Symptoms of carpal tunnel syndrome are a common early sign among people with a potentially serious heart condition called transthyretin amyloidosis (ATTR). However, carpal tunnel is much more common than ATTR, so most cases of carpal tunnel are unrelated to ATTR.
To understand how the conditions can be connected, you need to know a bit about each condition:
What is carpal tunnel syndrome? The condition develops when something, like swelling of the tissues around the nerve, compresses the nerve that runs through the space between your wrist bones. This causes symptoms like pain, numbness, and tingling in your hand. Carpal tunnel syndrome affects about 1-5% of people.
What is ATTR? It is a kind of amyloidosis. In amyloidosis, proteins don’t fold correctly to form the right shape. Because of this, they make abnormal clumps and fibers. They get stuck in parts of the body where they don’t belong, interfering with normal activities. With ATTR, it is the transthyretin protein that clumps. ATTR can be a genetic condition you inherit, but not always.
How ATTR can lead to carpal tunnel: In ATTR, the abnormal fibers most often affect your heart and your nerves. Sometimes, abnormal fibers from ATTR affect the nerve in your wrist, causing symptoms of carpal tunnel syndrome.
Yes, carpal tunnel syndrome can be the first sign of transthyretin amyloidosis. About half of the people with heart issues from ATTR have symptoms of carpal tunnel. These symptoms typically start about 5-15 years before the diagnosis of any heart issues.
If you have carpal tunnel syndrome, the risk of later being diagnosed with ATTR is about three times higher compared to someone who doesn’t have carpal tunnel syndrome. However, the overall chance of getting amyloidosis is still very low. For most people, carpal tunnel is NOT a sign of ATTR.
Still, experts have been considering how people with carpal tunnel might need to be screened for ATTR. That’s because ATTR can be serious, and treatment is most effective with early diagnosis. So screening for ATTR among people with carpal tunnel syndrome might lead to earlier diagnosis of and better outcomes for ATTR.
If you have symptoms that might be from carpal tunnel, see your primary care provider. Symptoms like pain and tingling in your hand and fingers might be from carpal tunnel syndrome, though they could stem from something else. Your provider can determine the cause.
If you’ve already been diagnosed with carpal tunnel syndrome and are concerned about ATTR, talk to your provider about seeing a cardiologist or neurologist. ATTR can be tricky to diagnose. These specialists have expertise in diagnosing ATTR since it most often affects the heart and nerves.
It’s especially important to talk to a doctor if you have any factors that put you at higher risk for ATTR. These include:
- Carpal tunnel in both of your wrists
- Other unexplained nerve problems
- Spinal stenosis or frequent injuries to your tendons
- Family history of ATTR, heart failure early in life, or unexplained nerve problems
- Lack of repetitive motion patterns that can cause carpal tunnel (like typing)
You should also see a doctor if you have any symptoms that could signal a heart problem, whether or not you have carpal tunnel. Examples are:
- Unexplained shortness of breath
- Heart palpitations
- Swelling in your legs
- Fatigue
Sudden severe problems, like intense chest pain, should get immediate medical attention.
