diabetestalk.net

Diabetic Stiff Hand Syndrome Treatment

Diabetic Cheiroarthropathy: A Case Report And Review Of The Literature

Diabetic Cheiroarthropathy: A Case Report And Review Of The Literature

Go to: 2. Case Presentation A 28-year-old female with a 12-year history of type 1 diabetes mellitus reported pain and stiffness in both hands of one-year duration. The pain was described as dull and aching lasting throughout the day and worsening at night. She reported morning stiffness in her hands lasting for 5 minutes. She admitted limited movements of all joints in her hands with associated tightening of the skin. She denied any changes in the color of her skin in her fingers with cold weather. There waere no dysphagia, no dry eyes, and no dry mouth. Of note, her glycemic control was poor with glycosylated hemoglobin (HbA1c) ranging between 8.5 and 10%. She was on an insulin pump. She was found to have nonproliferative diabetic retinopathy and microalbuminuria. She did not have any neuropathy. There was no family history of rheumatologic disease. Diabetic cheiroarthropathy was diagnosed clinically after eliciting the “prayer” and “table top” signs. The prayer sign is said to occur whenever there is incomplete approximation of one or more of the digits when the patient attempts to approximate the palmar surfaces of the proximal and distal interphalangeal joints with palms pressed together and the fingers abducted (Figure 1). She was not able to completely lay her palms flat on a horizontal surface which denotes a positive tabletop sign. There was no evidence of Duputren's contracture. Carpal tunnel syndrome was ruled out with negative Tinel's and Phalen's tests. There was no flexor tenosynovitis as evidenced by the absence of palpable crepitus. Laboratory investigations such as erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, and other collagen vascular workup were normal. Radiographs of both hands showed mild prominence of proximal to m Continue reading >>

Why Is My Hand Cramping?

Why Is My Hand Cramping?

Hand cramps can be extremely uncomfortable and either sporadic or chronic. When your hand cramps up, you may have difficulty making a fist or bringing your fingers together. You might experience cramping in other parts of your body as well. While hand cramping isn’t dangerous in and of itself, it may be a sign of a larger issue when other symptoms are present. If you are able to determine the cause of your hand cramps, you’re more likely to be able to keep them from occurring in the future. The following are only a few of the possible reasons for hand cramps. Contact your doctor for more information. Low magnesium Magnesium helps to maintain strong bones and relax muscles. This mineral can aid in preventing muscle cramps, including hand cramps, as well as restless leg syndrome and eye twitches. If you’re low on magnesium, you may also experience some of the following symptoms: fatigue PMS and menstrual cramps headaches asthma decreased tolerance for exercise insomnia dizziness Learn more about the health benefits of magnesium. Dehydration If you don’t drink enough water, you may become dehydrated. Dehydration occurs when the body lacks enough water to properly function. Dehydration affects the functioning of the muscles and causes them to cramp. While dehydration is more likely to occur in hot temperatures, you can develop dehydration without proper water intake in cold temperatures as well. Other symptoms of dehydration include: bad breath fever and chills dry skin craving sweet foods headaches Poor circulation Poor circulation happens when your body lacks sufficient blood flow. Circulation sends blood, nutrients, and oxygen through your body. You may feel circulation issues in your hands, arms and legs. You may also experience the following symptoms: pain ting Continue reading >>

What Is Diabetic Hand Syndrome?

What Is Diabetic Hand Syndrome?

