How Hypothyroidism Leads to Carpal Tunnel Syndrome & How to Fix It

Few things in this world are more frustrating than nerve problems which is why carpal tunnel syndrome can be so debilitating. 

Sure, there are definitely more serious medical conditions out there like heart disease, but that doesn’t mean that people who have carpal tunnel syndrome aren’t suffering. 

And while there are many causes of carpal tunnel syndrome, one that should never be missed is hypothyroidism. 

Why?

Because it’s a treatable disease!

If you are one of the roughly 16-20% of hypothyroid patients with numbness or tingling in your hands then this article is for you!

It’s possible to get relief, but getting there will most likely require that you look into treatments that may not even be on your doctor’s radar. 

We will get to treatments in just a minute, but first, let’s start with some basics: 

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome, which I will refer to as CTS from here on out, is the most common nerve entrapment syndrome in the body. 

As you are probably well aware, the function of your nerves is to provide both sensation and physical movement to the muscles of your body. 

In order to do this, they need to be able to send messages back and forth from the spinal cord all the way to the brain. 

If a nerve gets entraped or impinged (when pressure is applied against it), it’s no longer able to effectively send messages which means you’ll end up with symptoms like numbness and weakness. 

This is your body’s warning sign that something is damaging your nerves. 

If this happens in a specific pattern on your hand, you have CTS. It’s that simple. 

The reason that CTS is the most common nerve entrapment in the entire body has to do with anatomy. 

The median nerve (the nerve that provides both sensation and physical movement to your hand) runs through a narrow tunnel in the wrist which is surrounded by bones and filled with ligaments. 

Since this tunnel is so tight, it’s easy for things to press against your median nerve. 

And when that happens… BAM, you’ll end up with CTS. 

Plenty of conditions can cause this problem (including just being overweight), but the one that we are going to focus on today is hypothyroidism. 

I hate to say it, but in addition to dealing with problems like weight gain, fatigue, and hair loss, thyroid patients also have to contend with annoying conditions like CTS as well. 

This is for two reasons:

How Hypothyroidism Causes Carpal Tunnel Syndrome: 

#1. The buildup of mucopolysaccharides in the tissues of the wrist. 

The hypothyroid state results in the buildup of sugar-like compounds called mucopolysaccharides as hyaluronic acid and glycosaminoglycans, in various tissues of the body (1). 

This promotes a big problem because these compounds happen to attract and hold a lot of water. 

And by a lot, I mean a lot. Hyaluronic acid, for instance, can hold up to 1,000 times its weight in water. 

And guess what happens when these compounds get into places they shouldn’t and start pulling water in with them? 

You end up with swelling and edema. 

This can happen EVERYWHERE, by the way, including the ligaments and tissues in the wrists. 

But because there’s not a lot of space in the tunnel of your wrist, and because the bones don’t allow for any expansion with the addition of water, any little extra swelling that occurs there will almost certainly cause issues with your nerve. 

The result? CTS symptoms like numbness and tingling. 

But that’s not the only way that hypothyroidism leads to CTS which leads us to #2…

#2. From weight gain and obesity. 

Just being overweight has been shown to be an independent risk factor for developing CTS (2). 

The reason for this is not well understood but probably has to do with the general inflammation and swelling that tends to accompany the obese state. 

The exact cause doesn’t matter that much for the purposes of this article because what you really need to know is that obesity is a risk factor. 

And because hypothyroidism very often leads to weight gain, in fact, it’s THE symptom that thyroid patients deal with most frequently, this is yet another reason that thyroid patients may develop CTS. 

This may seem depressing but there’s a silver lining: 

Both hypothyroidism and obesity are treatable and reversible conditions!

The only thing standing between you and a life free of numbness and tingling in your hand is the right knowledge: 

What to do about it? 

If you are like most people with CTS then you will probably start by going to your doctor to get some recommendations. 

And if you go that route, here’s what they will probably tell you: 

• Try Nonsteroidal anti-inflammatory drugs like ibuprofen (3) to see if they reduce the swelling in your wrist. 
• If that doesn’t work then you can try wearing a wrist brace or splint (4). 
• If that doesn’t work then you can try a steroidal injection directly into the wrist (5) to try and reduce swelling (this is a more powerful option than NSAIDs)
• And, finally, if none of those options work then they may recommend surgical intervention. 

