You’re pretty sure something is going on with your hands. Your fingertips are so numb that you can’t feel the buttons on your shirt when you’re trying to get dressed. Your hand tingles when you send a quick text on your phone. And when you grip the steering wheel during rush hour traffic, it feels like an electric shock that starts at your wrist and travels up your arm.
You may find yourself wondering, is this what carpal tunnel feels like? Could I have carpal tunnel syndrome, or is it something else?
Many adults have hand and wrist problems. One of the most common is carpal tunnel syndrome, a condition that affects about 4% of the population.
But there are other possible causes for numbness, tingling and pain in your hands, wrists and fingers. Learn how to know if you have carpal tunnel syndrome, conditions that mimic it and how to get relief.
What is carpal tunnel syndrome?
Carpal tunnel syndrome occurs when pressure on the median nerve at the wrist causes numbness, tingling and pain in the hand.
So why is it called carpal tunnel syndrome? It has to do with where the pressure or squeezing of the nerve happens: in the carpal tunnel in your wrist. The carpal tunnel is a narrow passageway surrounded by the wrist bones. It’s very little – only about an inch wide – and the median nerve, plus nine tendons go through it, making it a tight fit. So if there’s swelling or inflammation in your wrist for any reason, it can cause increased pressure on the median nerve and result in carpal tunnel syndrome.
Who gets carpal tunnel syndrome?
We often think about carpal tunnel syndrome happening to office workers who use a keyboard all day long – and there’s some truth to that. However, in most cases, it cannot always be identified why someone develops carpal tunnel syndrome.
Carpal tunnel syndrome can result from injury and other medical conditions. For example, many pregnant people have carpal tunnel syndrome, most likely due to the increase of blood flow that happens during pregnancy.
Common carpal tunnel syndrome symptoms
Because carpal tunnel syndrome is a nerve issue, changes in sensation are the most common symptoms. If you have carpal tunnel syndrome, you’ll notice symptoms in your thumb and index, middle or ring finger (not your little finger). The most common symptoms are:
- Numbness. You may feel numbness in the palm of your hand or in your fingers. In more extreme cases, your hands may feel numb most of the time or you may be unable to tell the difference between hot and cold.
- Burning or tingling. If you have carpal tunnel syndrome, it can feel like pins and needles, or an electric shock.
- Numbness and tingling that wakes you from sleep. This is one of the most common and problematic symptoms of carpal tunnel syndrome.
- Weakened grip. As a result of weakness in your hand, you may drop things. It may be hard to pick up small objects, open jars or button your clothes.
- Sensation that extends up the arm. If your carpal tunnel syndrome is bad enough, you may feel it up your arm and into your elbow, particularly when you’re holding something.
Carpal tunnel syndrome symptoms usually start gradually and often come and go, depending on how much you’re using your hands. Most often, people first notice carpal tunnel syndrome at night, after a long day of using their hands.
What are conditions mistaken for carpal tunnel syndrome?
Before seeing a doctor, it’s common for people to misdiagnose themselves for having carpal tunnel syndrome when it may be something else. Without seeing a doctor, it’s not always easy to tell what could be wrong with your hand or wrist because many conditions have symptoms that are similar to carpal tunnel syndrome.
But, in general, here are key similarities and differences between carpal tunnel syndrome and other conditions that affect your hands, wrists, fingers and forearms.
1. Carpal tunnel syndrome vs. wrist tendonitis
Tendonitis is inflammation of a tendon in your wrist, which can happen when you overuse your wrist. Activities that can cause tendonitis include crocheting, tennis, hammering and using a computer.
Common symptoms between wrist tendonitis and carpal tunnel syndrome
Both conditions can cause pain in the wrist and hand, but tendonitis does not cause numbness and tingling.
When it might be tendonitis of the wrist
It’s more likely to be tendonitis if you feel pain and stiffness that doesn’t go away when you stop the activity, if you feel tenderness directly over the affected tendon, or if the pain affects both the palm and back sides of your hand and wrist.
2. Carpal tunnel syndrome vs. arthritis
Arthritis is inflammation and loss of the cartilage, which is the gliding surface of the joint. There are many different types of arthritis, and it can affect any of the joints in your body, including your wrists, hands and fingers. It’s more common in older adults, but it can affect people of all ages.
Common symptoms between arthritis and carpal tunnel syndrome
Arthritis can cause joint pain and swelling but does not cause numbness or tingling. Hand arthritis most often causes stiffness that is worst first thing in the morning.
When it might be arthritis of the hand
The location of the symptoms is a little different than with carpal tunnel syndrome. If your hand pain is due to arthritis, you’ll typically feel it in your finger joints or at the base of your thumb.
With arthritis, you generally won’t feel tingling or numbness either. Instead you’ll have swelling, stiffness and tenderness, specifically around your joints. You may also have bony bumps around the joints, especially in your finger knuckles.
However, it’s possible to have both conditions at the same time. If you have arthritis in your hand or wrist, you have a higher chance of developing carpal tunnel syndrome. One reason is because the swelling in your wrists and tendons increases pressure on the median nerve.