I fielded a question earlier this week on my Facebook page in regards to a fellow type 1 diabetic having diabetic hand pain and issues with their hands being stiff and they seemed harder to move. Immediately carpal tunnel syndrome popped into my head, but after she brought this up to her doctor and they ruled out carpal tunnel, they moved on to another diagnosis. A condition called diabetic hand syndrome (DHS). Honestly, I’ve never heard of DHS but like most things that grab my attention and not knowing much about something, I decided to see what this was all about. So what is DHS? Let’s take a closer look! What Is Diabetic Stiff Hand Syndrome? So here we are, diabetic hand syndrome or as its more formerly know as, stiff hand syndrome or cheiroarthropathy. Stiff hand syndrome is one of the most common hand disorders for people with diabetes. Another common nerve and joint problem is Carpal Tunnel Syndrome (CTS). Granted carpal tunnel is not caused by diabetes, but happens more often to people with diabetes, especially those who have diabetic neuropathy. Diabetic Hand Syndrome Symptoms Stiff Hand Syndrome is painless and can effect both type 1 and type 2 diabetics. It usually begins in your little finger. Then it spreads over time to your thumb. This stiffness then keeps you from being able to straighten your fingers fully. In addition, the skin on the back of your hand may also become thick, tight and waxy-looking. One way to tell if you have Stiff Hand Syndrome is to hold the palms of your hands together as if you are praying. If all of the skin and joints of your palms and fingers don’t touch, there is the possibility that you may have stiff hand Syndrome. What Causes Diabetes Hand Syndrome While it’s not fully known, doctors believe that multiple factors are Continue reading >>

Diabetic Hand Syndrome

Diabetic Hand Syndrome

Jewels Doskicz is a registered nurse, freelance writer, patient advocate, health coach, and long-distance cyclist. Jewels is the moderator of Diabetic Connect’s weekly #DCDE Twitter chat, and she and her daughter both live healthfully with type 1 diabetes. Diabetic hand syndrome, also known as “diabetic stiff hand syndrome,” is a grouping of potentially disabling affiliations causing both chronic pain and physical limitations. Restricted movement of the hands may not be a life-threatening condition, but it is a serious concern for people living independently with diabetes. Limited mobility of the hands can make daily tasks and diabetes care activities, which we take for granted, become quite difficult. The potential is real: a loss of motion can greatly impact one’s quality of life. What is diabetic hand syndrome? A number of hand conditions fall under the umbrella of diabetic hand syndromes: limited joint mobility (LJM), Dupuytren’s disease (DD), trigger finger (TF), and carpal tunnel syndrome (CTS). Common thought holds that high blood sugars may change the collagen and protein structure your tissues, effecting the fine patchwork of fabric that connects the skin, muscles, and tendons. A 2013 research study on hand disorders found that 67 percent of people with diabetes had at least one of the aforementioned hand disorders, with LJM being the most common condition. Symptoms you may notice include: • Thick, tight waxy skin (you can’t pinch or “tent” skin on your fingers or hands). • Hand joints with limited range of motion (flexion and extension). • Unable to perform the prayer sign. “Prayer sign” is the inability to press your palms together without a gap between the opposite fingers and palms. Treatment of diabetic hand syndrome The causes of Continue reading >>

Oh My Aching Hands: It May Not Be Neuropathy

Oh My Aching Hands: It May Not Be Neuropathy

Arthur Segal had Type 2 diabetes for many years. So when he began to have trouble opening medication bottles and turning door knobs, using a knife and counting his change, he assumed it was neuropathy and that nothing could be done. Most people with diabetes have heard of a condition called diabetic neuropathy. Diabetic neuropathy takes many forms and its effects vary from person to person. Because of this, treatment is often difficult and outcomes vary depending on the nature of the individual case. However, your pain may not be due to diabetic neuropathy at all. Long-term diabetics with hand pain may actually be suffering from other hand conditions. These two often-overlooked conditions are carpal tunnel syndrome and trigger finger. According to Dr. Keith Segalman, orthopedic hand surgeon with the Curtis Hand Center at Union Memorial Hospital in Baltimore, MD, both of these conditions are more prevalent in diabetics than in the general public. Surprisingly, these conditions are not caused by poor circulation, nor are they forms of diabetic neuropathy. In long-term diabetics, advanced glycation end-products, or AGEs, can collect on the tendons in the palms of the hand. The accumulation causes the tendons to thicken, thereby causing nerve compression by pressing on the nerve in the carpal tunnel. This leads to numbness and tingling, similar to neuropathy symptoms, especially when the hands are in certain positions. Many diabetics also find that they have stiffness or restricted movement in one or more fingers. This may be due to trigger finger. Trigger finger results when the thickened tendons can no longer slide easily through the cartilage rings along the fingers. The rubbing causes the tendon to swell even further to the point where the tendon can no longer slide thr Continue reading >>