For the most part, this is probably the extent of treatment options that your doctor has to offer for this problem. 

And if you are paying attention then you should notice that something is missing: 

The thyroid factor. 

The treatments above may all potentially help to address the nerve entrapment, but they do nothing to fix the underlying cause of the problem!

In addition to this, these therapies typically don’t have a great success rate. 

That’s the bad news. 

The good news is that there are plenty of things that you can do that are very likely to provide at least some relief to your symptoms (sometimes as quickly as just a few hours or days).

So before you fret about about surgery or injections, take a look at these treatments first.

As long as you are diligent in using them, you should see enough improvement to eliminate the need for surgery and see significant improvement in your quality of life. 

#1. Start By Optimizing Your Thyroid 

The reason you need to focus on your thyroid first is simple: 

If your thyroid is responsible for causing your condition then it won’t go away until your thyroid problem is resolved. 

What’s that? You are already taking thyroid medication so you think you can skip this step? 

Think again. 

There are a large number of thyroid patients out there taking thyroid medication right now who are being undertreated. 

Even having so-called “normal” thyroid lab tests doesn’t mean your thyroid is being properly and adequately treated and this is especially true if you have residual thyroid-related symptoms (like carpal tunnel syndrome). 

For hard-to-treat thyroid-related conditions, it’s often necessary to change thyroid medications to include those that contain more powerful thyroid hormones like T3. 

If you are taking something like levothyroxine and not seeing any improvement in your symptoms then that’s a good sign you probably fit into this camp. 

T4-only thyroid medications like levothyroxine can work for some people, but it’s not often the case that these T4-only thyroid medications will allow every single tissue in your body to get an adequate amount of T3. 

This issue can be solved by adding some T3 to your existing thyroid medication regimen.

You can do this either by adding T3 directly in the form of Cytomel or liothyronine or switching to a combination T4/T3 medication like Armour thyroid, NP thyroid, or Adthyza. 

Additionally, you may find relief simply by changing the route that you use to take your thyroid medication. 

For instance, taking your thyroid medication sublingually, as opposed to orally, may improve the absorption of your medication and, therefore, its action in the body. 

You can learn more about taking your thyroid medication under your tongue here. 

No matter what, don’t skip this step, and make sure when you are evaluating whether or not your thyroid is optimized that you are looking at more than just the TSH. 

You’ll need a more comprehensive set of labs as well as an eye for their optimal ranges. 

#2. Improve Flexibility, Mobility, and Posture 

Even though your thyroid may be the root cause of your symptoms, doesn’t mean that other tissues aren’t playing a role. 

It’s very often the case that thyroid patients, by virtue of the symptoms related to thyroid dysfunction like fatigue, are not as active as they should be. 

Other symptoms like muscle aches and pains, again caused by thyroid dysfunction, can further limit their ability to exercise and move their body. 

And guess what happens when you don’t exercise or move? 

Your body, joints, ligaments, and tendons, all become less compliant. 

They are more stiff, you are less flexible, and there’s less blood flow moving to all of the tissues and cells in your body. 

This is a problem because it means less thyroid hormone will make it to your wrist which is necessary to help your body eliminate the mucopolysaccharides contributing to the swelling in that location. 

This problem can be resolved by utilizing the right forms of activity. 

Pretty much any type of exercise will be beneficial in getting blood pumping throughout your body but some will be better for improving blood flow specifically to your wrist. 

If CTS is an issue then yoga and pilates are ideal. 

These forms of movement will help improve the function of your entire upper body, including your shoulder girdle and neck, which is where the median nerve originates. 

You’ll also get the added benefit of more mobility to nerve directly through nerve flossing which is typically incorporated into these types of exercise routines. 

Together, they will help bring a more natural function to your entire body which will, in turn, enhance blood flow to the wrist, improve lymphatic drainage and swelling out of the wrist, and improve the range of motion of your median nerve. 

Exercising regularly will also provide direct benefits to your thyroid and will help you lose weight as well!

#3. Open Up the Tissues Where Impingement Can Occur

When you look at the anatomy of the median nerve, you will find something very interesting: 

Your wrist is not the only place that it can get entrapped!

