Are you experiencing tingling, numbness, or weakness in your hands and wondering if it’s Carpal Tunnel Syndrome (CTS)? While CTS is a common culprit, some conditions mimic its symptoms and are often misdiagnosed, leading to delayed treatment or even unnecessary procedures. Two conditions, in particular, rheumatoid arthritis and tendonitis, can present similarly but require very different approaches. In this article, we’ll explore these commonly misdiagnosed conditions and share tips on how to tell them apart from CTS, helping you get the right diagnosis and treatment sooner.

Two Conditions That Are Often Misdiagnosed as Carpal Tunnel Syndrome

Though Carpal tunnel syndrome is a common condition, it is important to consider that the symptoms associated with it might be caused by other conditions too. So, you need to be aware of those conditions to prevent misdiagnosis. The two conditions that are often misdiagnosed as carpal tunnel syndrome are rheumatoid arthritis and tendonitis.

Carpal Tunnel Syndrome vs Rheumatoid Arthritis

Rheumatoid arthritis (RA) is typically an autoimmune disorder where the immune system mistakenly attacks the joints of the hand and wrist. This can result in joint damage, inflammation, stiffness, and pain.

Why is it misdiagnosed as Carpal Tunnel Syndrome?

Rheumatoid arthritis often attacks the joints in the wrists, causing numbness, tingling, and pain, which are the symptoms associated with CTS.
Wrist inflammation caused by RA can cause secondary compression of the median nerve, which mimics a symptom of CTS.
Early symptoms, such as tingling fingers, hand weakness, and morning stiffness, are shared by both medical conditions.
In some people with RA, swelling can lead to compression of the median nerve, which can contribute to CTS, further causing misdiagnosis.

Key Differences Between Carpal Tunnel Syndrome and Rheumatoid Arthritis

Feature	Carpal Tunnel Syndrome (CTS)	Rheumatoid arthritis (RA)
Cause	Compression of the median nerve at the wrist	inflammation of joints by the attack of the immune system
Location of the symptoms	Median nerve in the wrist	Multiple joints (often of both hands)
Affected Area	Often impacts one hand only	Generally affects both hands symmetrically
Joint Appearance	No swelling in the joint, but the wrist might feel painful or tight	Swollen, tender, and red joints

Carpal Tunnel Syndrome vs Tendonitis

Tendonitis is the inflammation of the tendon, a cord that connects muscles to the bones. This condition occurs when tendons in the hand and the wrists undergo inflammation, resulting in swelling, pain, and limited motion.

Why is it misdiagnosed as Carpal Tunnel Syndrome?

Both tendonitis and CTS can cause weakness, pain, and discomfort in the hand or wrist.

Swelling in the wrist due to tendonitis can mimic the symptoms of nerve compression, which is the cause of CTS.
People may complain about difficulty gripping, pain during repetitive movements, or stiffness, the symptoms which with CTS.
The irritation of tendons can be mistaken for nerve-related pain associated with CTS.

Key Differences Between Carpal Tunnel Syndrome and Tendonitis

Feature	Carpal Tunnel Syndrome (CTS)	Tendonitis
Cause	Compression of the median nerve in the wrist	Inflammation of tendons from injury or overuse
Main Symptom	Tingling or numbness, particularly at nighttime or while resting	Pain after or during physical activities, such as lifting or typing
Location of Symptoms	In the median nerve path (palm side)	Mainly to the tendon area (such as the thumb side and wrist)
Pain Type	Numbness, burning, or tingling sensation in the thumb, middle fingers, and index finger.	Localized, aching, and sharp pain with hand movement

So, these are the two conditions that are often misdiagnosed as CTS. For accurate diagnosis and the right treatment, consult the best orthopedic specialists in your area.

What Other Conditions Have the Same Symptoms as Carpal Tunnel Syndrome?

The following conditions may share the same symptoms as carpal tunnel syndrome:

Cervical Radiculopathy (Pinched nerve in the neck)
Thoracic Outlet Syndrome (nerve compression between the collarbone and first rib)
Peripheral Neuropathy (nerve damage in the hands and arms)
Wrist injury
Ligament damage
Pronator Teres Syndrome (compression of the median nerve running through the forearm by the pronator teres muscle)

Why Misdiagnosis Occurs?