Diabetic Arthropathy

Diabetic Arthropathy

Fact Explanation History of diabetes mellitus Patients have a long history of diabetes mellitus (DM). Patients with type 1 DM are at higher risk than the patients with type 2 DM, because of the long duration of disease. [1] Stiff hands Diabetic cheiroarthropathy affecting the hands causes stiff hands with limited joint mobility later progressing to deformed hands due to contractures. [1,3,5] Symptoms of trigger finger Patients complain of catching sensation and associated pain while they try to flex the affected finger. This is due to the disparity in the sizes of the flexor tendon and the retinacular pulley system. Patients might have noticed a palpable nodule over the affected finger joint. It can affect any finger but index, thumb, middle, or ring finger involvement is common. [1,5] Flexed ring finger Patients with DM can develop Dupuytren’s contractures, which results in semiflexed ring finger. This commonly involves the ring finger but can affect other fingers as well. Dupuytren's contractures can be seen in 16% to 42% of patients with DM. [1,5] Symptoms of carpal tunnel syndrome (CTS) Patients with DM can develop CTS due to compression of the median nerve. The symptoms include burning sensation, paresthesias, or sensory loss over the first three fingers and the lateral half of the fourth finger. Pain is much prominent during night time and while doing activities which involve flexion and extension of the wrist. With advanced disease patients may complain of motor weakness, and might drop the objects from the affected hand. [1] Shoulder stiffness About 19% of the patients with DM suffer from frozen shoulder (adhesive capsulitis) and they present with the complain of stiff shoulder joint. Calcific periarthritis of the shoulder is also common in patients with DM. T Continue reading >>

Shoulders, Hands, Fingers And Feet

Shoulders, Hands, Fingers And Feet

Do you ever wake up in the morning feeling stiff and tingly? Do you find that sometimes these feelings go away as the day goes on, but sometimes they don’t? For many people the problem is arthritis, but for others it is not. Did you ever wonder if these feelings are related to diabetes? Certain problems that happen in the joints of your shoulders, hands, fingers and feet are more common for people who have diabetes. Some are even caused by its long-term effects. The good news is that these joint problems can get better with specific treatments. Also, keeping your blood glucose closer to the normal range may help avoid some of these problems. SHOULDERS Frozen Shoulder is just like it sounds. It is a painful stiffness in one or both of your shoulder joints. This stiffness makes it difficult to move your shoulder all the way around, like it normally would. Some people with Frozen Shoulder find they can’t move their shoulders at all. It feels stuck or frozen in place. This stiffness can make it hard or even impossible to carry out simple everyday activities like dressing, eating and sleeping. Frozen Shoulder is seen five times more often among people who have diabetes than among people who do not. THREE STAGES OF FROZEN SHOULDER: Stage one: The affected shoulder begins to ache and feel stiff before becoming increasingly painful. It may be worse at night, especially if you sleep on that shoulder. Stage two: The affected shoulder becomes stiffer, but usually not more painful. You may notice that the size of your shoulder muscles decrease. This is because you are using your shoulder less. This stage usually lasts between four and twelve months. Stage three: You start to regain some movement in the affected shoulder, and the pain starts to go away, but the pain is not gone Continue reading >>

Diabetic Stiff Hand Syndrome

Diabetic Stiff Hand Syndrome

Summary The association of diabetes mellitus and ‘stiff hands’ is well documented. We report on twenty-three cases of the syndrome and the incidence of diabetic complications in this group relative to controls matched for age, sex, duration of diabetes and therapy. Preview Unable to display preview. Download preview PDF. Continue reading >>

