CTS or B12 deficiency

Marion
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I attended my GP today regarding my tingling and pain in both hands. The pain wakes me up several times a night and I also have symptoms during the day. He said that my symptoms were giving mixed messages, as I get tingling on all my fingers and my palm and back of fingers too, whereas with carpal tunnel syndrome it should just affect one half of my hand. He decided to test me for vitamin b12 to see if the tingling is due to this. I don't have tingling in my feet.

Does the fact that I experience symptoms over almost all my hand rule out CTS?

jeremydpbland
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Not at all. We asked 22980 patients with CTS which fingers were affected. The answers were

Thumb/Index/Middle (ie median nerve distribution) - 44.4%

Little and Ring (ulnar nerve distribution) - 1.7%

Middle and ring - 10.1%

Whole hand - 32%

Just the four fingers, not the thumb - 7.4%

Other distribution - the rest

Thus about one third of patients seem to experience symptoms in the whole hand. This distribution has been found to be associated with milder CTS interestingly. B12 deficiency would be more likely to produce symptoms in the feet, either first or in association with hand symptoms, but there are reports of patients with B12 deficiency whose symptoms began in the hands. Your description of the symptoms here sounds quite likely to be CTS - try the questionnaire here and see what probability it comes up with. JB

Marion
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Thanks for the information. I took the test and the scores are 78 and 85.

jeremydpbland
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With scores like that I would be very surprised indeed if you did not have CTS when tested. If you haven't tried it already get yourself a splint (or a pair) - they are quite widely available online, pretty much harmless and might get you a decent night's sleep. You can find illustrations of the sort of thing to look for on here. Unfortunately most NHS GPs seem unable to provide them. JB

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