Your wrists are complex joints, and they do a wide range of motions every day, from typing and gripping to bending and twisting. The wrist joint is made up of eight small bones, ligaments, tendons and nerves, all working together to enable hand movements. One of the main nerves that passes through the wrist is the median nerve, which runs through a narrow passageway called the carpal tunnel. When this nerve gets compressed or irritated, it can lead to a condition called carpal tunnel syndrome.

Carpal tunnel syndrome can be fairly common, especially among people who do repetitive hand and wrist motions. Symptoms of carpal tunnel syndrome can include:

• Tingling
• Numbness
• Pain
• Weakness in the hand or fingers

Several factors can contribute to carpal tunnel syndrome, such as:

• Repetitive strain from movements
• Wrist injuries
• Certain medical conditions

Because carpal tunnel syndrome affects the wrist and hands, it can sometimes be hard to tell apart from other wrist-related conditions. Let’s delve into why these conditions can be confused with carpal tunnel syndrome.

2 conditions often mistaken for carpal tunnel syndrome

Although carpal tunnel syndrome is a specific nerve compression issue, other conditions affecting the wrist and hand can present similar symptoms, leading to confusion and misdiagnosis. Here are two conditions that are frequently mistaken for carpal tunnel syndrome:

• Arthritis — Arthritis is an inflammatory condition that affects the joints and can cause pain, stiffness and swelling. Since arthritis can affect the wrist, it can mimic the pain and numbness associated with carpal tunnel syndrome. Swelling from arthritis in the wrist can even compress the median nerve, similar to what happens in carpal tunnel syndrome. Arthritis pain can also radiate down into the fingers, causing tingling or numbness. There are several types of arthritis, but two of the most common types that affect the wrists are:
• Rheumatoid arthritis (RA) — RA is an autoimmune condition that causes the body to attack its own joints, leading to chronic inflammation and damage. 
• Osteoarthritis (OA) — OA is due to wear and tear on the joints, causing the cartilage that cushions them to break down over time. 
• Tendinitis — Tendinitis is inflammation or irritation of the tendons, the thick cords that attach muscles to bones. Tendinitis in the wrist is typically caused by overuse, repetitive motions or direct injury to the tendons around the wrist. Tendinitis in the wrist, particularly if it affects the tendons near the median nerve, can feel similar to carpal tunnel syndrome. Both conditions can:
• Make it hard to grip objects
• Make certain movements uncomfortable
• Cause pain and tingling to radiate into the fingers

What if carpal tunnel syndrome is misdiagnosed?

Carpal tunnel syndrome can often be misdiagnosed due to its similarities with other wrist and hand conditions. People diagnosed with carpal tunnel syndrome may actually have a different condition that is mimicking its symptoms. This is why an accurate diagnosis is so crucial. If carpal tunnel syndrome is misdiagnosed, you may receive ineffective treatments, which can prolong your pain and discomfort unnecessarily and potentially allow your condition to get worse. 

How to spot the differences between wrist conditions

To differentiate between carpal tunnel syndrome, arthritis and tendinitis, it’s important to pay attention to the specific symptoms and the location of the pain.

• Carpal tunnel syndrome — Carpal tunnel syndrome typically affects the thumb, index finger, middle finger and half of the ring finger. Symptoms may get worse at night or when you do repetitive hand motions. 
• Arthritis — Arthritis often affects multiple joints in the hand and wrist. Symptoms may get worse with cold weather or after periods of inactivity. 
• Tendinitis — Tendinitis usually affects specific tendons in the wrist and hand, leading to localized pain and tenderness. 

By understanding these differences, it may become easier to identify the likely cause of your wrist pain and seek the most appropriate treatment. You should see your health care provider for a diagnosis. 

