Woman with wrist pain, on her computer.

Not All Wrist Pain Is Carpal Tunnel Syndrome

Since the advent of computers, the term “carpal tunnel” has come into much more common usage. Though there has been some debate over whether carpal tunnel syndrome (CTS) is actually caused by frequent computer use, wrists are certainly at risk for pain and dysfunction in the modern world. It is, however, a mistake to self-diagnose CTS without getting checked out by a first-rate physiatrist — a doctor who specializes in pain management and rehabilitation. At Long Island Spine Rehabilitation Medicine, all of our physiatrists have outstanding credentials and histories of successful diagnosis and treatment.

Risk factors for Wrist Injuries

While of course, anyone can fracture a wrist due to an accident, there are certain people who are at greater risk of developing temporary wrist pain or chronic problems with pain, numbness, or impaired range of motion in the region. The following are risk factors for wrist pain:  

  • Engaging in sports that involve direct impact or repetitive wrist movements (e.g bowling or tennis)
  • Performing repetitive work involving the hands and wrists, such as sewing, knitting, haircutting, or certain types of factory work
  • Being pregnant, obese, or diabetic
  • Having rheumatoid arthritis or gout

Knowing what predisposed you to the wrist pain you’re experiencing is helpful, but diagnosing its precise cause is essential.

How Wrist Pain Is Diagnosed Accurately

In order to diagnose wrist pain, it is necessary to have a physical examination of your hand(s) and wrist(s). A well-trained diagnostician will take note of described symptoms and see how your sensitivity is affected by nerve compression and whether your range of motion is restricted.

Once you have been physically examined, you will most likely require an electromyography (EMG) study and/or a nerve conduction study to evaluate the electrical signals between your muscles and nerves. Such testing can be very useful not only in establishing a diagnosis, but also in determining if more significant damage to the nerve has occured.  

Symptoms Can Be Caused by a Range of Wrist Problems

The reason carpal tunnel is often misdiagnosed is that its symptoms are common to a number of other wrist conditions. These symptoms include:

  • Wrist pain, usually dull, when hand is in use
  • Tingling (pins and needles), especially at night
  • Occasional shooting pain that may reach the forearm
  • Numbness or burning sensation
  • Weakness in the hand
  • Difficulty grasping

It is not just scientific curiosity that impels us to determine whether or not your pain is caused by CTS.  Correct diagnosis leads to correct treatment.

If my wrist pain isn’t carpal tunnel syndrome, what is it?

There are numerous reasons for wrist pain, even if we eliminate CTS. While it takes a trained professional to make an accurate diagnosis, below are some other conditions that may be at the root of your wrist symptoms. In each case, we have noted details that may help to differentiate each condition from CTS:

Arthritis

Both osteoarthritis, which occurs when the cartilage that cushions the ends of your bones deteriorates due to aging or acute injury, and rheumatoid arthritis, which is an autoimmune disorder, can cause symptoms similar to CTS. Arthritis, however, typically affects all the fingers whereas CTS does not affect the pinky. Also, CTS is worse at night while arthritis pain is more or less constant. Osteoarthritis affecting the thumb side of the wrist is especially common and may also occur in conjunction with CTS.

Cervical Radiculopathy 

It is entirely possible for spinal nerve compression to cause symptoms that mimic those of CTS.  Spinal nerve compression can result from a herniated or degenerated disc or cervical stenosis (narrowing of the cervical spinal canal). The underlying cause of the latter may be cervical osteoarthritis. 

Wrist Tendonitis

The pain, numbness and tingling of tendonitis may affect tendons in any part of the hand or wrist, whereas these symptoms when present in CTS typically only affect the thumb, index and middle fingers, the palm side of the wrist and the inner half of the ring finger. Swelling of the wrist tendons themselves can also contribute to pressure on the nerves of the wrist and lead to CTS.

Thoracic Outlet Syndrome

Similarly, in thoracic outlet syndrome, a condition in which blood vessels or nerves in the space between the collarbone and the first rib are compressed, pain affects areas different than those affected by CTS. Patients with thoracic outlet syndrome experience pain in the shoulders and neck in addition to the fingers. Moreover, the pinky and outer half of the ring finger are affected, regions not affected by CTS.

Repetitive Strain Injury 

RSI symptoms can include throbbing pain and stiffness in muscles and tendons anywhere in the body, though the condition most often affects the neck, shoulders, forearms, elbows, hands and wrists.

Ganglion Cysts 

Ganglion cysts most commonly develop on the outer part of the wrist, affecting the adjacent tendons or joints, though they may also occur in the ankles and feet. Though painful, they are benign and almost always go away by themselves.

Kienbock’s Disease 

Kienbock’s disease, also known as avascular necrosis of the lunate, is a rare disorder that usually appears in young adult men. In patients with this condition, the primary symptoms are pain and stiffness due to the gradual collapse of the lunate bone in the wrist. The lunate bone’s collapse occurs when its blood supply is restricted. The condition can lead to premature arthritis.

Whatever the Cause of Your Pain, You Want It to Stop

When you consult with Long Island Spine Rehabilitation Medicine, you are a major step closer to stopping your wrist from hurting. Our holistic approach makes relieving your pain and restoring your function our primary goal.