3. Carpal tunnel syndrome vs. sprained wrist
A sprained wrist happens when the ligaments that connect the wrist and hand bones stretch too far, resulting in a tiny tear or a ligament break. The most common reason for wrist sprain is when a person uses their hand to break a fall. This type of injury can also be the result of getting hit on the wrist, extreme pressure on the wrist or having the wrist twisted. Sprained wrists are one of the most common hand injuries from playing sports, but they also happen in daily life.
That being said, the inflammation and swelling from a sprained wrist can narrow the carpal tunnel and irritate the median nerve. So, you may experience some symptoms of carpal tunnel syndrome as you heal.
Common symptoms between a sprained wrist and carpal tunnel syndrome
Hand weakness is a common symptom in both of these conditions.
When it might be a sprained wrist
If your symptoms start after a sudden fall or an injury, it’s more likely to be a sprained or broken wrist. In addition, be on the lookout for symptoms such as:
- Tenderness and warmth
- A popping or tearing in your wrist
- Weakness and loss of motion
4. Carpal tunnel syndrome vs. nerve damage from neuropathy
Neuropathy is another name for nerve degeneration that can come from a variety of causes. If you have nerve damage from neuropathy in your hands and experience carpal tunnel-like symptoms, it’s because your nerves aren’t working the way they should. Neuropathy is very common, and an estimated 25-30% of Americans will be affected by neuropathy at some point.
Older people are more likely to have neuropathy, but it can affect people of all ages. You are more likely to have neuropathy if you have certain medical conditions such as diabetes (60-70% of people with diabetes also have neuropathy). Other risk factors include alcoholism, exposure to toxins and some medications like chemotherapy.
Common symptoms between neuropathy and carpal tunnel syndrome
Both neuropathy and carpal tunnel syndrome can cause numbness, tingling, muscle weakness and pain in your hands and fingers. Like with carpal tunnel syndrome, the symptoms of neuropathy can develop slowly, taking months or even years to develop.
When it might be neuropathy
If the neuropathy is limited to your hands and fingers, it might be hard to tell the difference between the two conditions.
However, neuropathy often affects different parts of the body. So if you’re experiencing similar symptoms in your lower legs and feet, that may be a sign that it’s neuropathy.
In addition, there are other symptoms that make it more likely that the cause is neuropathy and not carpal tunnel. These include:
- Loss of coordination
- Muscle spasms
- Low blood pressure
- Abnormal heart rate
- Excessive sweating
- Bladder, bowel and digestive problems
- Sexual function problems
- Unintentional weight loss
5. Carpal tunnel syndrome vs. pinched nerves
Pinched nerves in the neck, a condition called cervical radiculopathy, happens when a nerve is squeezed or irritated as it branches from the spinal cord. The cause of these pinched nerves can be arthritic changes in the spine and is more common in older adults. In younger people, pinched nerves in the neck are more likely the result of a sudden injury that caused a herniated disc.
Common symptoms between cervical radiculopathy and carpal tunnel syndrome
There are a lot of similar symptoms between the two conditions. Both can result in tingling in your fingers and hands, a weakened grip and numbness.
When it might be a pinched nerve in the neck
It comes down to where the pain starts. It might be cervical radiculopathy if the pain starts in your neck and travels down your arm, or if you have increased pain when you turn your head or extend your neck.
6. Carpal tunnel syndrome vs. tennis elbow
Despite the name, this injury doesn’t only happen to tennis players or athletes. Anyone who does repetitive motions with their lower arm can get tennis elbow – so that may include painters, plumbers and butchers. Tennis elbow is most likely to occur in people who are between 40 and 60 years old.
Common symptoms between tennis elbow and carpal tunnel syndrome
Both conditions can cause pain in the arm, but tennis elbow does not cause numbness and tingling.
When it might be tennis elbow
If the pain is primarily in the upper part of your forearm and outside of your elbow, and the pain gets worse when gripping objects, you may have tennis elbow.
When to talk to a doctor about your hand symptoms
While you may be able to guess what’s causing your problems based on your symptoms, it’s a good idea to get an official diagnosis and treatment plan from a doctor.
To diagnose your condition, your doctor will examine your hand and other affected areas. They’ll likely ask you to move your hand in different ways and to explain how and where it hurts. They may also ask questions about your activities and what you do that causes or increases the pain.
Based on what your doctor sees and hears, they may recommend a nerve test called an EMG (electromyogram) to help determine the diagnosis. They may also recommend X-rays or other imaging, blood work or additional testing to confirm the diagnosis.
Once you have a diagnosis, your doctor will develop a personalized treatment plan for you. Treatments for hand problems vary by conditions but can include exercises, changing activities, splints, medications and surgery.
Let us give you a hand
If your hands, wrists or fingers are bothering you, we can help.
Our award-winning hand specialists will determine the source of your hand problems and develop a treatment plan just for you. If it turns out that the source of your problem is a pinched nerve in your neck, we also have doctors who treat neck and back pain.
And if you’re experiencing severe hand pain, you don’t need an appointment. Just stop by one of the TRIA urgent care locations across the Twin Cities metro area, open daily.