How To Diagnose Carpal Tunnel Syndrome
Since carpal tunnel syndrome affects the nerves, it is often diagnosed using the nerve conduction velocity test. With the NCV test, a doctor places a small electrode on your skin near your elbow. The electrode sends a mild electrical current to your median nerve to test how fast it travels from your elbow to your fingers. If it takes longer than expected, they will likely diagnose you with carpal tunnel syndrome.
If your doctor requires more reliable testing, they will order an imaging test to get a clearer picture of the nerves, ligaments and muscles in your wrist. Some imaging tests that can help with a carpal tunnel diagnosis include:
- Past trauma to the wrist
- Repetitive strain injuries , such as tendinitis
Differences Between Carpal Tunnel And Arthritis
While several forms of arthritis and carpal tunnel syndrome can all cause hand and wrist pain, there are certain features of each disease that distinguish the two. Carpal tunnel syndrome pain is primarily the result of nerve compression, while arthritis is swelling and inflammation of the joint itself.
What Triggers Carpal Tunnel
Carpal Tunnel Syndrome Causes Repetitive motions, like typing, or any wrist movements that you do over and over. This is especially true of things you do when your hands are lower than your wrists. Conditions like hypothyroidism, obesity, rheumatoid arthritis, and diabetes. Pregnancy…. read more
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My Top Five Signs You May Have Carpal Tunnel Syndrome
Some of the above factors are more indicative of carpal tunnel than others, so let me show you my top five signs you may have carpal tunnel syndrome. Go through this list quickly and watch the video which should be helpful. In order to nail it down, Ill typically do a number of orthopedic tests if you come to the office, but I initially look for these 5 important factors to narrow down my diagnosis list.
Here are the 5 signs of carpal tunnel syndrome that I use to diagnose this condition in my office:
Finding The Right Treatment Plan
Treatment of both conditions starts with the correct diagnosis, including a full history of symptoms, a physical examination and X-rays of the affected areas. Nerve tests can be performed to help determine if you have carpal tunnel syndrome or if another problem may be causing your symptoms.
The first line of treatment is often specialized supportive bracing. Anti-inflammatory medications can help, but only use under the advice of your doctor if needed longer than a few days. Cortisone injections are also very effective. Injections can especially control arthritis symptoms in the hand and wrist for many months or years prior to needing surgery.
Other treatment options include stretching exercises where the fingers are pulled back towards the top of the wrist, allowing you to feel the stretch in the palm of your hand. Hold this position for approximately 15-20 seconds then repeat. Other over the counter remedies includes vitamin B6 which may help nerve recovery and can be beneficial in the early stages of carpal tunnel syndrome. Wearing a wrist splint at night may also help. These splints keep the wrist from bending while we sleep which may prevent the numbness and aching from occurring, allowing us to have a restful night sleep.
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Understanding Carpal Tunnel Pain In The Hands
Conversely, carpal tunnel syndrome is caused as a result of compression of the median nerve and wear and tear over time.6,8 This nerve extends from the forearm through the wrist and into the hand.7 Repetitive work, a wrist fracture, and chronic diseases like diabetes are risk factors for developing carpal tunnel syndrome.8,9 Inflammatory conditions, such as rheumatoid arthritis, can lead to carpal tunnel syndrome as well.10
Carpal tunnel syndrome feels like numbness and tingling in the hands that can be described as a pins and needles sensation.6,7,8This condition gets worse with use, especially while gripping objects or bending the wrist. Symptoms may be felt in either one hand or both hands and symptoms tend to be worse at night. Nonsurgical therapies for treatment include nonsteroidal anti-inflammatory drugs and wrist splinting.7,11 Surgery may be required for severe cases to relieve pressure on the median nerve.
What Does Arthritis In The Hand Feel Like
Early symptoms of arthritis of the hand include joint pain that may feel “dull,” or a “burning” sensation. The pain often occurs after periods of increased joint use, such as heavy gripping or grasping. The pain may not be present immediately, but may show up hours later or even the following day…. see details
People who suffer from rheumatoid arthritis often have joint pain in other regions of the body in addition to the hands. Carpal tunnel syndrome pain, however, is typically restricted to the hand, forearm, and shoulder…. view details
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How Is Carpal Tunnel Syndrome Diagnosed
In order to properly diagnose carpal tunnel syndrome, youll want to see your health care provider. Your doctor may look for the Tinels sign by tapping the palm side of your wrist. They may also have you flex your wrist fully while your arms are extended to test for carpal tunnel syndrome. Imaging tests such as ultrasound, MRI, or X-rays may be ordered so your doctor can look at your tissues and bones. An electromyogram uses a thin electrode to measure the muscles electrical activity. Your doctor may also connect electrodes to your hand, wrist, and arm to measure the nerve signals.
