Conditions That Are Often Misdiagnosed As Carpal Tunnel Syndrome

Carpal Tunnel is one of the best-known medical conditions to cause wrist and finger pain. That may explain why many other conditions are often misdiagnosed as Carpal Tunnel Syndrome. 

We’ll talk you through what those are and how to tell them apart. But first, what is Carpal Tunnel Syndrome? 

What Is Carpal Tunnel Syndrome? 

Carpal Tunnel Syndrome is a condition that affects the wrist, causing numbness and pain. 

The carpal tunnel, which gives the condition its name, is a bone and ligament passageway at the base of the hand. People with Carpal Tunnel develop the condition because the median nerve compresses.

Since the median nerve controls stimulus and feeling in your fingers, the worse the compression, the more severe the numbness and restricted dexterity you experience. 

Symptoms of Carpal Tunnel Syndrome 

But how do you tell if you have Carpal Tunnel Syndrome? 

The most obvious indicator is numbness in your wrist and fingers. Some people experience the sensation as far up as their forearms. 

People with Carpal Tunnel also describe losing dexterity or utility in their fingers, despite no obvious swelling or cause of clumsiness. 

Another classic symptom is the need to shake your fingers first thing in the morning. This ties back to the decreased dexterity since people try to stimulate more feeling in their wrists and fingers by increasing blood flow.

As the condition progresses, many people experience weakening in their hands and fingers, exacerbating the sensation of clumsiness. Tingling is also a late-stage Carpal Tunnel symptom. 

Conditions That Get Misdiagnosed as Carpal Tunnel Syndrome 

That’s a comprehensive list of symptoms, but there is a surprising amount of overlap between Carpal Tunnel symptoms and other illnesses. That’s why so many conditions are often misdiagnosed as Carpal Tunnel Syndrome. 

Here are the most common conditions that affect the wrist and get confused for Carpal Tunnel.   

Rheumatoid Arthritis

The condition that most often gets misdiagnosed as Carpal Tunnel is Rheumatoid Arthritis. 

Rheumatoid Arthritis primarily affects the joints, especially in:

• Knees 
• Wrists 
• Hands 

However, if it advances, it may also affect organs and other tissues, including:

• Lungs
• Eyes 
• Heart 

Rheumatoid Arthritis is a disease that develops when your immune system mistakes healthy cells for foreign bodies and attacks them. The cells respond by swelling. That’s what causes the systemic pain familiar to people with Rheumatoid Arthritis. 

The severity of the swelling depends on how aggressively your immune system attacks the rest of your body. It’s the most distinctive sign of Rheumatoid Arthritis, but it’s not the only symptom. Others include: 

• Joint pain/aches 
• Stiffness/ inability to move joints
• Joint swelling 
• Tenderness/sensitivity 
• Weakness 
• Fever 
• Fatigue/lethargy 

One of the most helpful ways of distinguishing Rheumatoid Arthritis from Carpal Tunnel is the symmetry of the condition. Nascent Carpal Tunnel typically presents in your dominant hand and doesn’t advance to your other wrist until much later. 

However, Rheumatoid Arthritis is symmetrical. People with this condition experience an equal degree of joint pain or sensitivity in the right and left sides of the body. It also doesn’t exhibit the tingling sensation that is the hallmark of Carpal Tunnel. 

Notably, it’s possible to suffer from Rheumatoid Arthritis and Carpal Tunnel simultaneously. This can complicate the diagnosis process and makes it imperative you see a doctor as soon as possible from the onset of symptoms. 

Tendonitis

Another condition that often gets misdiagnosed as Carpal Tunnel is Tendonitis. 

Like Rheumatoid Arthritis, Tendonitis involves inflammation. But with Tendonitis, the joints remain intact while the tendons connecting them to bones become swollen. 

You can get Tendonitis anywhere, but the most common places are: 

Shoulders 

• Wrists 
• Knees 
• Elbows  
• Heels 

It’s important to catch and treat Tendonitis quickly because tendons that remain inflamed for too long can tear and cause more significant problems. 

Classic Tendonitis symptoms include: 

• Mild ache when moving the affected area 
• Swelling 
• Tenderness 

Even on paper, these symptoms sound vague, and you can see how they would easily get misdiagnosed as Carpal Tunnel Syndrome. The symptom they most obviously share is unattributed local pain. Crucially, Tendonitis doesn’t elicit the tingling sensation Carpal Tunnel sufferers describe. 

Depending on the type of Tendonitis you develop, the symptoms can vary, and that helps with the diagnosis process. Some of the best-known examples of Tendonitis are:

• Tennis Elbow
• Golfer’s Elbow 
• Achilles Tendonitis 

However, if you experience Tendonitis in your wrists, it can be difficult to pinpoint the specific cause of pain without further testing, like x-rays.  

That said, Carpal Tunnel symptoms tend to lessen when you stop the activity responsible for compressing the median nerve. Conversely, Tendonitis pain persists long after you stop the activity causing damage since any pain it generates goes directly into the tendon. 

Neuropathy

Neuropathy is another condition often misdiagnosed as Carpal Tunnel. That’s because Neuropathy is a difficult illness to describe. 

