How Do I Know If It's Carpal Tunnel or Arthritis?

Physical examinations

A physical examination involves a thorough examination of your hand, wrist, shoulder, and neck to rule out other potential reasons for nerve pressure. Your doctor will examine your wrists for soreness, swelling, and abnormalities. They will examine the feeling in your fingers and the strength of the muscles in your hand.

• Tinel’s sign: The doctor taps the median nerve at the wrist to examine if it causes tingling in the fingers.
• Wrist flexion test (or Phalen test): You rest your elbows on a table and let the wrist slip forward freely. In the case of carpal tunnel syndrome, you may notice numbness and tingling in your fingers within 60 seconds. The severity of carpal tunnel syndrome increases the rapidity of the onset of symptoms.
• Two-point discrimination test: When severe carpal tunnel syndrome is suspected, this test is performed. This test is not accurate for moderate carpal tunnel syndrome. Your doctor will ask you to close your eyes and then, use tiny devices, such as the tops of two opened paper clips, to touch two places on your hand or finger that are relatively close together. Separate touches are often felt when two spots are at least 0.5 cm apart. In severe carpal tunnel syndrome, you may not be able to distinguish between the two touches, making it appear as though only one spot is being touched.

Radiological tests

• X-rays: If you have restricted wrist motion or pain, your doctor may request X-rays to rule out other possible reasons, such as arthritis, ligament damage, or a fracture.
• Magnetic resonance imaging (MRI): MRI scans are more accurate than X-rays in capturing pictures of the body's soft tissues. An MRI may be ordered by your doctor to evaluate possible reasons for your symptoms or search for abnormal tissues that might be affecting the median nerve. MRI can help your doctor determine whether there are any issues with the nerve itself, such as a tumor or scarring from an accident.
• Ultrasound: Ultrasound imaging employs high-frequency sound waves to make images of bone and tissue. Your doctor may advise you to get an ultrasound of your wrist to check for evidence of median nerve compression.

Electrophysiological tests

• Nerve conduction studies: Nerve conduction studies are diagnostic examinations that assess the speed at which your nerve impulses travel. Carpal tunnel syndrome occurs when the nerve impulse is slower than normal because it travels through the hand.
• Electromyography (EMG): An EMG test detects the electrical activity in muscles. EMG measures the function of the median nerve and how well it governs muscle action and reveals the presence of nerve or muscle damage.

Physical examination

The doctor will inquire about your symptoms and how joint discomfort impacts your daily life. A physical exam will be performed by your physician, which may include:

• Assessing joint mobility and range of motion
• Examine your joints for areas of soreness or edema
• Evaluating your general health to see whether another issue is affecting your symptoms

Radiological tests

Imaging exams can offer your doctor a detailed view of your bones, joints, and soft tissues. X-rays, magnetic resonance imaging, and ultrasounds can reveal:

• Joint discomfort caused by bone fractures or dislocations
• Degeneration of cartilage surrounding your joints
• Injuries to your muscles, ligaments, or tendons around your joints
• Inflammation of soft tissues

Blood tests

No blood test can identify arthritis. However, if your doctor suspects gout or rheumatoid arthritis, you may undergo blood tests to look for Rh factor or anticyclic citrullinated peptide (anti-CCP) antibodies test. They may look for blood uric acid levels and inflammatory proteins present in the blood.

Patients with rheumatoid arthritis often exhibit high erythrocyte sedimentation rate or C-reactive protein levels, which may suggest the existence of an inflammatory process in the body.

If blood tests reveal high uric acid levels, you may have gout. However, high uric acid in the blood does not necessarily indicate gout; the doctor considers clinical signs to diagnose the condition.

Carpal tunnel syndrome is a common ailment that produces tingling, numbness, and discomfort in the hand and forearm. The median nerve is one of the principal nerves of the hand that provides sensory intervention to the palm and fingers, except for the pinky finger and half of the ring finger. If the median nerve is compressed during its course through the wrist, it leads to carpal tunnel syndrome.

Carpal tunnel syndrome worsens with time in most cases. If left untreated for too long, it can result in irreversible hand dysfunction, including loss of feeling in the fingers and weakening. As a result, it is crucial to detect and treat carpal tunnel syndrome as soon as possible.

Early symptoms are frequently addressed by simple actions, such as:

• Sleeping with a wrist splint
• Exercises to keep the nerve mobile
• Avoiding activities that exacerbate your symptoms
• Injection of steroids into the carpal tunnel.

However, continued pressure on the median nerve can result in nerve injury and worsened symptoms. For certain individuals, surgery may be done to relieve pressure on the median nerve to prevent permanent damage.

1. Numbness, burning, and discomfort in all the fingers except the pinky finger; this frequently awakens individuals up in the middle of the night
2. Tingling sensation in the fingertips
3. Reduced sensation in the fingers
4. Shock-like feelings that spread to the thumb, index, middle, and ring fingers on occasion
5. Tingling or pain that travels up the forearm toward the shoulder
6. Swollen feeling in the fingers
7. Hand weakness and clumsiness can make fine actions, such as buttoning your garments difficult
8. Dropping objects because of muscle weakness and loss of grip, numbness, or a lack of proprioception (awareness of where your hand is in space)
9. Difficulty utilizing your hand for tasks, such as:
   • Handling small things
   • Driving and grasping the steering wheel
   • Holding a book to read
   • Writing
   • Using a computer keyboard

Arthritis is inflammation of joints and can affect practically any bone of the body. Most commonly the hip, knee, spine, or other weight-bearing joints are affected, but it can affect the fingers and other non-weight-bearing joints.

Inflammation of joints leads to redness and swelling that causes pain and stiffness. If left untreated, inflammation can cause considerable and sometimes, irreversible damage to the affected regions, resulting in loss of function and impairment.

Arthritis refers to a collection of numerous disorders, such as osteoarthritis, rheumatoid arthritis, inflammatory arthritis, and more. These cause inflammation in the joints or other parts of the body.

1. Inflammation of the joints
2. Pain, stiffness, and tenderness of the joints
3. Joint stiffness that worsens in the mornings and after inactivity
4. Swelling and warm skin over the affected joint
5. Red eyes and mouth ulcers
6. Reduced range of motion
7. Loss of appetite
8. Restricted range of motion that occasionally disappears after movement
9. Clicking or popping with bending
10. Muscular weakness surrounding the joint
11. Joint instability
12. Bony growths in the fingers
13. Grating or scraping sensation in the knees
14. Morning stiffness that might last 30 minutes or longer, beginning in smaller joints, such as the feet and hands
15. Both sides of the body are affected by the same joints
16. Fatigue
17. Fever
18. Heart muscle and blood vessel inflammation
19. Red blood cell count is low

Carpal tunnel syndrome is caused by median nerve compression and does not cause any type of arthritis. In contrast, arthritis, which causes joint inflammation, can produce inflammation and swelling in the tissue around the affected joints.

The median nerve, which runs through the carpal tunnel in the wrist, is compressed due to structural abnormalities, thickening of the tendinous band in the area, repeated friction at the wrist, or nerve swelling, resulting in carpal tunnel syndrome.

Arthritis leads to the following changes, which cause compression of the median nerve leading to carpal tunnel syndrome:

• The joints of small bones in the wrist (carpals) around the carpal tunnel develop boney projections secondary to arthritis. This causes compression of the median nerve and leads to carpal tunnel syndrome.
• Swelling in the wrist compresses the median nerve.
• Swelling of the tendons in the carpal tunnel can cause compression of the median nerve.