My Advice For Patients With Arthritis & Carpal Tunnel
If you have arthritis & carpal tunnel syndrome, my advice to Christina is the same. That is:
Use the CarpalRx. For RA, a gentle knuckle massage will feel wonderful. It won’t treat the arthritis, but it will ease the pain. Pay attention and dont massage too hard because it might irritate.
Christina concluded by praising the CarpalRx in getting rid of most of her hand pain. She said it changed her life.My satisfaction in hearing that never ends.
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How Do You Know If Your Carpal Tunnel Is Severe
But the general medical consensus it that “severe” means when carpal tunnel symptoms are so intense they interfere with almost every aspect of your life. That means: Symptoms are constant, with practically no rest from them. Most patients have lost significant finger dexterity and hand strength…. read more
Weekend Wellness: Carpal Tunnel Affects Hands Symptoms Differ From Arthritis
DEAR MAYO CLINIC: I have a job in which I make repetitive movements with my hand, and have had pain and numbness in my hand for years. I assumed it was due to osteoarthritis, which I was diagnosed with 20 years ago. But my doctor thinks it may be carpal tunnel syndrome. Are the two conditions related? How is carpal tunnel syndrome diagnosed?
ANSWER: Although carpal tunnel syndrome and osteoarthritis can happen together, the causes of the two conditions are not related. But if you are diagnosed with osteoarthritis and carpal tunnel syndrome, effective treatments are available for both.
When you have arthritis within your hand, the two most common places to get it are the ends of the finger joints and at the base of the thumb. From your description, it sounds like you may have thumb arthritis. Arthritis happens when the cartilage in your joints wears away. Without cartilage to cushion them, the ends of the bones in the joint rub together. That can lead to a variety of symptoms.
The most common symptom of thumb arthritis is pain at the base of the thumb. Other signs and symptoms may include swelling, stiffness and tenderness at the base of your thumb, a lack of strength when you grasp objects, and a decreased range of thumb motion. A diagnosis of thumb arthritis typically involves a review of symptoms, along with an imaging exam, such as an X-ray, that can show the loss of cartilage.
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Carpal Tunnel Syndrome Diagnosis And Tests
Your doctor may tap the palm side of your wrist, a test called Tinel sign, or fully flex your wrist with your arms extended. They might also do tests including:
- Imaging tests. X-rays, ultrasounds, or MRI exams can let your doctor look at your bones and tissues.
- Electromyogram. Your doctor puts a thin electrode into a muscle to measure its electrical activity.
- Nerve conduction studies. Your doctor tapes electrodes to your skin to measure the signals in the nerves of your hand and arm.
Risk Factors Of Carpal Tunnel Syndrome
Some people are at higher risk of developing carpal tunnel syndrome, including:
- Women between the ages of 40 and 60 years
- People with certain types of arthritis
- Anyone who experiences a period of rapid weight gain
- People who use their hands repetitively in their day-to-day activities, such as typists or assembly line workers.
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Is It Carpal Tunnel Arthritis Or Tendinitis
Your wrist is only a small part of your body, but it has a huge impact on your ability to perform daily tasks. Wrist pain impacts your ability to type, write, drive, lift and grip objects and much more. With that in mind, if youre experiencing wrist pain, it pays to find out what is causing the pain.
Various conditions cause wrist pain with similar symptoms. Three common culprits of wrist pain include carpal tunnel, arthritis and tendinitis. These conditions affect different parts of the wrist. Still, as the wrist is compact, the symptoms of these three conditions often overlap. Read through the differences btween carpal tunnel, arthritis and tendinitis and how doctors typically diagnose these conditions.
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Carpal Tunnel Syndrome Diagnostic Tools
Here are some tests to expect when you see your doctor about carpal tunnel syndrome. In addition to Tinsels Sign and Phalens maneuver, expect to have these tests performed by your doctor.
- Two-Point Discrimination Test
This test explores the sensitivity of your hand by using a small metal tool called a 2-point disk-criminator. Your doctor will place the two points of this tool on a finger. They will move these two metal prongs closer together on your finger. Your doctor will stop when you can only feel one point of pressure from the two prongs. The distance between the prongs will help them determine your nerve function.
- Nerve Conduction Velocity Test
When your doctor performs this test, they check how quickly your median nerve can communicate with your muscles. This is one of the most effective tests to reveal CTS. Your doctor will put a small electrode near your elbow on a muscle. A weak electric current is sent along your median nerve. If the current travels slowly, this shows that there is nerve damage.
This test measures how well your hand and wrist muscles are working. A small electrode will be put into your hand and will use electrical signals to test how well your median functions. This test will tell your doctor if this significant nerve that travels through the carpal tunnel is being compromised or damaged.