Differences in treatment approaches for wrist conditions

Here are typical treatment plans for each condition:

• Carpal tunnel syndrome — For carpal tunnel syndrome, common treatments can include:
• Wrist splints to keep the wrist in a neutral position, especially at night
• Physical therapy exercises focused on stretching and strengthening the wrist and hand
• Anti-inflammatory medications to help reduce pain and swelling
• Steroid injections for temporary relief if other treatments don’t work
• In severe cases, surgery may be necessary to relieve pressure on the median nerve. 
• Arthritis — Arthritis treatment focuses on managing inflammation and preserving joint function. Treatment can include:
• Anti-inflammatory medications (or, for RA, disease-modifying antirheumatic drugs)
• Physical therapy or occupational therapy to help improve joint function
• Assistive devices to reduce strain on affected joints
• Steroid injections or other medications to help control inflammation
• Tendinitis — Tendinitis treatment focuses on reducing inflammation and preventing further strain on the tendon:
• Rest and avoiding activities that make symptoms worse
• Ice therapy to reduce swelling and inflammation
• Physical therapy to improve flexibility and strength around the tendon 
• Nonsteroidal anti-inflammatory drugs for pain relief
• If symptoms persist, steroid injections may be used, though sparingly. 

If it’s not carpal tunnel syndrome, what could it be?

When you’re experiencing pain, numbness or tingling in your wrist and hand, it’s easy to assume carpal tunnel syndrome may be the cause. However, in addition to arthritis and tendinitis, there are other conditions that may also cause similar symptoms to carpal tunnel syndrome, including:

• Cervical radiculopathy — Nerve compression or irritation in the cervical spine (the neck area) can cause pain, numbness or weakness in the arm, wrist and hand. This condition occurs when a spinal nerve root becomes pinched, often due to a herniated disc, bone spurs or degenerative changes in the spine. 
• Sprained wrist — A sprained wrist occurs when the ligaments that support the wrist joint are stretched or torn due to injury. Symptoms can include pain, swelling and tenderness, which can mimic carpal tunnel syndrome. However, a sprained wrist can be painful to the touch and may have visible bruising and swelling, which aren’t as common in carpal tunnel syndrome.
• Neuropathy — Neuropathy is nerve damage due to a variety of conditions that can cause tingling, burning and weakness in the hands and feet. Unlike carpal tunnel syndrome, neuropathy symptoms aren’t limited to the wrist and can be more widespread, affecting both hands symmetrically. 
• Pinched nerve — A pinched nerve can occur at various locations in the arm or neck, leading to similar symptoms as carpal tunnel syndrome. When a nerve is compressed due to injury, repetitive movements or inflammation, it can cause pain, numbness and tingling in the hand and fingers. 
• Thoracic outlet syndrome (TOS) — TOS is a condition caused by the compression of nerves and blood vessels between the collarbone and the first rib. This compression can cause symptoms such as numbness, tingling and weakness in the shoulder, arm and hand. The pain and tingling in the hand can be mistaken for carpal tunnel syndrome but can be distinguished by TOS also causing swelling, arm fatigue and coolness in the fingers. 
• Multiple sclerosis (MS) — MS is a chronic autoimmune disease that affects the central nervous system, causing nerve damage and disrupting communication between the brain and the body. It can cause a wide range of symptoms, including numbness, tingling, muscle weakness and coordination issues. If MS affects the hand, it can create sensations similar to carpal tunnel syndrome. However, MS comes with additional symptoms, such as vision changes, balance problems or fatigue, that aren’t seen in carpal tunnel syndrome. 
• Focal dystonia — Focal dystonia is a neurological condition that causes involuntary muscle contractions and abnormal postures in specific body parts, often the hands and fingers. It can cause stiffness, discomfort and impaired hand function. Additional symptoms of focal dystonia include abnormal hand positioning or having a hard time with fine motor skills. 

Each of these conditions can cause symptoms similar to carpal tunnel syndrome, which is why a careful evaluation is critical for an accurate diagnosis. 

How to know for sure what’s causing your symptoms

To accurately diagnose what’s causing your wrist and hand symptoms, health care providers often use a combination of tests, including:

• Physical examination
• Nerve conduction studies
• Electromyography
• Imaging studies
• Blood tests

By combining these tools, doctors can pinpoint the cause of symptoms and guide treatment effectively. 

Lattimore PT can treat your hand and wrist pain

At Lattimore PT, we understand how challenging it can be to experience hand and wrist pain. Our skilled team of physical therapists is dedicated to providing compassionate and comprehensive care, helping you find relief and improve function through personalized physical therapy treatment plans. No matter what is affecting your hand and wrist, we will work with you to help restore your mobility, reduce your pain and get you back to the activities you enjoy most. Let us guide you on your path to recovery with treatments designed to support your unique needs. 

Contact our team today for more information or to schedule an initial appointment.