Carpal Tunnel Syndrome vs. Tendonitis Symptoms

Although patients may describe both conditions generally as "hand pain" or "wrist pain," their symptoms can be different.

Carpal tunnel syndrome commonly produces symptoms associated with the median nerve, which can include:

• Numbness or tingling in the hand
• Symptoms affecting the thumb, index, middle, and part of the ring finger
• Hand symptoms that may be more noticeable at night
• Weakness or difficulty gripping objects
• A tendency to drop objects
• Symptoms that may extend from the wrist into the hand

Tendon problems are more likely to produce symptoms associated with a particular tendon or movement. Pain may become more noticeable when the affected tendon is used or stressed.

A medical evaluation can help determine whether symptoms are coming from a tendon, the median nerve, or another source.

Why Can Carpal Tunnel Syndrome Be Misdiagnosed as Tendonitis?

One reason for confusion is that patients often seek care because of discomfort in the hand or wrist rather than because they already know which anatomical structure is causing the problem.

However, Dr. Ichtertz explains that tendonitis can generally be evaluated by isolating the specific tendon involved. The signs and symptoms of a tendon problem are different from those associated with compression of the median nerve.

If carpal tunnel syndrome is treated as though it were simply tendon inflammation, the underlying nerve compression may remain.

Is Carpal Tunnel Syndrome Caused by Inflammation?

Dr. Ichtertz emphasizes an important distinction: carpal tunnel syndrome itself is not primarily an inflammatory condition.

The central issue is compression of the median nerve within the carpal tunnel.

This is one reason determining the cause of a patient's symptoms is so important. Treatment intended to reduce inflammation does not necessarily relieve mechanical pressure on the median nerve.

Do Anti-Inflammatory Medications Help Carpal Tunnel Syndrome?

Anti-inflammatory medications may be appropriate for certain inflammatory or musculoskeletal conditions, but Dr. Ichtertz explains that they do not correct the underlying problem in carpal tunnel syndrome: pressure on the median nerve.

A patient might therefore take medication for what is believed to be tendonitis while continuing to experience numbness, tingling, weakness, or other symptoms caused by median nerve compression.

If hand symptoms persist despite treatment for tendonitis, further evaluation may be appropriate.

Do Cortisone Injections Fix Carpal Tunnel Syndrome?

Corticosteroid injections may provide temporary symptom relief for some people with carpal tunnel syndrome. However, symptom relief is not necessarily the same as correcting the underlying compression.

Dr. Ichtertz cautions that the pressure on the median nerve can still be present even when symptoms temporarily improve following an injection.

This is an important consideration when evaluating longer-term treatment options. A physician should consider the severity and duration of symptoms, examination findings, nerve involvement, previous treatments, and other individual factors.

What About Rheumatoid Disease, Lupus, and Carpal Tunnel Syndrome?

Not every patient experiencing inflammation in the hands has simple tendonitis.

Systemic inflammatory or autoimmune diseases, including rheumatoid disease and lupus, can cause significant inflammation involving the hands and wrists. Dr. Ichtertz explains that when an untreated condition is causing obvious widespread inflammation, addressing that disease may need to come before treating carpal tunnel syndrome.

That does not mean a patient cannot have both conditions.

Someone with an inflammatory disease may also experience median nerve compression and ultimately require treatment for carpal tunnel syndrome. The appropriate course of care depends on the individual patient.

How Do You Know If You Have Carpal Tunnel Syndrome or Tendonitis?

The location of symptoms, movements that trigger them, presence of numbness or tingling, nighttime symptoms, weakness, and physical examination findings can all help a physician distinguish between different hand and wrist conditions.

If you've been diagnosed with tendonitis but treatment hasn't resolved your symptoms, particularly if you're experiencing persistent numbness, tingling, or weakness, it may be worth having the diagnosis reevaluated.

The goal isn't simply to put a name on hand or wrist discomfort. It's to identify which structure is actually causing the symptoms so treatment can address the underlying problem.

Carpal Tunnel Treatment at Nebraska Hand & Shoulder Institute

Carpal tunnel syndrome treatment should be based on the individual patient, the severity of median nerve compression, symptoms, and other health considerations.

For patients whose symptoms require surgical treatment, carpal tunnel release is designed to relieve pressure on the median nerve rather than simply treating symptoms associated with the compression.

Dr. Dolf Ichtertz and Nebraska Hand & Shoulder Institute evaluate hand and upper-extremity conditions to determine the source of a patient's symptoms and an appropriate treatment approach.

If you've been treated for tendonitis but continue to experience symptoms that could be related to carpal tunnel syndrome, schedule an evaluation with Nebraska Hand & Shoulder Institute.

Frequently Asked Questions About Carpal Tunnel vs. Tendonitis