If you are suffering from pain in your wrist, you may be unclear on the cause of the pain. Two common causes of wrist pain are carpal tunnel syndrome and arthritis. While both conditions may share some similarities, there are key differences between the two that will influence the type of treatment required.
Carpal tunnel syndrome (CTS) is a common condition that occurs when the median nerve in the wrist is compressed or entrapped, preventing it from functioning properly. Symptoms can include pain and numbness in the hand and wrist. Arthritis, however, is not a single disease. There are actually more than 100 types of arthritis that affect the musculoskeletal system, predominantly affecting the joints. Osteoarthritis and rheumatoid arthritis are common types of arthritis that affect the joints in the hands. Both conditions cause pain, stiffness, swelling, and a decreased range of motion within joints.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition caused by pressure on the median nerve in the wrist. It develops when the tissues and tendons in the carpal tunnel become swollen, making the area within the tunnel smaller. The median nerve, which runs from the forearm to the hand, carries messages between the brain, spinal cord, and hand, and signals for sensation and muscle movement. If the nerve becomes compressed or entrapped, it disrupts the way the nerve works, leading to symptoms such as pain, numbness, tingling, and weakness in the hand, wrist, and arm. It can make activities that involve grasping and gripping actions difficult.
The exact cause of carpal tunnel syndrome is unknown, but it is more common in individuals between the ages of 30 and 60. Other factors that may increase the chance of developing the condition include:
- Structural factors, such as a wrist deformity, fracture, or dislocation
- Medical conditions including diabetes and thyroid disorders
- Rheumatoid arthritis, joint dislocations, and fractures, which can cause the space in the tunnel to narrow
- Work or hobbies involving prolonged or repetitive flexing of the wrist
- Fluid retention caused by hormonal changes (pregnancy, premenstrual syndrome, and menopause)
The hand is a common part of the body to be affected by arthritis. It can cause pain, stiffness, and swelling inside joints, and can get worse over time with the aging process. Osteoarthritis, which can result from wear and tear, injury, or overuse, causes the protective cartilage covering the ends of bones to gradually wear away, resulting in painful bone-on-bone rubbing. Abnormal bone growths, called spurs can also develop in joints, which can add to pain and swelling, and disrupt movement.
Rheumatoid arthritis is an autoimmune disease, meaning the immune system, which usually fights infection and prevents diseases, doesn’t work properly and mistakenly attacks the joints. It can also cause damage to other parts of the body, such as internal organs, and it is one of the most serious and disabling types of arthritis. Rheumatoid arthritis affects the lining (synovium) of the joints, which can cause it to deteriorate and become inflamed, stiff, and painful. It may involve many joints at the same time and surrounding tissue may also be affected. The condition is more common in women and individuals over the age of 30.
Diagnosis and Treatment
It is important to get the correct diagnosis for hand and wrist pain, as treatment for carpal tunnel syndrome can be different from treatment for arthritis. In order to diagnose the pain, the doctor will conduct a medical examination, review your medical history, and find out about your activities and symptoms. Simple tests such as the Phalen’s test can help to determine if there is pressure on the median nerve. Lab tests such as blood tests, X-ray, MRI, or bone scan may also be required if the doctor suspects a medical condition such as arthritis.
Treatment will vary depending on the type of diagnosis and severity of the condition. Rest, medications, pain relief injections, and occupational and/or physical therapy may be recommended to improve symptoms for both conditions. Wearing a splint may be recommended to position the wrist properly and provide support.
Surgery may be recommended if non-surgical treatments do not work successfully or if the condition becomes worse. Examples of surgeries include carpal tunnel release surgery for severe carpal tunnel syndrome. Surgery may also be necessary for severe arthritis, which can include removing the diseased or damaged synovium (a synovectomy), realigning the bones in a joint (an osteotomy), and joint replacement surgery.
Hand and Wrist Specialists in Greater Chesapeake
If you have wrist or hand pain, speak with the experts at Greater Chesapeake Hand to Shoulder to get the correct diagnosis and treatment you need. Our Maryland surgeons treat a broad range of conditions affecting the hand, wrist, elbow, and shoulder. To find out more about the services we provide, call us at (410) 296-6232 or you can request an appointment online at one of our offices throughout Maryland.