At its simplest, it’s a catch-all term for degenerative nerve damage. The damage can occur anywhere in the body and still be neuropathy. And while anything can cause it, some pre-existing conditions and even medical treatments can foster it, including: 

• Diabetes 
• Chemotherapy 
• HIV 
• Shingles 
• Kidney Disease 

But it can also come from sustained trauma, like a fall while playing sports. Additionally, at least 23% of neuropathy cases have no discernible cause. 

Some of the most common neuropathy symptoms include: 

• Muscle weakness/wasting 
• Numbness 
• Tingling sensation 
• Discoordination 
• Muscle spasms 

Neuropathy can strike anywhere and isn't reversible. When these symptoms target the wrists and hands, it’s challenging to distinguish them from Carpal Tunnel Syndrome. 

Complicating the issue, both illnesses progress gradually, meaning you may not catch either disorder until it's substantially advanced. 

That’s why medical histories are vital for diagnosis. Several external factors make Neuropathy more likely than Carpal Tunnel, and these include:

• Second-hand smoke exposure
• Alcohol consumption 
• Exposure to chemotherapy drugs 
• Heritable conditions 

Hand or Wrist Sprain

Hand or wrist sprains are an incredibly common injury. You wouldn’t think they would get misdiagnosed as Carpal Tunnel as often as they do, especially because typically someone with a sprained wrist can tell you the moment it happened. 

That’s seldom true of Carpal Tunnel’s onset. But there’s enough symptom overlap to ensure that sprained hands and wrists often get conflated with Carpal Tunnel. 

So, how do you distinguish between them? Symptoms of wrist and hand sprain include:

• Swelling 
• Tenderness 
• Bruising 
• Discoordination/loss of finger and hand range 
• Muscle weakness 

It also includes feelings of warmth and occasionally a popping or tearing at the moment of spraining. 

Of these symptoms, the swelling, tenderness, and muscle weakening most closely resemble Carpal Tunnel Syndrome. With that in mind, the best way to assess whether you have Carpal Tunnel or a sprained wrist is to take a brief medical history. 

If you fell badly or were involved in a sports accident, it's probably a sprained wrist. If the symptoms don’t alleviate with time and healing, consult your doctor. 

Another fast and effective way to assess if you have a sprain is to elevate your arm. Often elevating it or keeping your wrist upright has an immediate and notable effect on the pain. If changing wrist position doesn’t help, it’s more likely to be Carpal Tunnel Syndrome. 

Repetitive Strain Injury 

Another condition frequently misdiagnosed as Carpal Tunnel is a Repetitive Strain Injury or RSI. 

You can develop an RSI anywhere in the body through repeated movement, but you most commonly see them in the:

• Shoulders
• Elbows 
• Hands/fingers 
• Forearms/wrists

Symptoms of an RSI can mimic Carpal Tunnel and include sensations like: 

• Warmth
• Tingling sensation/ pins and needles 
• Muscle spasm/cramp 
• Swelling 
• Weakness 
• Stiffness 

The main difference between Carpal Tunnel and an RSI in the wrist is the type of pain. Whereas Carpal Tunnel makes the surrounding area numb, RSIs engender a pain that ranges from burning to aching or throbbing. However severe the sensation, patients always feel something.  

And while RSIs develop gradually, they don’t lead to the same difficulty assessing temperature or other touch-based sensations as Carpal Tunnel. 

Crucially, if you suspect an RSI, you shouldn’t stop the activity behind it completely. It’s important to rest the affected muscles, but too prolonged a respite can lead to muscle weakening and exacerbate the injury. 

Instead, scale back how often you go through the motions that caused the RSI in the first place. 

Pinched Nerves 

Pinched Nerves, sometimes called Cervical Radiculopathy are the least likely alternative to Carpal Tunnel on this list. But they’re still worth investigating because they also can be misdiagnosed as Carpal Tunnel Syndrome. 

Pinched nerves occur when pressure on the spinal cord pinches or irritates nerves, especially in the neck. Because of the way nerve networks work, these signals travel down to your arm and into your wrist. From there, they emulate many of the symptoms associated with Carpal Tunnel, including:

• Tingling Sensation
• Numbness 
• Weakness 

However, Carpal Tunnel Syndrome is highly localized. You feel it in your wrists and hands, but nowhere else. If you aren’t sure if you have a Pinched Nerve or Carpal Tunnel, the best thing to do is try extending your neck. If that motion causes pain, the source of your problem is a Pinched Nerve. 

The other key difference is the nature of the wrist pain. People with Carpal Tunnel describe the sensation as an ache, which is why Arthritis gets easily and frequently confused with the syndrome. 

But Pinched Nerves exhibit short, sharp stabbing pains in the wrist and hands. It’s also much less localized and can shift up your arm and into your neck depending on the neural feedback your body receives. 

Keeping a pain journal and detailing the specific nature of the wrist pain can be extremely helpful to a doctor trying to determine what’s causing your symptoms. 

Final Thoughts 

Hopefully, that makes clear how many conditions are often misdiagnosed as Carpal Tunnel. 

Understanding how these illnesses differ from Carpal Tunnel can help you get to the root of your problem. 

Pay particular attention to where the pain occurs and what it feels like. That way, you’re in a better position to give your doctor as much information as possible and diagnose the cause more quickly.