Carpel tunnel, or neuropathy?

Diabetes Complications and other Conditions Other Conditions
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I will, of course, be seeing a doctor about this. But I thought I'd get some opinions here before going (I'm going to both my endocrinologist and GP on April 22nd).

A few months ago I noticed that I would sometimes wake up with a numb hand. I didn't think much of it, thought my hands just fell asleep while sleeping, but it started to happen more often. So I did some googling, and decided that it might be carpel tunnel syndrome. I noticed that Google said that, if it was carpel tunnel, usually the thumb and first two fingers are numb. Well, the next time it happened I paid attention to how my hand was numb, and it corresponds EXACTLY to what happens with carpel tunnel. It's my thumb and index and middle finger, and to a lesser extent my ring finger. My pinky and the outside edge of my hand are usually fine.

So, as usual I put it off in hopes it would go away. It hasn't ... In the past week or two it's started waking me up at night because my hand will be so tingly it feels like it's asleep (except doesn't "wake up" quickly like your foot does if it falls asleep). Some nights are fine, but some nights I'm woken up multiple times with this problem, and it happens to both hands. I've tried to not sleep on my hands and not sleep with my wrists bent, but it's hard to pay attention to when you're sleeping!

On a different but related note, I've recently had a few times where the top of one foot goes numb when I exercise. I googled it, and this also appears to be related to a compressed nerve somewhere. It only ever happens when I'm exercising, and then only sometimes. The only other time my foot goes numb is if I'm sitting on it. I have a ton of foot problems (structural problems, orthotics, arthritis) and am going to insist on going to a foot doctor, which for some reason no one seems to want to refer me to.

Of course, in the back of my mind the other day I started to wonder about neuropathy. I've never had the greatest diabetes control (I mean it hasn't been horrible, A1c around 7% usually with a few blips to the 8% and 6% range). After over 21 years, I'm sort of just "waiting" for something to develop.

Anyway, I'm wondering if anyone here who has carpel tunnel or neuropathy can share how it developed and the type of symptoms they had. And also the type of doctor I should be going to and the type of tests I might ask for. My endocrinologist already does a test for sensation in my feet at least every year, which is always normal. And I think neuropathy usually develops in your feet before your hands? But in the back of my mind, I worry ... Most people fear blindness the most as a complication; I fear neuropathy (well, and having a heart attack/stroke).

Thanks all! I haven't been too active on this site lately because my "real life" has been crazy with work and school, but I do stop by daily to read.

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It may not be carpel tunnel. It could also be a pinched nerve in your neck. I had to have a spinal fusion to my neck a few years back because of this same reason. After the surgery was done the tingling and numbness went away.

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Ok, so first off. Carpel Tunnel Syndrome (CTS) "is" neuropathy. To be precise, it is a median entrapment neuropathy. A simple test can confirm CTS, it is called Phalen's test (shown below). I suffer from CTS and I have lost significant flexibility in my wrist. If you have a bad case of CTS, doing this test will render your fingers and thumb numb within a minute, probably seconds.

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I also had episodes of waking up with numbness in my hands. I was uncertain if it was carpel tunnel, neuropathy, or a bit of both. My doctor prescribed a low dose of amitriptyline (elavil) and my symptoms disappeared. I stopped taking that drug about a year ago when I went low-carb and my BGs improved. The symptoms did not return.

I tried the CP test in the video that Brian posted and came up negative. Looking back, I'm not sure what the correct diagnosis of my numb hands was. Without ongoing symptoms, it remains a mystery.

I wish you luck finding out what is going on and identifying an effective treatment.

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Sorry to say I have had all of the above. I work at a keyboard 10 hours a day (mostly) and never had a problem until I fell and broke my arm. After the break healed, I began getting the numbness in my the thumb and two fingers of my right hand. I tried all the rest and exercise and support strategies that I could find. Rather than getting better it progressed to a sensation that wasn't quite pain but was uncomfortable enough to wake me up. It had also progressed to the whole hand being numb and/or buzzing.

I finally visited an orthopedic hand doctor who diagnosed that I not only had carpal (wrist) but cubital (elbow)tunnel syndrome. I wanted to take the conservative route through therapy before trying surgery. The bone/joint guy sent me to one of his partners whose specialty was neurology to test for neuropathy and confirm the cubital involvement. He did find some neuropathy in both arms but the real problem was the carpal/cubital nerves. They prescribed Lyrica which eliminated the pain but not the numbness. Therapy did not improve the conditions and I eventually had the surgery which resolved both the numbness and the "pain."