Here are the reasons for diagnostic confusion:

1. Overlapping of Symptoms (Obvious Reason)

All three conditions lead to similar symptoms, like hand weakness, wrist pain, and discomfort during hand movement.
Numbness and tingling sensations (that is common in CTS) can also occur in RA (because of the inflammation) or tendonitis.

2. Confusion about Location

All three conditions affect the hand and wrist, which makes it challenging to find the exact source of symptoms.
This may require a proper diagnostic test.

3. Lack of Specialized Diagnostic Tests

Diagnosis focusing only on physical exam and symptoms without blood tests, imaging, and nerve studies.
This can increase the chances of misdiagnosis.

4. Delayed or Unclear Symptoms

Mild tendonitis or early rheumatoid arthritis may come with subtle or unclear symptoms.
This can make it difficult to differentiate from early CTS without a comprehensive medical evaluation.

Why Accurate Diagnosis Matters:

for effective treatments
to avoid the progression of the actual health condition
to prevent unnecessary medical expenses

How to Avoid a Misdiagnosis?

You can consider these tips:

1. Closely watch for symptoms

Pay attention to when the symptoms occur (for instance, stiffness in the morning, which indicates the chances of RA).
Check whether the symptoms are localized to a specific area or are symmetrical (common in RA).

2. Seek a Medical Evaluation

See a rheumatologist for symptoms related to joints (that might be due to RA).
Consult an orthopedic doctor if you experience CTS-like symptoms or tendon pain.
Don’t rely solely on a general exam — specialists use targeted tests to narrow down the cause.

3. Ask for the Proper Diagnostic Tests

Do not rely only on the general exam; request nerve conduction studies & EMG to confirm CTS.
Blood tests to detect activity of the uncontrolled immune system in RA.
MRI or ultrasound for identifying the inflammation in the tendon or joint damage.

5. Educate Yourself & Go for Second Opinions

Understand the differences between CTS, tendonitis, and RA.
If symptoms last longer even after the CTS treatment, request re-evaluation.
Get a second opinion if you are not sure of your test results.

6. Monitor Response to the Treatment

If doctors diagnose CTS but the symptoms are not improving, this can indicate a misdiagnosis.
Consult your doctor again if any symptoms of CTS worsen or spread to tendons or other joints.

When to See a Doctor?

Consult a healthcare provider if you experience the CTS symptoms, such as:

Pain, unusual sensations, or discomfort in the hand, fingers, wrist, shoulder, and forearm.
Weakness in the hand
Challenges with fine motor skills

Moreover, also seek medical attention if you suspect these symptoms do not belong to CTS. With a correct physical exam and tests, the doctors can find the exact cause and provide the right treatment.

How Do Doctors Diagnose CTS Correctly?

If you experience symptoms similar to CTS, the doctors help find out the exact cause through:

1. Physical Exam

Check for symptoms, like weakness, tingling, and numbness in the hand or fingers.
Perform a Tinel's sign by tapping on the wrist nerve to check for nerve compression.
Run a Phalen’s test by pressing the back of the hands together by bending the wrists for a minute.

2. Nerve Tests

Nerve Conduction Studies: Examines the rate at which the electrical signals run through the median nerve. If signals are slow, it indicates CTS.
Electromyography (EMG): Evaluates the response of the muscles to nerve signals and checks whether the median nerve plays a role in muscle damage.

3. Imaging Tests

Ultrasound: Help find the median nerve size and confirm CTS.
MRI: Detect the causes of wrist pain or nerve-related issues if required.

Holistic Treatments for Carpal Tunnel Syndrome

You can follow some home remedies, medications, and alternative therapies to relieve symptoms:

1. Home Remedies:

The following are a few home remedies that can help treat mild to moderate symptoms of CTS:

Massage your palms, wrists, and the back side of your hand.

Apply heat to your affected wrist to relieve pain.

