The Difference Between Carpal Tunnel Syndrome and Tendinitis
Repetitive Strain Injury (RSI) can occur when you repeatedly perform strenuous activities with your fingers, hand, and wrist. The strain may be in the form of something seemingly harmless, like typing at a keyboard. You don’t have to be working a jackhammer all day to get RSI. The stress can result from rapid small motions or short forceful motions. Either way, the strain causes your tissues to react to the stress.
Exactly where the tissue react and how the injury progresses in those tissues defines the type of RSI you have. Inflammation of the actual tendons of the wrist and forearm is called wrist tendinitis, a particular kind of RSI.
In contrast, carpal tunnel syndrome (CTS) is a condition that can result from repetitively straining your fingers, hand or wrist. CTS is a disease, like diabetes. If you’re already predisposed to having diabetes, obesity can trigger it. Similarly, if you’re predisposed to having CTS, repetitive straining can trigger it. And since CTS is probably hereditary, if you have a close relative with it you are at higher risk of having it manifest in you.
How to Tell the Difference
CTS and tendinitis can manifest with the same symptoms. Usually, CTS symptoms are more involved, more well-defined, and follow a pattern. Therefore, you should check for symptoms of CTS first. Traditionally, the conclusive evidence to determine a CTS diagnosis has been the electrodiagnostic test. However, more and more studies show that a good and through physical exam is as good as (or even better than) the electrodiagnosis. Thus, both are preferred, although seldom done.
The following are quick self-assessments and not a diagnosis. You can do them at home and they potentially show if you have CTS. Of course, these are not definitive tests and you should consult your doctor for a thorough diagnosis.
If you answer YES to any of these tests, then you may have carpal tunnel syndrome instead of tendinitis.
1. With your fingers straight, flex your left wrist gently and as far as possible (i.e., bring your fingers as close to your wrist as you can). Then hold this position for one minute. (This is the Phalen maneuver.) Do your symptoms appear or get worse? Do you feel numbness?
2. Next, with your hand straight, lightly tap the skin over your wrist-crease. Tap left to right, and back again (This is the Tinel test.) Does it result in a tingling or “pins-and-needles” in the hand?
3. Now, with your hand straight, using your opposite thumb apply firm pressure to the entire width of your wrist-crease for 30 seconds. Relax one minute, and then apply firm pressure on the palm of the wrist-crease for 30 seconds. (This is the Durkan test.) Do either of these make your symptoms appear or get worse? Do you feel numbness?
If you answered NO to the above questions, then try the following test. If you also answer YES to the following test, then you may have tendonitis.
Use two fingers of your other hand to tap your flexor tendons just below your wrist-crease. The flexor tendons are the rope-like structures on the palm side (not the back side) of your forearm. Keep your affected hand straight while tapping. Tap each tendon all along its length, half way to your elbow. Tap several times up and down on each tendon. Then tap vigorously all around your forearm. Does any of that reproduce your symptoms or make them worse?
What to do Next
If your self-assessment indicates you have carpal tunnel syndrome or tendinitis, your next step should be to seek treatment. There are excellent resources available on the internet for self-treatment techniques and methods to keep the dysfunction from interfering with your way of life. Your doctor can also advise you of the best treatment for your condition.
And remember, surgery is not the answer – only one of many treatment options. Almost every healthcare professional advises to use conservative (non-surgical) therapies first. Properly applied, most often they reduce or eliminate symptoms completely.
Whatever treatment you need to choose, make sure it is appropriate for the condition you have. And whether you have carpal tunnel syndrome or tendinitis, there are many different treatment options available so you don’t have to live with the misery of hand pain forever.