Wrist pain can be tricky, especially for athletes and weekend warriors who love pickleball, tennis, or other racket sports. Two of the most common causes—carpal tunnel syndrome (CTS) and wrist tendonitis—can feel surprisingly similar, but they affect different tissues and require different treatment approaches. While both can make gripping a paddle or swinging a racket uncomfortable, identifying the true source of wrist pain is key to getting back on the court faster and long-lasting relief.
Carpal Tunnel Syndrome: Signs Your Median Nerve Is Under Pressure
Carpal tunnel syndrome (CTS) occurs when the median nerve, which runs from the forearm into the hand, becomes compressed within the carpal tunnel—a narrow passageway in the wrist. This nerve compression can cause:
- Numbness or tingling in the thumb, index, middle, or part of the ring finger
- Hand weakness or frequent dropping of objects
- Pain that may radiate into the forearm
Carpal tunnel syndrome often results from repetitive hand or wrist motions, structural narrowing of the carpal tunnel, or medical conditions like diabetes, thyroid disorders, or rheumatoid arthritis. Early diagnosis is important to avoid permanent nerve damage.
Wrist Tendonitis Explained: When Overuse Inflames Your Tendons
Wrist tendonitis is inflammation of the tendons around the wrist, usually triggered by overuse or repetitive strain. Unlike CTS, tendonitis involves the tendons, not the nerve. Common symptoms include:
- Localized pain in the wrist or along the forearm
- Swelling or tenderness over affected tendons
- Pain that worsens with gripping, twisting, or specific wrist motions
Athletes, manual laborers, or anyone who performs repetitive wrist motions are at a higher risk of developing tendinitis. Rest, ergonomic adjustments, and targeted therapy are essential to recovery.
Carpal Tunnel vs. Tendonitis: Spotting the Key Differences
While both conditions cause wrist discomfort, there are important distinctions:
- Numbness and tingling: More typical of CTS (nerve compression)
- Localized swelling and pain with movement: More typical of tendonitis
- Weakness or clumsiness of the hand: Often associated with CTS
- Pain triggered by a specific activity: More often tendonitis
A thorough exam by an orthopedic hand specialist, sometimes with nerve studies or imaging, helps establish the correct diagnosis.
Treatment Approaches
Treatment depends on the underlying problem:
- Carpal Tunnel Syndrome: Wrist splints (especially at night), activity modifications, corticosteroid injections, and surgery in severe cases
- Wrist Tendonitis: Rest, ice, anti-inflammatory medications, physical therapy, and occasionally corticosteroid injections
Early treatment can prevent worsening symptoms and speed recovery. Persistent wrist pain, numbness, or weakness should never be ignored. If wrist pain is keeping you from pickleball, tennis, or daily activities, it’s time to consult an orthopedic hand specialist. With an accurate diagnosis and a personalized treatment plan, you can move better, recover faster, and prevent long-term complications.
About the Author
Baris Yildirim, MD specializes in Hand and Upper Extremity Surgery at Town Center Orthopaedics in Ashburn, Reston and Fairfax. His primary areas of focus are the treatment of injuries and disorders of the shoulder, elbow, wrist, and hand. Dr. Yildirim believes in a patient-centered, team-oriented approach to care.
