Both carpal tunnel syndrome and lupus are more common in women.
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Carpal tunnel syndrome, or CTS, causes chronic wrist pain due to compression of the median nerve. When excess pressure builds up on the nerve as it travels through a bony structure in the wrist, called the carpal tunnel, carpal tunnel syndrome develops. CTS can occur as a result of injury or repetitive motions and is sometimes associated with an underlying medical condition, such as lupus. Lupus is an autoimmune disorder characterized by widespread inflammation that often affects the joints, including the wrist.
Carpal Tunnel Syndrome
Carpal tunnel syndrome affects at least 4 million people in the U.S. Common symptoms include wrist pain, tingling and numbness in the hand and diminished grip strength. Symptoms tend to be worse at night. Typically, one hand is more affected than the other. The bony canal that transports the median nerve from the upper arm into the hand is a rigid structure that can sometimes compress the nerve. Repetitive movements while using a computer or other device increase the likelihood of CTS. Inflammatory disorders, including lupus, can also compress the median nerve, leading to CTS.
Estimates vary, but about 200,000 people in the U.S. have systemic lupus erythematosus, or lupus for short. As with other autoimmune diseases, immune system abnormalities due to lupus cause the body to attack its own tissue. Lupus symptoms may involve any organ, but the skin, joints and kidneys are commonly affected. Lupus-related inflammation of the tissue around the median nerve can result in swelling and carpal tunnel syndrome. In contrast to people with CTS due to other causes, those with lupus often experience intense stiffness of the wrists and hands in the morning. Additionally, both hands are likely to be affected by CTS in people with lupus, rather than just one.
A physical exam can help identify signs of carpal tunnel syndrome. Maneuvers to elicit indications of nerve compression, such as a burning or tingling sensation in the fingers, may be performed. Special tests to examine nerve function, called nerve conduction studies, may also be pursued. When lupus is suspected as the cause of wrist and hand discomfort, blood work will be checked as well. People with lupus usually have other symptoms, including hair loss, oral ulcers, swelling in other joints and skin rashes, particularly on the face.
Nonsteroidal antiinflammatory drugs, such as ibuprofen (Motrin, Advil) and naproxen (Aleve, Naprosyn), are often used to treat carpal tunnel syndrome. NSAIDs are also commonly used to address lupus flare-ups, including CTS symptoms. Even so, NSAIDs should be used with caution in people with lupus who have underlying kidney disease. In some cases, steroid injections into the wrist or oral steroids can help alleviate CTS symptoms. Surgery may be considered to release pressure around the carpal tunnel in people with persistent symptoms.