Pointing Out The Facts: Diabetes Stiff Hand Syndrome (dshs)

Pointing Out The Facts: Diabetes Stiff Hand Syndrome (dshs)

Pointing Out the Facts: Diabetes Stiff Hand Syndrome (DSHS) Diabetic stiff hand syndrome (DSHS) is a painless disorder that can limit hand function in patients with diabetes. Patients who develop DSHS suffer from an increased stiffness of the hands, which can limit mobility and make it harder to complete daily tasks. DSHS occurs in up to 58% of patients with type 1 diabetes and occurs up to 76%of patients with type 2 diabetes. DSHS is most common in those who have uncontrolled diabetes, have a long history of diabetes (greater than 30 years) and have diabetic nerve damage (neuropathy). Scientists are still unsure why diabetes increases the risk for hand complications. Possible theories for this condition appear to be related to problems with your bodys collagen. Collagen is a protein that makes up tendons, joints, ligaments and other connective tissue in the body. Increased collagen production, decreased collagen break down, and changes to the composition of collagen can lead to abnormal gathering of proteins in your hands, which makes them more stiff. Symptoms include thick, tight, waxy skin that is often found on the back of the hand. Stiffness usually begins at the little finger and spreads to the thumb.Inability to flex or extend the fingers and severely limited hand function is also described. A test for DSHS is the prayer sign test: try pressing your hands together completely without gaps between the palms and fingers. If your hands cannot press together, and there are significant gaps, this may be indicative of diabetic stiff hand syndrome. Tight blood sugar control is the best way to prevent or slow the development of DSHS.In the images above, a patient is shown attempting the prayer sign test, and in the second image improvement is seen in the patient after fo Continue reading >>

Cheiroarthropathy|causes|symptoms|treatment

Cheiroarthropathy|causes|symptoms|treatment

Cheiroarthropathy: Causes, Symptoms, Treatment Cheiroarthropathy is a disorder in which there is a limited finger movement as the hands become waxy and thickened. This is a diabetes complication and is also known as Diabetic cheiroarthropathy or Diabetic stiff hand syndrome. People with both the types of diabetes, i.e. diabetes type 1 and diabetes type 2 can be affected by Cheiroarthropathy. However, optimizing glycemic control and physical therapy can slow down the development of this diabetes complication. Let us know about the condition in a more precise way. An Introduction On "Cheiroarthropathy: A Diabetes Complication": Diabetes mellitus or diabetes , is a chronic medical condition that is associated with abnormally high levels of glucose or sugar in the blood. This condition can lead to eye, kidney, nerve as well as heart damage. Diabetes can also be complicated by a syndrome that affects the function of your hands, and is known as Cheiroarthropathy, where there is a limited joint mobility in the fingers and the hands. Here the patients are unable to extend the fingers to fully flatten the hand. In Cheiroarthropathy, typically both the hands are affected. Rarely, the larger joints are affected in Cheiroarthropathy. This diabetes complication has been reported in more than half of patients with insulin-dependent diabetes and approximately three quarters of those people with noninsulin-dependent diabetes. Cheiroarthropathy occurs more frequently in individuals with a long history of diabetes Cheiroarthropathy is characterized by the inability to strengthen joints in the hands and thus the function of the hands can be severely limited. The sufferers find stiffness begins in their little finger and the spreads to the thumbs. Eventually, this stiffness can prevent th Continue reading >>