The median nerve originates from the spinal cord and makes a very long journey from your neck, through your shoulder, and in between the bones of the elbow before it finally reaches your wrist. 

Yes, many people do have impingement in the wrist, but there are probably plenty of other people who have impingement in other sites along the way (6). 

This is explained by the idea of the double crush syndrome. 

This syndrome suggests that, at least in some patients, those who experience median nerve entrapment in the wrist also have entrapment at some other location (7) (thus the name double crush syndrome). 

And it isn’t until the nerve gets entrapped at two locations that you finally start to experience the symptoms of CTS. 

In other words, you may think your problem is in your wrist but it may be in your head, neck, shoulder, or even elbow instead, and the symptoms are just manifesting in your wrist/hand. 

What do you do about this? 

Fortunately, you can improve the mobility of the tissues in your head, neck, and shoulder with relative ease. 

Treatments like massage therapy, myofascial release, trigger point therapies, and treatments with physical devices such as massage guns can all help. 

Exercise, like yoga and pilates, can also improve the function of these tissues by treating muscle imbalances and improving posture. 

#4. Prevent Repetitive Strain/Stress Injury & Evaluate Ergonomics

Next, you’ll want to take a look at your daily activities. 

Yes, it may be the case that your thyroid is the principal cause of your CTS but it’s also very possible that you aren’t doing your body any favors with certain inflammatory and repetitive motions. 

Constant use and misuse of your hands may result in a condition called repetitive stress injury or RSI for short (8). 

Examples of RSI include conditions like tennis elbow, Blackberry thumb, iPod finger, Rubik’s wrist, and stylus finger. 

In each of these conditions, you are putting your body through repetitive motions doing some sort of activity that results in inflammation and pain in whatever joint is being used repeatedly. 

What you may not realize is that this very thing can happen in your hands and wrist as well and one of the most common reasons for it is the constant use of computers. 

Putting your hands in a position to use a keyboard and a mouse may be necessary for your job, but it’s not great for the function of your hands. 

It’s been known since as early as 1998 that computer users experience higher rates of injury and disability (9) and this problem has only gotten worse over the last two decades. 

The treatment for any type of RSI is to stop the offending movement to allow your body to heal but this is easier said than done, especially for those who use their computer as part of their livelihood. 

That’s why the second part of #4 is an evaluation of your ergonomics. 

While you may not be able to completely eliminate the need for using a computer, you can ensure that your body is in the best possible ergonomic position to reduce the negative impact that repetitive motions have on your ligaments and nerves. 

If you need to use a computer every day then try these tips: 

• Practice good posture when sitting at a computer. It’s okay to move around but you shouldn’t be slouching forward. 
• Use an ergonomic-friendly mouse (one that keeps your wrist in a more natural upright position as opposed to a hands-down position)
• Use a sit-stand desk. 
• Elevate your monitor so that it’s at eye level. You can do this with a monitor stand or with a monitor arm. 
• Get a pad for your mouse and your keyboard so that your wrist has cushioning. 
• Invest in a nice chair. Expensive chairs from brands like Herman Miller and Steelcase can make all of the difference for your back and posture. 
• Make sure that your elbows are supported by either the arms of your chair or your desk. You want to avoid your wrists as being the primary point of contact with your desk. They can lay flat on your desk but your elbows and forearms should bear the majority of your weight. 
• Take frequent breaks and don’t be afraid to move positions! Avoid staying in the same position for hours on end. 

If you use your computer for your day job then it’s worth spending some time, energy, and money to figure out how you can minimize the negative effects that poor ergonomics have on your health and wrists. 

Final Thoughts

It can be hard to know if CTS is directly related to your thyroid or caused by some other issue but the therapies listed above should be helpful regardless. 

But if you think your thyroid is primarily at fault then make sure you spend a lot of time optimizing thyroid function. 

And if you need help with this, I would recommend checking out this article next. 

It walks you through some simple steps you can take to optimize your thyroid medication. 

Now I want to hear from you: 

Are you currently dealing with carpal tunnel syndrome?

Do you feel it’s related to your thyroid? Why or why not? 

Have you tried any of the treatments I’ve listed here? 

Have they worked for you?

Let me know below!