What Are Two Conditions That Are Often Misdiagnosed as Carpal Tunnel Syndrome?

Dec 15, 2024

Do you wake up at night with tingling fingers and think it might be carpal tunnel syndrome? You’re not alone. Many people assume this common nerve issue causes wrist pain, but it could be something else. There are two conditions that are often misdiagnosed as carpal tunnel syndrome. Let’s find out which ones are and why.

Two Conditions That Resemble Carpal Tunnel Syndrome

When people experience hand pain, they often think it’s carpal tunnel syndrome (CTS), but this isn’t always the case. Two conditions that can mimic CTS symptoms are neuropathy and arthritis, each with unique features.

Neuropathy

Neuropathy is nerve damage that causes tingling, numbness, and weakness, similar to CTS. However, unlike CTS, neuropathy often affects both the hands and feet. It can also cause coordination problems and muscle spasms, which aren’t typical of CTS. Common causes of neuropathy include diabetes, certain medications, and exposure to toxins.

Arthritis

Arthritis, especially rheumatoid arthritis, can also have overlapping symptoms with CTS, such as pain, stiffness, and swelling in the hands. However, arthritis usually affects multiple joints and involves chronic inflammation, while CTS is caused by pressure on the median nerve in the wrist. Recognizing these differences is essential for proper diagnosis and treatment.

Carpal Tunnel Syndrome Test

If you experience a hand condition similar to carpal tunnel syndrome. Following are some tests to find out whether its carpal tunnel or something else.

Physical Exam

Symptom Check: The doctor will ask about your symptoms, like numbness, tingling, or weakness in your hand or fingers.
Tinel’s Sign: The doctor taps on the median nerve at your wrist. If this causes tingling or shock-like feelings in your fingers, it may indicate CTS.
Phalen’s Test: You will press the backs of your hands together with your wrists bent for about a minute. If this causes symptoms, it suggests CTS.
Carpal Compression Test: The doctor presses on the carpal tunnel for 30 seconds. Pain or tingling during this test can indicate CTS.

Nerve Tests

Nerve Conduction Studies (NCS): This test measures how fast electrical signals move through the median nerve. Slower signals suggest CTS.
Electromyography (EMG): This checks how muscles respond to nerve signals and can show if the median nerve has caused muscle damage.

Imaging Tests

Ultrasound: A simple scan that shows the size of the median nerve and can help confirm CTS.
MRI: Rarely used but can help find other causes of wrist pain or nerve issues if needed.

Additional Tests

Hand Elevation Test: You raise your hands above your head for a minute. Symptoms during this test may indicate CTS.
Square Sign Test: The doctor measures your wrist’s shape, as certain dimensions may suggest a higher risk for CTS.

What Will Happen If Carpal Tunnel Syndrome Is Not Treated?

Ignoring carpal tunnel syndrome (CTS) can cause serious problems that may permanently affect your daily life. If untreated, CTS can worsen from mild discomfort to ongoing pain, making activities like typing, driving, or buttoning a shirt difficult. Over time, symptoms like numbness, tingling, and hand weakness can become constant, reducing grip strength and fine motor skills. This can impact both personal and work tasks.

In severe cases, untreated CTS can cause permanent nerve damage, leading to muscle wasting and a lasting loss of feeling in the fingers. Once nerve damage happens, it cannot be fixed. Acting early when symptoms first appear is essential to prevent these serious effects and maintain a good quality of life.

Ending Note

Hand pain is usually associated with carpal tunnel syndrome. However, there are two conditions that are often mistaken as carpal tunnel syndrome so, if you are dealing with hand pain, seeing a specialist will help.

Visit our board-certified orthopedic surgeon, Dr. Luo, at Randy Y. Luo, MD. Our doctor is highly skilled in the latest orthopedic and hand surgeries. Call us at any of the following: