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Diabetes and Common Hand Conditions

16th March 2017
By Erika Lassig

Hand and joint conditions can occur in people with or without diabetes. However, the likelihood is greater with diabetes. In fact, the longer you have lived with diabetes (type 1 or type 2) and the older you are, the higher your chances of developing a hand condition.

Lifestyle factors including smoking and high blood glucose levels have also been shown to heighten risk factors. If you smoke, see your GP and try to quit as soon as you can. Importantly, keeping your blood glucose levels under control improves circulation and healing potential.

Of interest, the conditions listed below (with the exception of Dupuytren’s disease) are more common in women than men, for which there is no known cause.

Carpal tunnel syndrome (CTS) is caused by compression of an important nerve at the wrist, called the median nerve. Symptoms include: pins and needles in the fingers and thumbs, dropping objects, weakness, pain in the wrist and hand, and in severe cases wasting of the muscles around the thumb. In mild cases CTS can be treated effectively with therapy. Severe or long-standing cases may require surgery.

Peripheral neuropathy or nerve damage from high blood glucose levels is also characterised by pins and needles or numbness in the fingers and hands, weakness, and in some cases pain. It can be difficult to tell the difference between CTS and peripheral neuropathy. To confuse matters, they may both be present at the same time. While an occupational therapist will be able to increase your hand function if you have peripheral neuropathy, the best treatment lies in maintaining healthy blood glucose levels.

Trigger finger or thumb (also known as flexor tenosynovitis) is a thickening of the tendon of the finger or thumb on the front surface of the hand, usually in the palm. Symptoms include: pain in the palm or joints, swelling of the fingers, reduced movement, and locking of the finger or thumb in a bent position that can only be straightened with force (and pain!). Therapy involves a custom-made finger splint, rest, and possibly some gentle exercises or other therapies focused on reducing inflammation.

Dupuytren’s disease is a thickening and contracture of the skin and underlying soft tissue in the palm that eventually forms nodules or raised cords. Usually there is a gradual loss of ability to straighten the affected finger or thumb. This condition is painless, takes years to progress and is not reversible with simple stretches or splinting. An occupational therapist will be able to help your hand function, but effective treatment can only be provided by a hand surgeon.

Often confused with Dupuytren’s disease, limited joint mobility occurs when the skin in the palm becomes thick, limiting the ability to straighten the fingers. Gentle low repetition exercises and therapy focused on maximising function may be helpful.

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