Hand Pain
Hand Pain
| Author: Judy Kohn, RN, BSN, CDE |
| Last Updated: Tuesday, October 03, 2006 |
Q: "My hands have so much pain in them. I thought it might be arthritis. My doctor said it was a result of my diabetes. Is that possible? Why would that happen?"
A: There are two related problems that could be behind your condition. These problems are as follows:
Digital Sclerosis:
According to the American Diabetes Association's book, The Diabetes Problem Solver, this is a condition linked to approximately 30% of people with type 1 diabetes. It involves stiffness in the joints, along with the development of thick, waxy skin. The exact cause is unknown, but it is known that glucose attaches to collagen, which is the underlying connective tissue of your skin. It is thought that the glucose attachment might disrupt the collagen, which gives your skin elasticity, and provides structure to the tendons and ligaments. Symptoms: thickening of your skin, giving it a waxy feel; difficulty moving your joints because they are stiff; if you try to press the palms of your hands together in a praying position, you may find it difficult to straighten your fingers completely. This book states that usually the condition is not painful. However, an earlier article (1993) in Diabetes Forecast stated that there can indeed be pain, usually in the form of an off-and-on ache in the finger joints.
There is no known treatment for this condition, but some studies show that achieving and maintaining good blood glucose control can improve and even reverse symptoms. In addition, some people benefit from hand stretches and muscle strengthening exercise. First check with your doctor and/or physical therapist.
Diabetic Peripheral Neuropathy:
It is estimated that probably 75% of people with diabetes have some form of diabetic neuropathy, which means damage to the nerves. Symptoms vary, depending on what nerves are damaged, but can include: tingling, burning feelings-similar to "pins and needles" of your arms and/or legs-that are usually most evident at night. There are various types of diabetic neuropathy, affecting the lower legs, bladder, digestive system, etc. but I will not address those issues here since your question concerns your hands.
There are ongoing studies that are attempting to determine the cause and treatment for diabetic neuropathy. It is generally explained that having too much glucose in the blood over time causes damage to the nerves. Studies have proven that keeping good control of your blood glucose can reduce the risk of neuropathy by 60%.
Treatments: Research continues to focus on developing effective drugs to prevent the glucose from damaging the nerves, as well as drugs to effectively control the pain. Important steps for you to take would be: carefully monitor your blood sugar levels and achieve and maintain good diabetes control; quit smoking; and reduce /limit alcohol intake (alcohol has been shown to aggravate neuropathy). Certain medications which have helped people with this condition include: an ointment called capsaicin, which when applied directly to the skin, may help to relieve the pain (even though this is an Over-the-Counter medication, it is expensive and requires specific instructions and precautions, so you should not consider this without first discussing it with your doctor); low dose anticonvulsive agents and antidepressants have also been known to relieve some of the symptoms of neuropathy, but it can sometimes take a month or longer to see an effect, so it is important to be patient and give these treatments time to work.
Ask your healthcare team about the above information, so you can learn what is the appropriate course of action for you.
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Related Links
American Diabetes Association (ADA)
http://www.diabetes.org
Important Notice: The responses provided by the team of Diabetes Educators are based on their personal experiences and expertise as practicing diabetes healthcare professionals, and are not to be considered diabetes management advice from Abbott Laboratories. Remember that information provided by the team of Diabetes Educators is for general background purposes and is not intended as a substitute for medical diagnosis or treatment by a trained professional. You should always consult your physician about any healthcare questions you may have, especially before trying a new medication, diet, fitness program, or approach to healthcare issues.
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