Diabetic Cheiroarthropathy

Diabetic Cheiroarthropathy

Diabetes may affect the muscle and joint systems in a variety of ways. Diabetic cheiroarthropathy, also known as diabetic stiff hand syndrome, is commonly found in patients with type 1 diabetes and to a lesser extent, type 2 diabetes . Diabetic cheiroarthropathy is found in 8% to 50% of all patients with type 1 diabetes, and a similar proportion of patients with type 2 diabetes. The longer someone has diabetes, the more likely it is that they will develop stiff hand syndrome. Risk Factors for Diabetic cheiroarthropathy The longer someone has diabetes, the more likely it is that they will develop diabetic cheiroarthropathy. How is Diabetic cheiroarthropathy Treated? There is currently no known way to reverse the effects of diabetic cheiroarthropathy. Control of blood sugar levels is one of the most important aspects, both to help prevent the development of diabetic cheiroarthropathy and other complications. Physiotherapy and occupational therapy are important to maintain hand mobility and prevent further loss of movement. [1] Aljahlan, Lee, Toth. Limited joint mobility in diabetes. (1999) Vol 105; No. 2 Postgraduate Medicine. [available online @ [2] Fisher L, Kurtz A, Shipley M. Association between cheiroarthropathy and frozen shoulder in patients with insulin-dependent diabetes mellitus. Br J Rheumatol 1986;25(2):141-6 [3] Ismail, Dasgupta, Tanqueray, et al. Ultrasonographic features of diabetic cheiroarthropathy. The British Journal of Rheumatology, Vol 35, 676-679. [4] Kim, Edelman, Kim. Musculoskeletal Complications of Diabetes Mellitus. [available online @ Continue reading >>

Stiff Hand Syndrome

Stiff Hand Syndrome

Tweet Diabetic stiff hand syndrome, also known as diabetic cheiroarthropathy, is a disorder in which finger movement becomes limited as the hands become waxy and thickened. Both people with type 1 diabetes and type 2 diabetes can be affected by diabetic stiff hand syndrome, but optimising glycemic control and physical therapy can slow down the development of the condition. Who is affected? Rachel Peterson Kim, MD et al report that diabetic stiff hand syndrome is found in eight to 50 per cent of patients with type 1 diabetes, but that type 2s can also develop the disorder. Prevalence is reportedly increased as patients have diabetes for longer, while it can also be more common in patients with diabetic neuropathy. Diabetic stiff hand syndrome is associated with being a predictor for other diabetes-related complications. Symptoms of diabetic stiff hand syndrome Diabetic stiff hand syndrome is characterised by the inability to strengthen joints in the hand. As a result, hand function can be severely limited. Affected patients find stiffness begins in the little finger and spreads to the thumb. Eventually, this stiffness can prevent people bringing all of the fingers together completely upon holding their palms together. Thick, tight, and waxy skin may also develop on the back of your hand as diabetic stiff hand syndrome develops. What causes diabetic stiff hand syndrome? Multiple factors are thought to be related to the underlying cause of diabetic stiff hand syndrome. Peterson et al report factors that can enhance development include when glycosylation - the process of sugar molecules attaching to protein molecules - is increased and causes additional collagen in the skin. Harry Belcher MS, FRCS also writes that changes to the composition of collagen which lead to abnorma Continue reading >>

Limited Joint Mobility In Diabetes Mellitus: The Clinical Implications

Limited Joint Mobility In Diabetes Mellitus: The Clinical Implications

ABSTRACT: Limited joint mobility (LJM) is a common complication of diabetes mellitus (DM). LJM often is characterized by hand stiffness, but other joints may be involved. The prayer and tabletop signs may be used to detect limitation of joint mobility in the hands. Range of motion should be checked in the large joints as well as in the hand and finger joints. LJM should be distinguished from other musculoskeletal conditions that also are seen frequently in the hands of patients with DM. LJM may be associated with the duration of DM. Treatment is controversial. Strict control of blood glucose usually is advocated. Physical therapy may improve function. No medications have been approved for clinical use. (J Musculoskel Med. 2011;28:118-124) Limited joint mobility (LJM), or diabetic cheiroarthropathy, is a condition characterized by hand stiffness resulting from flexion contractures of the fingers and by thickened, tight, waxy skin.1 “LJM” is the newer, preferred term used in describing the condition because joints other than those in the hands (eg, in the wrists and elbows, feet, and spine) also may be involved.2 Lundbaek3 first reported LJM in 5 patients with diabetes mellitus (DM) in 1957, but the syndrome did not receive more attention until 1974, when Rosenbloom and Frias4 described it again in children with DM. The existence of this clinical entity was confirmed by larger studies of children with insulin-dependent (type 1) DM5-7 and, subsequently, was demonstrated in adult and geriatric patients with non–insulin-dependent (type 2) DM.8-12 LJM is a common complication of DM, occurring in 8% to 58% of patients; most studies suggest that the prevalence is about 30% to 40%.1,7,13,14 Although early investigators did not find sex differences, one study reported that Continue reading >>