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How Is Arthritis Diagnosed
If youre experiencing severe joint pain, you should plan a visit to your health care provider for an examination and treatment options. Your doctor may request blood or joint fluid samples to determine the type of arthritis you have. These tests look for specific antibodies such as rheumatoid factor , antinuclear antibody , and anti-cyclic citrullinated peptide . You also may have imaging scans ordered such as an MRI, CT scan, or X-ray to help rule out bone spurs or other non-arthritis causes.
What Is Arthritis Of The Wrist & Hand
Arthritis is the inflammation of joints triggered by wear and tear to the bones and cartilage. The main symptoms of wrist arthritis include pain, tenderness, inflammation, redness, stiffness, warmth at the joint, and decreased range of movement.
There are two main types of arthritis:
- Osteoarthritisis caused by repeated wear and tear and grinding in the joints after the cartilage has been damaged or worn away. This most often occurs in older individuals or those who perform tasks that require extensive use of the wrist and hand joints.
- Rheumatoid arthritis, a degenerative disease, can affect the wrist and hand as well. This is an immune disorder that causes the body to attack the joints. It is often accompanied by visible swelling and twisting or distortion of the joints.
As mentioned above, both forms of wrist and hand arthritis have symptoms in common, including pain, swelling, and difficulty with movement. However, osteoarthritis is usually felt in the joints closest to the ends of the fingers. The discomfort may go away after moving around and using the joint. Rheumatoid arthritis is more likely to affect the wrists, with pain that lasts longer in the mornings and is more difficult to alleviate with movement.
Some people who have wrist arthritis will develop carpal tunnel syndrome, but this doesnt happen to everyone.
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Is The Pain In Your Hand Carpal Tunnel Or Arthritis
May 25, 2022
Carpal tunnel syndrome and arthritis are two of the most common complaints seen by orthopedic surgeons specializing in the hand and upper extremity care. While there are some common overlapping symptoms, such as pain and aching with gripping, the two conditions are vastly different.
Carpal tunnel syndrome occurs when there is increased pressure on the nerve that gives sensation to most of the palm of the hand except your small finger. Think of the nerve as an electrical wire carrying impulses and it can be affected by external compression , says Jordan Grier, MD, orthopedic hand surgeon at University Hospitals.
Numbness, tingling, aching in the hand and fingers, and pain that wakes you up at night are hallmarks of carpal tunnel, says Dr. Grier. Initially, this pain may seem to come and go, but as the condition worsens, it becomes more prevalent with numbness involving the thumb, index and middle finger.
Arthritis, most commonly osteoarthritis, is caused by the loss of cartilage between the two bones that make up a joint. Our joints rely on this layer of cartilage to create smooth motion and absorb shock stresses. As the cartilage wears out, increased friction occurs triggering pain, swelling, and decreased motion. I always tell my patients it is exactly like wearing the tread off of your tires says Dr. Grier.
How Do I Know If I Have Carpal Tunnel Syndrome
Your doctor may use a handful of tests to diagnose carpal tunnel syndrome and rule out other causes of hand and wrist pain.
Theyâll probably start with questions about your medical history. Then theyâll examine your hands, arms, shoulders, and neck to figure out if your pain results from another condition, like an injury or arthritis. Theyâll also make sure your daily activities arenât to blame.
The doctor may focus on your wrist to see if the area is tender, swollen, warm, or discolored. Theyâll probably test each finger to see if youâve lost any feeling. And theyâll check the strength of the muscles in your hand.
After that, they may do tests focusing on the median nerve, which runs through your forearm into your hand. When that nerve gets pressed or squeezed through the carpal tunnel, it causes carpal tunnel syndrome.
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What Are Conditions Mistaken For Carpal Tunnel Syndrome
Before seeing a doctor, its common for people to misdiagnose themselves for having carpal tunnel syndrome when it may be something else. Without seeing a doctor, its 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.
What Treatments Are Available For Arthritis
Treatment for arthritis focuses on reducing your pain and preventing further damage. Options include:
- Heat/ice. Using a heating pad of ice pack may alleviate swelling and pain.
- Lifestyle changes. Eating healthfully, losing weight, and exercising regularly may alleviate your symptoms as well.
- Cane/walker. Mobility assistance devices may make it easier to get around.
- Medications. Analgesics, nonsteroidal anti-inflammatory drugs, menthol and capsaicin creams, and immunosuppressants may all help in reducing your inflammation.
- Physical therapy. Exercises to strengthen the muscles surrounding the affected joint may be to your benefit.
- Surgery. Joint replacement and joint fusion are two surgical options for arthritis treatment.
If you or someone you love is experiencing pain in the hand or wrist, reach out to The Hand and Wrist Institute. We have the specialized knowledge and experience necessary to diagnose and treat any issues surrounding the hand or wrist.
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