Unveiling the Hidden Culprits: Conditions Misdiagnosed as Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a prevalent condition that plagues many individuals who engage in repetitive hand movements or face certain risk factors. It’s often the go-to diagnosis when people experience hand pain, but what if their symptoms are being misrepresented?

In this blog, we delve into the world of hand pain, examining how arthritis and flexor tendonitis can mimic the symptoms of carpal tunnel syndrome and understanding the critical differences between them. If you’ve been grappling with hand discomfort and suspect CTS, it’s essential to uncover the source of your pain and explore the right avenues for treating hand arthritis, tendonitis, and CTS.

What Are the Two Conditions Often Misdiagnosed as Carpal Tunnel Syndrome (CTS)?

Frequently, patients visit our office with various concerns, often convinced they are dealing with carpal tunnel syndrome due to their primary complaint of hand pain. However, as mentioned, it’s essential to recognize that there are two conditions that are often misdiagnosed as carpal tunnel syndrome: tendonitis and arthritis. They affect different areas of the wrist and hand, and can frequently masquerade as carpal tunnel.

Through a thorough examination and detailed patient history, we can swiftly discern these conditions, ruling them in or out as potential sources of discomfort. carpal tunnel, with its distinct presentation, requires a different diagnostic approach.

How Do Arthritis and Flexor Tendonitis Symptoms Mimic CTS?

These conditions, including carpal tunnel, arthritis, and tendonitis, are often present with hand pain, prompting patients to seek answers on the internet. CTS is a common search result due to its prevalence as a nerve compression issue.

Distinguishing between these conditions necessitates a comprehensive approach, involving a thorough physical examination and a detailed patient history. CTS features nocturnal pain, thumb, index, and ring finger numbness, and potential weakness, whereas tendonitis varies depending on the affected tendon, causing pain and stiffness. Arthritis in the fingers may lead to morning stiffness, often misattributed to nerve-related issues.

Carpal Tunnel or Arthritis: How Does Arthritis in the Hand and Wrist Differ from CTS?

In the context of CTS, healthcare providers typically assess key indicators in their patients’ histories, which include examining for nocturnal symptoms, such as night pain.

On the other hand, arthritis in hands and wrists often presents differently. Patients with arthritis commonly report pain related to hand usage, particularly in areas like the base of the thumb, a common site for arthritis-related discomfort. They describe experiencing pain when gripping and pinching objects, in contrast to the nocturnal pain frequently associated with CTS. Notably, numbness and tingling, indicative of nerve compression, are prevalent symptoms in carpal tunnel cases but are not typical features of arthritis-related pain.

Carpal Tunnel vs Tendonitis: How Does Flexor Tendonitis of the Hand Differ from CTS?

Tendonitis, like trigger finger, displays unique symptoms such as finger stiffness and mechanical issues when flexed. Patients with tendonitis typically experience localized pain and tenderness around the flexor tendons of the hand and fingers, especially during hand use.

In contrast, CTS shares some symptoms of hand pain during use. Still, it is distinguished by specific features: nocturnal pain, numbness, and tingling in the fingers, indicative of nerve compression. Weakness and difficulty holding objects are more frequently linked to nerve entrapment, establishing a distinct pattern.

What’s the Difference in Carpal Tunnel Syndrome (CTS) Treatment vs Tendonitis and Arthritis?

In the treatment of CTS, healthcare providers often follow a step-wise approach, tailoring interventions to the patient’s specific needs:

Treatment Initiation

• Patients with classic carpal tunnel findings on physical examination may initially receive conservative treatment.
• Nighttime splinting with a wrist brace is a common and effective approach in early CTS cases, often alleviating symptoms significantly.
• Follow-up appointments at four weeks are scheduled to assess treatment efficacy.

Progress Evaluation

• If patients report significant relief and improvement in their symptoms, no further treatment may be necessary.
• However, if patients return after four weeks and indicate that splints have provided some relief but insignificant improvement, additional options are explored.

Advanced Treatment Options

• In persistent or severe symptoms, healthcare providers may offer cortisone injections, which can provide significant relief, though they may not always constitute a cure.
• For patients for whom conservative measures have proven ineffective, a surgical option known as “carpal tunnel release” is considered.

Carpal Tunnel Release Surgery

• Carpal tunnel release can be performed under local anesthesia, with the patient awake during the procedure.
• The surgery typically lasts for a brief period, ranging from two to three minutes.
  By relieving the compression on the median nerve, the surgery often provides immediate relief for symptoms that come and go.

When Addressing Tendonitis

• Conservative treatments, including splinting and injections, are often the first-line approach.
• In cases of trigger finger tendonitis, a mechanical issue resulting in finger triggering, healthcare providers may opt for a surgical release procedure.
• The release procedure, typically performed under local anesthesia, offers immediate improvement for this condition, particularly in alleviating mechanical symptoms.

For hand pain or related symptoms, take the next step toward relief and accurate diagnosis. Request an appointment with Town Center Orthopaedics today, where our experienced hand doctors are ready to guide you toward better hand health. Begin your journey to a pain-free future by requesting an appointment.