The Link Between Rheumatoid Arthritis and Carpal Tunnel

Carpal tunnel syndrome negatively affects the hands and wrists and is characterized by pain, numbness, and tingling. Carpal tunnel syndrome occurs when the tissues inside the carpal tunnel at the base of the hands become swollen and irritated. The ligaments in the carpal tunnel compress and entrap the median nerve, which runs from the palm of the hand to the forearm and allows the thumb and fingers to feel pressure or pain. 

Carpal tunnel syndrome can be caused by a number of factors, such as continued use of hand tools that vibrate, retention of fluids during menopause or pregnancy, sprains or fractures, or repeated use and movements of the hands and wrists. People with various conditions, such as an underactive thyroid gland or diabetes, may also be susceptible to developing carpal tunnel syndrome.

Research has determined that people with rheumatoid arthritis are also at an increased risk for developing carpal tunnel syndrome. Rheumatoid arthritis commonly affects the wrist joints, as one of the hallmarks of the condition is swelling and inflammation of the lining of the joints (the synovium).

Carpal tunnel is characterized by numbness, pain, and tingling at the base of the hands. When the tissues inside the carpal become irritated and swollen, carpal tunnel syndrome occurs. A number of factors can cause this condition. According to research, the risk of developing carpal tunnel syndrome may increase in people with rheumatoid arthritis. Since rheumatoid arthritis causes wrist and hand pain as well as swelling, RA patients tend to experience worsened carpal tunnel syndrome. People with rheumatoid arthritis do not necessarily have to engage in repetitive hands motions in order to develop this disease. 

In 2015, a research study showed that those who receive certain medications to treat rheumatoid arthritis may experience a decreased risk of carpal tunnel syndrome. Dr. Donald Rapoport from Fall River, Massachusetts is a rheumatologist who stated that, through his own clinical trials, he noticed a decreased incidence of carpal tunnel syndrome due to such medications. He has seen fewer people with rheumatoid arthritis developing the syndrome and feels that the risk of developing the condition may increase due to certain activities and jobs. Work related to computers or sewing machines, for example, can contribute to the development of carpal tunnel syndrome. On the other hand, the odds of getting the disease can be improved by taking certain medications. According to one Dr. Kohler, the risk of carpal tunnel syndrome can decrease due to modern medications for rheumatoid arthritis. He says the medications that reduce swelling and inflammation can also lessen swelling on the median nerve as well as irritation.

According to the American Academy of Orthopedic Surgeons, over time, carpal tunnel syndrome worsens if it is left undiagnosed and untreated, so early diagnosis and treatment are very important. Electromyography, or nerve conduction studies, are done to confirm the diagnosis. Ultrasound images can reveal swollen, enlarged nerves. In the case of carpal tunnel syndrome, it can show swelling or any other abnormalities. Permanent nerve damage can occur if treatment is delayed. In rheumatoid arthritis, treatment plans for carpal tunnel syndrome first start with treating the underlying symptoms of arthritis, such as swelling, inflammation, and irritation. Patients are usually suggested to take pain reducers or to wear a splint on the wrist. The pressure on the median nerve is relieved by wearing a splint, and it also prevents further damage to the wrist. These splints are easily available at local pharmacies and supermarkets. Injecting cortisone into the carpal tunnel is another step in the treatment. They help to reduce the symptoms of the condition for several weeks or even months. While managing symptoms, the focus of treatment can turn towards rheumatoid arthritis if it is the cause of the carpal tunnel syndrome. If there is no improvement after using all possible treatments, namely, medications, cortisone injections, and splints, then the only option left is surgery. The surgeon will open up the carpal tunnel in order to relieve pressure on the median nerve. Immediately, the person will experience relief, and this is known as carpal tunnel release. Surgery cannot be performed on an outpatient basis; it is done either through a surgical or endoscopic procedure.