Carpal Tunnel vs. Arthritis in the Hand: How to Tell the Difference and Find Relief

Understanding the Root of Hand and Wrist Pain

If you're dealing with ongoing wrist or hand pain—without a specific injury like a fall or sudden impact—you might be wondering what's behind it. At Nebraska Hand & Shoulder, many of our patients come in unsure whether their symptoms point to carpal tunnel syndrome or hand arthritis, especially when pain is centered at the base of the thumb.

This guide will help you identify whether your symptoms are caused by carpal tunnel or arthritis—and explain what treatment options are available to relieve your pain and restore hand function.

Where Is the Pain Coming From?

Arthritis in the hand often affects the trapeziometacarpal (TMC) joint at the base of the thumb. This type of pain tends to be localized and may come with joint stiffness or swelling. It’s especially common in people who perform repetitive thumb movements—like texting or gripping tools—or who are experiencing age-related joint changes.

Carpal tunnel syndrome is caused by a pinched median nerve as it passes through the wrist. Symptoms include numbness, tingling, and reduced dexterity, especially in the thumb, index finger, and middle finger. Surprisingly, carpal tunnel doesn’t always cause pain, which often leads to misdiagnosis or delayed treatment—even among healthcare providers.

Shared Symptoms Can Be Misleading

One common source of confusion is pain in the fleshy area at the base of the thumb called the abductor pollicis brevis. Both thumb arthritis and carpal tunnel syndrome can cause discomfort here, making it tricky to tell the difference without a proper evaluation.

However:

Arthritis pain is usually constant and accompanied by joint stiffness.

Carpal tunnel symptoms often worsen at night, and involve numbness, tingling, and a loss of coordination—making small object handling difficult (e.g., dropping pens, struggling with paper clips or sewing needles).

Can You Have Both Conditions?

Yes, you can have both. It’s actually quite common to have thumb arthritis and carpal tunnel syndrome at the same time. Research shows that around 50% of patients with thumb arthritis also develop carpal tunnel. When both are present, we often recommend addressing them together—sometimes with a combined surgical approach.

At Nebraska Hand & Shoulder, we often perform carpal tunnel release surgery at the same time as thumb joint surgery to ensure full relief and improved hand function.

Functional Impact vs. Pain

To summarize the key difference:

Arthritis causes pain and stiffness.

Carpal tunnel syndrome causes loss of function, numbness, tingling, and hand weakness.

Knowing the difference can lead to faster diagnosis and more effective treatment. If you're unsure which condition you might have, or if you suspect both may be present, schedule a consultation today.

Expert Care for Hand and Wrist Conditions

At Nebraska Hand & Shoulder, Dr. Dolf Ichtertz specializes in diagnosing and treating complex hand and wrist problems. Whether you're suffering from thumb arthritis, carpal tunnel syndrome, or both, our goal is to restore comfort and function to your hands—so you can get back to doing the things you love. Schedule your consultation today!