Two Conditions That Are Often Misdiagnosed as Carpal Tunnel Syndrome: Carpal Tunnel Syndrome (CTS) is a prevalent condition characterized by numbness, tingling, and weakness in the hand due to compression of the median nerve within the wrist. However, several other conditions exhibit similar symptoms, leading to frequent misdiagnoses. Two such conditions are Rheumatoid Arthritis and Tendonitis.
Rheumatoid Arthritis
Rheumatoid Arthritis (RA) is an inflammatory musculoskeletal disorder for which the major organ involved is the joint, especially the wrists and hand joints. This results in oedema, tenderness, stiffness, and decreased range of motion, which are clinical characteristics that resemble CTS. Both can lead to pain, weakness, numbness, tingly sensation and morning stiffening of the wrists and hands. At times, it is hard to differentiate.
The main difference consists in the kind of log hailed and places where it has shown symptoms. While CTS is a condition limited to the hand and the wrist, RA affects other joints in the body as well. RA often accompanies other systemic complaints such as fatigue, fever and loss of weight which are not always associated with CTS. Furthermore, it can cause joint deformities in the long run, which is not typical for CTS.
It is necessary to make the diagnosis correct because the therapy of RA and CTS requires the use of different medications. RA management is centred on the prevention of inflammation and may involve the use of drugs such as disease-modifying anti rheumatic drugs (DMARDs), biologics, and physical therapy. On the other hand, CTS treatment involves wrist immobilization with bands, injection of steroids into the palm, and, in the worst scenarios, surgery to decompress the nerve.
Tendonitis
tendonitis involves irritation of tendons, thick cords connecting muscles to bones, causing pain and swelling in affected areas. Wrist tendonitis causes symptoms like pain, swelling, and stiffness, which overlap with CTS, leading to potential confusion. Both conditions can weaken the hand and cause discomfort, making symptom-based diagnosis difficult without further evaluation. Tendonitis pain is usually localized and worsens with specific movements involving the affected tendon in the wrist.
For example, De Quervain’s Tenosynovitis causes pain on the thumb side, especially during gripping or twisting motions. CTS symptoms focus on the thumb, index, and middle fingers, often worsening at night or with repeated wrist movements. Differentiating tendonitis and CTS is important, as each condition requires specific treatment approaches for effective relief. Tendonitis treatments include rest, anti-inflammatory medications, physical therapy, or corticosteroid injections to reduce pain and inflammation. CTS treatment aims to reduce nerve compression using splints, medications, or surgery for severe or prolonged cases.
How to Differentiate Between These Conditions
Rheumatoid Arthritis (RA) and Carpal Tunnel Syndrome (CTS) have similar manifestations. They are sometimes hard to differentiate since both are characterized by pain, swelling, numbness, tingling and stiffness, especially in the wrist and hand region. But, certain differences are noticeable. RA is an autoimmune condition where the body attacks joints of the body, other systems and organisations concurrently, and the patient presents with fatigue, fever and weight loss. Eventually, joint deformities can occur with RA. On the other hand, CTS is a differential diagnosis arising from median nerve entrapment at the wrist, which involves the hand but does not feature general complaints.
CTS affects only the wrist and hand, while RA involves multiple joints. It is very important to diagnose it early because the treatments are very different. RA management comprises DMARDs and biologics derived mainly from inflammation suppression. The treatment of CTS comprises wrist splinting, corticosteroid injection, or surgery to decompress the nerve. Proper diagnosis should always lead to proper and proper treatment.
The Bottom Line
CTS is a common cause of hand pain, yet other conditions exist: Rheumatoid Arthritis and Tendonitis mimic symptoms. Diagnosing requires a detailed evaluation: patient history, physical exams, and testing are essential for accuracy. Proper diagnosis ensures treatment is targeted: mistakes could lead to worsened or prolonged issues for the patient. Consulting a healthcare professional helps: their expertise identifies and addresses the true cause of discomfort more effectively.