Use an ice pack to reduce swelling.

Use a wrist splint to reduce pressure on the median nerve.

Perform gentle wrist, hand, and finger stretching exercises.

Wear work gloves to cover the wrists and hands.

Give rest to your affected wrist and hand for about 2 weeks.

Place extra fabric or cloth on the utensils or tools for a more comfortable grip.

Have over-the-counter (OTC) painkillers like naproxen or ibuprofen.

2. Alternative Therapies:

These are some therapies that can help provide relief from symptoms associated with CTS in the short term:

Yoga with strengthening and stretching exercises might lower the pain and improve wrist grip.

Ultrasound therapy can increase the temperature of the injured hand or wrist area, potentially relieving pain and facilitating recovery.

Hand therapy methods such as joint mobilization, massage, etc., may relieve symptoms.

The application of topical anti-inflammatory medications might also help.

Low-level laser therapy may also relieve symptoms, as per research, but the evidence is limited.

If the symptoms of CTS become more severe, medical treatment and surgery are the only options.

3. Medical Treatment and Surgery

Medical Treatment

Oral corticosteroid medications and injections are prescribed to lower swelling and inflammation, reducing pressure or strain on the median nerve.

Surgery

When medications are ineffective and symptoms become more severe, doctors recommend surgery. According to a study, CTS improves more after surgery than non-surgical treatments. The surgical procedure includes:

Open surgery: Involves cutting through the palm side of the patient's wrist to cut ligaments that press on the nerve. Thus, it relieves the pressure on the median nerve.
Endoscopic surgery: Involves making a small cut on the wrist and passing the endoscope (a tiny device with a small, attached camera) through it to cut the ligament. This relieves stress on the median nerve.

Can a Chiropractor Help Carpal Tunnel Syndrome?

Yes. A chiropractor focuses on your spine and neck, as both parts of the body also contribute to carpal tunnel syndrome. Using some techniques such as stretching, gentle massage, and electrical stimulation on the spine and neck, a chiropractor can help give relief. These specialists basically closely look at your situation and try to customize a treatment plan according to your health needs.

Can Carpal Tunnel Cause Shoulder Pain?

Yes, in very rare cases, CTS can lead to shoulder pain. A person can feel referred pain (a pain which you feel somewhere else rather than the injured area) that rises rapidly up from the wrist to the shoulder and sometimes to the neck. This pain or discomfort can feel similar to an electric shock.

Why Does Carpal Tunnel Hurt More at Night?

Carpal tunnel usually hurts more at night because the tissue fluid present in the arms gets redistributed when the muscle pump is not in action. In other words, when we sleep during the night, our body is not moving, and due to the increased fluid in the arms, there is pressure on the carpal tunnel, which causes symptoms to emerge more at night.

Can I Prevent Carpal Tunnel Syndrome?

Though it can’t be prevented, you can manage it with some lifestyle measures to reduce the development and progression of such a condition. Those may include:

1. Practice hand and wrist stretches regularly before, during, and after repetitive movements

Regular hand and wrist stretches can help enhance the strength of the wrist and lower the pressure or strain on the carpal tunnel.

2. Maintain appropriate hand and wrist positions while working on a computer or using any tools

This is particularly necessary if you work more at computers and often use keywords and a mouse. Better to use ergonomic office chairs, a mouse, and keyboards that are designed to improve the posture of hands and wrists.

3. Wear wrist splints, particularly at night

When you sleep, wrists and elbows are bent, which can put pressure on the median nerve in the carpal tunnel.

4. Maintain a Healthy Lifestyle

Focus on maintaining a healthy body weight, consuming a nutritious diet, quitting smoking, and managing your medical issues, like diabetes, hypothyroidism, or arthritis (the risk factors for CTS).

Final Thoughts

These are the two conditions often misdiagnosed as carpal tunnel syndrome due to overlapping symptoms. Misdiagnosis can prolong suffering and delay proper treatment, making early medical care crucial. A correct diagnosis ensures the most effective treatment plan.

Two Conditions That Are Often Misdiagnosed As Carpal Tunnel Syndrome