Diabetes And Your Hands

Diabetes And Your Hands

While it’s common knowledge that diabetes involves an elevation of a person’s blood sugar, it is not well known why diabetes can cause stiffness of the hands, shoulders, and other joints and how exactly it plays a role in diseases like trigger finger and Dupuytren’s contracture. Diabetes Stiff Hand Syndrome Diabetes can cause stiffness of the hands in a condition known both as diabetic stiff hand syndrome or diabetic cheiroarthropathy. It is an uncommon condition in which a person’s finger movement becomes decreased and the hands take on a thickened and waxy appearance. As it turns out, people with both type 1 diabetes and type 2 diabetes can both get the disorder. People who keep their blood sugars under good control and partake in physical therapy usually can overcome the condition. Diabetes stiff hand syndrome is found in 8 to 50 percent of type 1 diabetic patients. Lesser numbers of type 2 diabetic patients will come down with the disease. The longer a person has diabetes and the worse control of the diabetes the person has, the greater is the chance of getting diabetic cheiroarthropathy. People who have diabetes that results in diabetic neuropathy have a greater chance of having stiff hands when compared to diabetics who don’t have diabetic neuropathy. Common symptoms of diabetic stiff hand syndrome include an inability to move the joints very much, which winds up causing limitations in the function of the hand. Usually the stiffness starts in the smallest fingers of the hands and progresses so that eventually all of the fingers are affected. In the most severe cases, the individual with stiff hand syndrome are unable to clench the hands at all and the fingers stick straight out, unable to hold onto anything with any degree of strength. The skin is also a Continue reading >>

Bone And Joint Problems Associated With Diabetes

Bone And Joint Problems Associated With Diabetes

If you have diabetes, you're at increased risk of various bone and joint disorders. Certain factors, such as nerve damage (diabetic neuropathy), arterial disease and obesity, may contribute to these problems — but often the cause isn't clear. Learn more about various bone and joint disorders, including symptoms and treatment options. Charcot joint What is it? Charcot (shahr-KOH) joint, also called neuropathic arthropathy, occurs when a joint deteriorates because of nerve damage — a common complication of diabetes. Charcot joint primarily affects the feet. What are the symptoms? You might have numbness and tingling or loss of sensation in the affected joints. They may become warm, red and swollen and become unstable or deformed. The involved joint may not be very painful despite its appearance. How is it treated? If detected early, progression of the disease can be slowed. Limiting weight-bearing activities and use of orthotic supports to the affected joint and surrounding structures can help. Diabetic hand syndrome What is it? Diabetic hand syndrome, also called diabetic cheiroarthropathy, is a disorder in which the skin on the hands becomes waxy and thickened. Eventually finger movement is limited. What causes diabetic hand syndrome isn't known. It's most common in people who've had diabetes for a long time. What are the symptoms? You may be unable to fully extend your fingers or press your palms together flat. How is it treated? Better management of blood glucose levels and physical therapy can slow the progress of this condition, but the limited mobility may not be reversible. Osteoporosis What is it? Osteoporosis is a disorder that causes bones to become weak and prone to fracture. People who have type 1 diabetes have an increased risk of osteoporosis. What are Continue reading >>

More in diabetes