BTW, some people have said that the neuropathy test hurts. I did not find it so. Basically, they tape wire sensors on the arm and then give the arm a little electrical shock. They shock you in different places to check out various nerves, measuring the strength of the reaction. While my right arm was the problem, they tested both to create a relative baseline. He found "measurable" neuropathy but not significant. I was happy to have the carpal/cubital confirmed and to know that the neuropathy was mild. I have been T1 for 42 years and while my A1c's are now 7.0, for many years they were much much higher.

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I've had CTS for many years, and eventually had surgery a couple years ago.

But usually I would get a flair up, after significant work with my hands, like house painting and yard work. During those times, night time was the worst, with numbness and pain.

I found the following wrist splits helped tremendously, and also used advil as needed. Usually went back to normal after several weeks, along with avoiding the activities that caused it.
http://www.amazon.com/Wellgate-Women-Slimfit-Wrist-Support/dp/B000GHG3RG/ref=sr_1_1?ie=UTF8&qid=1365526029&sr=8-1&keywords=wrist+splint+women

Gradually it got to the point where the splits didn't help, and I had some pain/numbness during day hours as well, triggered by working on computer, rather than the other activities. So I had a nerve test, and eventually had surgery on both hands (2 weeks apart).

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I had bilateral Carpal Tunnel release surgery... then discovered I have Rheumatoid Arthritis which was the cause of the CTS. Had my doctor paid more attention, I would have avoided the surgery. It's worth a blood test and appt with a rheumatologist to see if RA is in play... good luck.

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I agree that it sounds like CTS to me. A few years ago, I noticed some pain in my right wrist, particularly around fantasy baseball season, when the 'scrolling' function on Yahoo involved dragging sliders up and down lists of players like a zombie. I switched to mousing with my left hand and it went away, and only took a little bit of getting used to. It also is useful at work as I can mouse and use the number pad at the same time.

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I do want to talk to my doctor about ruling out RA. My aunt has it and my grandmother had it. I think it's just a simple blood test to check for it, right?

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Jen,
Any tendon or ligament problems can be related to neruopathy. Elevated blood sugars can cause tendons, ligaments, arteries, etc, to become less flexible. I have neruopathy in my feet which for me a little carelessneess causes essentially sprained feet, which the docs like to suggest is either a sprained ankle or platar fascitis, but that is a different part of the foot, and that is another topic, I think.

You mentioned in your blog post that you have been doing a lot of academic writing lately. When I changed jobs from designing bridges to writing specs for bridge contracts, the additional writing and different mouse usage was pretty traumatic on my hands. Recently I changed from writing specs (or typing) to doing cost estimating which uses the 10 key and completely different hand movements. Both job transitions caused my hands to go numb at times, and even freeze sometimes so the only way I could open them was to massage them in warm water.

It was suggested I try yoga. I hate yoga, but I tried it anyway because I was desperate. The hand and arm movements were perfect to increase circulation to my hands and the motions stretched my muscles and tendons which eliminated my hand cramping after about a week or two. After about a month my hands were perfect again. Not sure if your problem is the same as mine, but good luck.

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Thanks for the thoughts. I have been doing a lot of academic writing lately, but it's not really "new work" for me ... I've done almost all my writing via typing for the past 15-20 years, due mostly to being visually impaired and not being able to read my own writing if I use a pen. People ask how I've achieved a typing speed of over 100 WPM, and I tell them LOTS of practice ... the disadvantage being that I can't write more than a few lines now without my hand cramping up from tiredness! I've recently bought a graphics tablet as I used to draw a lot, and I'm hoping this will help me get into it again (as I can magnify whatever I'm drawing on screen), but I have to re-build those pen-holding muscles!

I also use a white cane most of the time when I'm walking around, which involves wrist movements. I also probably use the mouse more often than most people. Even though I rely on keyboard commands more often than most, the screen magnification software I use requires the mouse to be moved every time I want to see or read anything on the screen, so I end up moving it around a lot. This weekend I was looking at ergonomic mice and keyboards, but they are so expensive because I want wireless.

I'm sure a combination of all these things doesn't help my hands/wrists.

I also have problems with my feet that I've had since my early 20s, flat feet and other issues that require orthotics, muscle weakness/tightness that affects my gait, arthritis in my toes, ankle pain (I think arthritis but it hasn't been checked out yet), swelling in my feet/ankles that has been going on for years and doctors claim is not related to any of my foot problems (I find kind of hard to believe!). So this is why I'd like to insist on seeing a specialist, at least they could probably know how everything is related (or not) better than my GP.

I did that test Brian posted above and my hands got very slightly prickly after a minute, but it wasn't major at all. It went away almost instantly when I stopped. I am pretty sure if I have a problem like this it's in the early stages, which is why I want to address it before it becomes more problematic.

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There are also "medical" mice which rotate your hand so that the thumb is up and provide better support. Helped me but not enough.