Monday, 31 May 2010

Limited Joint Mobility


26.05.10
No, I'm not praying for a cure for diabetes in this photo!!! It's to show the limited joint mobility I have in my hands. This is also known as Diabetic Cheiroarthropathy (DC) (now there's a mouthful.....try saying that after a few glsses of rose!!!).
As always, here is a proper explanation of it taken from the internet as they can usually explain things much better on these websites than I can......... :o)(http://www.diabetes.org.uk/Guide-to-diabetes/Other_associated_conditions/Musculoskeletal_Conditions/Limited_joint_mobility/)
"Limited joint mobility is a type of rheumatism that causes the joints to lose their normal flexibility. Although most common in the hands (where it is also known as diabetic cheiroarthropathy), limited joint mobility can also affect the wrists, elbows, shoulders, knees, ankles and, in some cases, the neck and lower back.
A classic sign of cheiroarthropathy is not being able to press the fingers together tightly in a palm to palm ‘prayer sign’. The affected fingers stay permanently bent (as shown in my photo above).
Although in itself limited joint mobility is usually troublesome rather than painful or disabling, it is closely associated with microvascular complications of diabetes - nephropathy (kidney disease) and retinopathy (eye disease - which I have already got and had several extensive laser treatment sessions for).
It is thought that about a third of people with diabetes have some degree of limited joint mobility. Like most complications of diabetes, good blood glucose control will help guard against it, as well as aiding recovery if it has already developed. Your healthcare team may be able to recommend exercises that will help restore some flexibility. Sometimes people are given steroid injections into the affected area and, in more extreme cases, where it is affecting a person’s ability to do day-to-day tasks, surgery may be required."

The Upper Limb Clinic also has some useful information: (http://www.theupperlimbclinic.co.uk/diabetic_cheiroarthropathy.htm)
"Diabetics have a higher incidence of hand problems than the general population. The reasons are not well understood but possible factors include: Abnormal accumulation of proteins in the tissues. This particularly involves collagen, which is the key contributor to the strength of tissues including skin, tendons, and ligaments. The composition of collagen is slightly altered, which can make it stiffer than normal.
Loss of blood flow in the tissues (ischaemia). Diabetes is complicated by abnormalities of the small blood vessels (micro-angiopathy). This is responsible for some of the most serious complications of diabetes, such as eye problems (retinopathy).
Diabetic stiff hand or diabetic cheiroarthropathy often causes a general sensation of "stiffness" or "slowness" in the hand. There is often some real loss of mobility in the joints, particularly the middle finger joints. This makes it difficult for you to bend the fingers right into the palm or to straighten them fully.
The condition is characterised by a number of specific problems. All are seen in non-diabetics but they are more common in diabetics. These can occur singly or together.
Flexor tenosynovitis is due to a thickening of the tissue lining the tendons that bend the fingers. This tissue is present from the wrist to the finger-tips. Thickening causes swelling of the palm and fingers. Rings may feel tight and the hand may ache. The palm and fingers may be tender to pressure. Tenosynovitis contributes to the finger stiffness. The symptoms are often worse in the night or on awakening. This is because fluid collects in the arms whilst you are asleep and inactive. When severe, it can cause a clicking sensation and even catching or "triggering" of the tendon.
Carpal tunnel syndrome is due to compression of the median nerve within a tunnel comprising a "U" shaped collection of bones with a tight ligament at the top. This causes 'pins and needles' in the area supplied by the nerve (thumb, index, middle and ring fingers). The condition is mainly caused by the tenosynovitis that squashes the nerve as it swells. It may also be contributed to by neuropathy (see 'Loss of blood flow' above).
Dupuytren's contracture is a thickening of deep tissue (fascia), which passes from the palm into the fingers. Shortening of this tissue causes 'bands' which pull the fingers into the palm. Once established, the background stiffness will persist and cannot be cured."

So there we have it.....you are now clued up on another lovely complication associated with diabetes!!!!

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