Have I or have I not got carpel tunnel?


Hello Dr Bland,

I'm 56 years of age and have been Type 1 diabetic for 26 years. I'm reasonably fit (ie I can cycle a 20km round trip to work each day without much problem) and have been a vegetarian for 32 years.

Around 18 months ago, the index fingers on both my hands began to start feeling stiff. Concerned, I had an ultrasound done on both hands but very little was revealed, the overall conclusion was something like 'minor wear and tear, due to age' - and I was given a cortisone injection which had no effect whatsoever on the pain or stiffness.

I asked the doctor whether he thought I had carpel tunnel but he was unsure.

Over the past 18 months the stiffness and pain has spread to the middle finger on each hand. My thumbs, ring fingers and little fingers are fine.

I've had blood tests for uric acid build-up and rheumatoid arthritis but these have come back normal.

I've played guitar and bass for more than 35 years and have spent the past 2o years working as a journalist - so my fingers have had a lot of keyboard use - so could it be a form of RSI?

I've never had numbness or pins and needle in either hands and I'm never woken because of pain.

Today, I've been painting walls and doing some minor gardening, but the pain and stiffness has 'peaked' to the point where I had to stop. When this happens I also get a burning sensation in both wrists.

When I try and straighten my fingers I can't, they're too stiff - almost like they're made of solid bone and inflexible - and very painful.

I've tried stretching my wrist flexors and forearms and holding them in this position for around a minute. After doing this three or four times I get some relief from the pain and the stiffness reduces - I can actually bend the index and middle fingers on both hands.

I understand it's impossible to diagnose this over the internet, but do you think I have a strong case for carpel tunnel?

Thanks in advance, Peter


Not very likely to be CTS overall. Diabetic stiff hand would be my first thought. Diabetics are prone not just to CTS but also to trigger digits, Dupuytren's contracture, and this odd problem of stiffness of the hand. Often the whole lot can be seen together. It would probably be worth checking the median nerve anyway with NCS to be sure, as presentations of CTS in diabetes can sometimes be strange, but I would expect the result to be normal, or at least to show only evidence of some diabetic polyneuropathy perhaps. You probably need to see a hand specialist about it really.

You could also run through the diagnostic questionnaire on here - it would be interesting to see what the AI makes of it. JB


Thanks for your speedy response Dr Bland.

I've taken the self-diagnosis test; Symptom Severity of both hands is 2 and Functional Impairment is 1.4 for the left and 1.6 for the right, with the chances of CTS being 4%.

I shall take your advice and arrange to see a hand specialist, again many thanks for your time.


I've looked through the questionnaire answers too and I agree with the AI - it doesn't sound at all like CTS. If it does turn out to be CTS would you let me know please as it would be an example of both me and the website being wrong and I need to analyse such cases to try and figure out why. Good luck with getting it sorted out. JB

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