The median nerve and tendons run through a passage in the wrist called carpal tunnel. Any swelling within the tunnel puts pressure on structures that produce symptoms such as numbness and tingling in the thumb, index, middle and ring fingers.
The condition often occurs at work, but is also linked to certain medical conditions such as rheumatoid arthritis and thyroid gland imbalance. Read more about : two conditions that are often misdiagnosed as carpal tunnel syndrome.
Cervical Radiculopathy
Cervical radiculopathy is neck pain that radiates into the shoulder and arm, and can be misdiagnosed as carpal tunnel syndrome. It occurs when the nerve root from the spinal cord is irritated or squeezed in the neck region.
The compression can be caused by herniated disks, degenerative changes in the bones, arthritis, and other injuries that cause a nerve to become compressed. Cervical radiculopathy is more common in older adults, and herniated discs are more likely to be the culprit than in younger individuals.
When a cervical radiculopathy is present, the symptoms may be identical to those of carpal tunnel syndrome, including tingling or numbness in your fingers and hand, weakness in your grip, and a loss of sensation in your thumb.
Both conditions can also lead to a feeling of pins and needles. The difference is that cervical radiculopathy symptoms begin in your neck and spread to your arm and hand, while carpal tunnel syndrome affects only your wrist.
Additionally, if your pain worsens when you extend your neck or twist your head, it’s more likely that you have cervical radiculopathy than carpal tunnel syndrome.
In order to diagnose cervical radiculopathy, your healthcare provider will take a complete medical history and perform a physical examination. They will test your strength and sensation, and may suggest tests such as a computed tomography (CT) scan or magnetic resonance imaging (MRI).
These will provide detailed images of your neck and upper extremities to help determine the underlying issue that is contributing to your pain.
A CT scan or an MRI will show if there is a herniated disk or other structural problems that are contributing to your pain. These diagnostic tools can also reveal signs of nerve compression such as foraminal narrowing.
Other tests that your healthcare provider may recommend include an electromyography (EMG) to assess the electrical activity of your muscles, and a nerve conduction study to measure how quickly signals are transmitted along a nerve.
Nonsurgical treatment for cervical radiculopathy focuses on managing pain through physical therapy and medications to reduce inflammation and swelling.
Tendinitis
Tendonitis is an inflammation of a tendon or the surrounding tendon sheath. The condition often develops in middle age as a result of repeated microtrauma or degeneration (tendinopathy).
Overuse of the affected joint or muscle, such as repetitive motions associated with work or sports, may contribute to the development of tendinitis. Chronic inflammation can lead to scarring of the sheath and loss of flexibility. Certain medications, such as fluoroquinolones, can also increase the risk of tendinitis and tendon rupture.
The most common type of tendinitis affects the tendons around the wrist. Wrist tendinitis can be caused by activities that cause the wrist to bend repeatedly, such as typing, crocheting, tennis, hammering or using a computer. Unlike carpal tunnel syndrome, tendonitis in the wrist does not usually cause numbness or tingling in the hand and fingers.
Symptoms of tendonitis in the wrist include pain, tenderness and swelling. The pain is often worst while the offending activity is being performed. If the symptoms persist, the doctor may recommend a steroid injection into the tendon sheath.
In a recent case, a 66-year-old woman complained of severe pain in her dominant hand and wrist, particularly the thumb, index and middle finger. The patient reported that her symptoms started around the thenar eminence, but quickly progressed to the entire hand and wrist. She denied any trauma to the wrist and did not have a history of repetitive motions or any previous wrist injuries.
Treatment of wrist tendonitis depends on the underlying cause. If the problem is caused by overuse, the doctor may suggest a change in the way you perform your job or favorite activity. Physical therapy is another option.
Specifically, a physical therapist can teach you exercises to help the median nerve move more freely within the confines of the carpal tunnel. These exercises are called nerve gliding exercises.
While both carpal tunnel syndrome and wrist tendonitis can have similar signs and symptoms, it is important to listen to your body. If your hand or wrist is hurting, it is a signal that something is wrong. By understanding the difference between the two conditions, you can get the right treatment for your symptoms.
Tennis Elbow
The elbow is a complex joint that includes three bones of the upper arm (humerus) and two bones of the forearm (radius and ulna). Muscles, ligaments, and tendons hold the joint together. The nerve that supplies feeling to most of the fingers and thumb in the hand travels through a tunnel on the outside of the elbow called the lateral epicondyle.
When a person overuses the muscles that straighten the wrist, tiny tears and inflammation may develop near the lateral epicondyle. This is what causes tennis elbow.
The symptoms of this condition are pain and tenderness on the outside of the elbow when straightening the wrist. This may be accompanied by a burning sensation and numbness. The symptoms often start gradually without a clear injury.
They get worse with activity, and they are often worst at night, when the patient is sleeping with a bent wrist. The symptoms may also be aggravated by certain activities, such as using a screwdriver or lifting heavy objects. The condition is more common in men than women. It typically affects people between 35 and 54 years of age.
Treatment of this condition involves resting the affected elbow, applying ice and taking acetaminophen to reduce pain and swelling. If these measures do not relieve the symptoms, a physician may recommend steroid injections. However, repeated injections can lead to tissue atrophy, so physicians usually recommend no more than two or four.
Another treatment option is platelet-rich plasma (PRP). This procedure involves obtaining a small sample of blood and then spinning it to separate the platelets, which are known for their high concentration of growth factors. This solution is then injected into the affected area.
Prevention of this condition involves a good stretching routine before and after playing racquet sports, and making sure that tools used for work are not too big for the hand. People who use keyboards or mice for long periods of time should also take breaks, and make sure that their work stations have good ergonomics.
There are many products on the market that claim to help prevent carpal tunnel syndrome, but so far no one has proven they actually do.
Golfer’s Elbow
Golfer’s elbow is a form of tendonitis that affects the tendons that connect your forearm muscles to the bony knob on the inside of your elbow. This is a common condition among people who play golf or participate in throwing sports.
The repetitive wrist and finger clenching movements of these sports can cause the tendons to become inflamed and painful. It can also be caused by occupations that involve repeated movement or forceful hand and arm use, like plumbing, carpentry, raking, painting, hammering, and weight lifting.
This injury is sometimes confused with tennis elbow (which hurts on the outside of your elbow). However, golfer’s elbow pain usually occurs at the inner elbow and down the forearm. It may be more intense when you bend your wrist forward or twist your forearm to grasp something. You may also notice that it is harder to make a fist with your fingers.
Similar to tennis elbow, golfer’s elbow is an overuse injury. Over time, the tendons that connect your forearm and elbow develop tiny tears and don’t heal correctly. The damaged tendons are re-injured every time you overuse your elbow and wrist, causing the area to become tender and inflamed.
There are several tests that can be performed to diagnose this condition, including a physical exam and diagnostic imaging. Your doctor will have you move your elbow, wrist, and fingers in different positions to check for pain. They may perform special muscle tests, like bending your elbow against resistance or trying to squeeze a rubber ball, to determine the cause of your symptoms.
Treatment for this condition includes rest, ice, and over-the-counter nonsteroidal anti-inflammatory drugs like aspirin or ibuprofen. You can also get help from a physical therapist to perform specialized exercises and to teach you proper body mechanics for your activities. Read more about : two conditions that are often misdiagnosed as carpal tunnel syndrome.
If your symptoms persist, your doctor may recommend injections into the affected tendon to reduce swelling and inflammation. At Complete, all of our injections are completed under ultrasound guidance to ensure accurate targeting and effective pain relief. This is the best way to get rid of your elbow pain and return you back to your normal activities.
