand.What are two conditions that are often misdiagnosed as carpal tunnel syndrome? There are actually several: arthritis and tendonitis, for instance. An important mimic for carpal tunnel is diabetic neuropathy. Carpal tunnel and diabetes complications can be mistaken for one another.

What Does Diabetic Neuropathy Feel Like?

Diabetic neuropathy is a complication of diabetes in which nerves are damaged. Over time, the high blood glucose levels cause chemical changes in the nerves of these patients, which prevents the nerves from sending signals to the rest of the body. High blood sugar levels can also damage the blood vessels that provide oxygen and nutrition to the nerves. 

Because there is no cure, when the symptoms associated with neuropathy appear in the hands and wrists, most people believe there is no alternative other than learning to live with the pain and loss of function.

Diabetes and prediabetes symptoms like tingling encompass more than just neuropathy. With diabetes, fingers and hands can also become stiff with limited mobility. Some people develop trigger finger or Dupuytren’s contracture.

What Does Carpal Tunnel Feel Like?

A woman uses her computer mouse while wearing a wrist bandage. Carpal tunnel syndrome (CTS), like diabetic neuropathy, is also a form of entrapment neuropathy, where the nerve has become trapped or compressed by surrounding tissue. Diabetic neuropathy, specifically the most common form (referred to as peripheral neuropathy), affects the nerves in the hands, arms, feet, and legs. Carpal tunnel syndrome refers only to the median nerve.

Typically, carpal tunnel symptoms appear gradually. They may come and go, but, sooner or later, they will get more intense and consistent. The most common carpal tunnel syndrome symptoms include:

  • Pain – often intense, generally in the wrist area but also can be felt in the hand and up the arm
  • Numbness – typically felt in the wrist and fingers (with carpal tunnel, only the thumb, first, second, and half of the third finger are affected)
  • Burning sensation in the wrist – there may be a burning sensation, like numbness, which is usually found in the wrist and fingers
  • Tingling – this may be experienced along the arm, in the wrist, or down into the hand and fingers
  • Shock-like sensations – often unsettling, shooting sensations that go up the arm, sometimes described as jolts of electricity
  • Weakness or clumsiness – fine motor skills and strength in the fingers and wrist are impacted

Can You Get Carpal Tunnel in Your Feet?

Diabetic patients often experience neuropathy in their feet and might wonder if their symptoms are a form of carpal tunnel. In fact, there is a similar condition called tarsal tunnel syndrome. Like carpal tunnel, it mimics symptoms of diabetic neuropathy.

Why Are These Conditions So Similar?

A doctor holds a patient’s hand and examines her wrist.The pain, numbness, tingling, burning, and jolts, as well as weakness and loss of strength and coordination associated with both carpal tunnel syndrome and diabetic peripheral neuropathy, are often indistinguishable.

Diabetes can cause carpal tunnel syndrome. The carpal tunnel is a passageway at the base of the hand. Within the carpal tunnel, you have the median nerve and tendons that bend the fingers. In diabetes, the blood sugar attaches to the proteins of these tendons, which causes inflammation and prevents the tendons from moving properly. The carpal tunnel then becomes narrowed and compresses the median nerve, which causes carpal tunnel syndrome. But it gets more complicated than that. According to research from the journal Diabetes Care, the incidence of carpal tunnel syndrome is increased even in pre-diabetic patients, before they are diagnosed with diabetes. Hyperglycemia (high blood glucose levels) and associated metabolic abnormalities may contribute to carpal tunnel in these patients.

Does the Difference Matter?

Since the symptoms are the same and both are caused by nerve compression, it may not seem to matter whether the pain in your wrist is from carpal tunnel syndrome or from diabetic neuropathy. There is one very good reason to have an accurate diagnosis: diabetic neuropathy may not have a cure, but treatment is available for carpal tunnel syndrome that can relieve symptoms and restore normal functioning.

If you are experiencing pain and other symptoms in your hand or wrist, it is important to consult with your healthcare professional to determine what exactly is causing it and what steps to take going forward.

If you have questions about carpal tunnel syndrome or any other orthopedic concerns, the physicians and staff of South Island Orthopedics are very experienced in a wide range of orthopedic conditions and are committed to providing personalized care in a state-of-the-art facility.

Visit us online to learn more and to request an appointment with one of our hand and wrist specialists. 

Posted in: Hand & Wrist