Both carpal tunnel syndrome and arthritis can cause symptoms that affect the hands and wrists. However, they differ in many ways, including how they affect this area of the body.
Carpal tunnel syndrome refers to a compression of the nerve running through the wrist and hand. Arthritis is a disease affecting the joints.
Carpal tunnel syndrome (CTS) may cause tingling, numbness, pain, and hand weakness. Arthritis may cause pain, stiffness, and swelling in the joints of the hands or wrist and limited range of motion.
A 2016 review states that although they are different conditions, osteoarthritis and rheumatoid arthritis may increase the risk of CTS.
This article looks at the similarities and differences between CTS, osteoarthritis, and rheumatoid arthritis, including symptoms, causes, and treatments.
CTS is a condition that occurs due to compression of the median nerve.
The median nerve is one of the main nerves leading to the hand, running from the forearm to the palm.
The median nerve provides sensation in the thumb side of the hand, the index and middle finger, and a portion of the ring finger. The median nerve runs through a narrow tunnel of bones and ligaments called the carpal tunnel.
Swelling or irritation to the tendons can cause the carpal tunnel to become narrower, squeezing or compressing the median nerve. This can cause numbness or pain in the hand, wrist, or forearm.
Symptoms of CTS may come on gradually and occur in the thumb, index, middle, and ring fingers. These symptoms may wake people at night, but they can also occur during daytime activities.
Symptoms of CTS can include:
- a tingling, burning sensation, or numbness, which may radiate up the arm
- pain
- hand weakness or clumsiness, which may make it difficult to hold objects or carry out certain tasks or make people more likely to drop things
- not being able to feel hot or cold temperatures by touch
- infrequent shock-like sensations in the thumb and fingers
Arthritis is a disorder or disease of the joints. It can cause swelling, pain, and stiffness around joints, limiting a person’s range of movement.
Without treatment, arthritis may lead to chronic pain and permanent damage to the joints.
There are different types of arthritis, and each has different causes, such as infections or autoimmune reactions. All types of the condition involve the breakdown of cartilage. This is the coating at the end of bones that allows them to glide over each other. Below are two of the most common types of arthritis.
OA is the most common form of arthritis and occurs when cartilage wears down, resulting in the bones rubbing against each other.
Symptoms of OA include:
- joint pain, which may ease with rest
- joint stiffness, usually lasting for
less than 30 minutes - reduced range of movement in the joints
- swelling in and around affected joints, which may worsen with prolonged use of the joints
- joint feels unstable or loose
RA is an autoimmune condition. It occurs when the immune system attacks the joints, destroying the cartilage and bone.
RA most commonly affects people between the ages of 30–50 years, while around 75% of individuals with the condition are women.
Symptoms of RA include:
- joint pain
- stiffness, which is usually worst in the mornings
- reduced range of motion in the joints
- usually affects the small joints of the hands or feet
- reduced energy
- low grade fever
- loss of appetite
- rheumatoid nodules, which are firm lumps that grow under the skin in areas of the body such as the hands and elbows.
RA may also cause symptoms in other organs, such as the skin, eyes, or lungs.
| Carpal tunnel syndrome (CTS) | Osteoarthritis (OA) | Rheumatoid arthritis (RA) | |
|---|---|---|---|
| Hand and wrist | CTS causes numbness or tingling in the fingers and thumb and hand weakness. | OA | RA most commonly affects small joints in the hands and can cause pain and swelling in the wrists. |
| Causes | Causes include wrist injury, repetitive movements of the hand or wrist, pregnancy, thyroid problems, diabetes, RA, and genetics. | Breakdown of cartilage and joint tissues. Ageing, injury or overuse, obesity, and family history of OA are risk factors. | RA is an autoimmune condition in which the immune system causes inflammation in the joints. The exact cause for this is unknown, but it may be genetic. Smoking is also a risk factor for RA. |
| When it is worse | CTS | Pain may be worse at night. Joint stiffness may be worse in the morning or after resting but usually only lasts around | Joint stiffness is worse in the mornings, which may last for 1–2 hours or a whole day. |
| Diagnosis | Doctors will do a physical examination of the hand and wrist. They may order electrophysiological tests to check nerve function. They may also use ultrasounds and X-rays. | Doctors assess symptoms and do a physical examination. X-rays and MRI scans may show changes to the bones or joints. Blood tests and fluid samples from the joints can help rule out other conditions. | Doctors use blood tests, ultrasounds, X-rays, MRI scans, and physical examinations to diagnose RA. |
| Medication | A person may take nonsteroidal anti-inflammatory drugs (NSAIDs) or have corticosteroid injections into the carpal tunnel. | Pain relief and anti-inflammatory medications, including topical ointments and corticosteroids. Hyaluronic acid injections can help knee OA. Selective serotonin and norepinephrine reuptake inhibitors to help manage pain over the long term. | Doctors prescribe disease-modifying antirheumatic drugs, NSAIDs, or corticosteroids. |
| Home remedies | A person can wear a splint to relieve pressure on the wrist. They can also modify activities that put pressure on the wrist and do nerve gliding exercises. | Ways to manage OA include regular exercise with low impact activities, such as swimming or walking, weight management, and orthotic devices to help support the joints. | A person can stay physically active but rest when symptoms flare up, maintaining stretching exercises to improve flexibility and range of motion. |
People will need to contact a doctor if they experience any symptoms of CTS or arthritis. This may include:
- numbness or tingling in the fingers or thumbs
- joint pain or stiffness
- weakness of the hand
A doctor will be able to assess any symptoms and carry out a physical examination or diagnostic tests to find out the underlying cause.
Recovery from CTS can take time, and it could take up to a year for people to recover fully.
In many cases, surgery of the wrist is an effective treatment for improving symptoms of carpal tunnel. Consulting a hand therapist may also help improve recovery.
Outcomes after surgery are better the sooner a person has an operation. Surgery for CTS is minimally invasive and has a fast recovery time.
Having an additional condition that affects the hand or wrist, such as arthritis or tendinitis, may slow down recovery times.
Treatment is important in preventing loss of sensation or muscle wastage in the thumb. If carpal tunnel continues over the long term with severe symptoms, a full recovery may not be possible.
CTS involves the compression of the median nerve, which runs through the forearm, wrist, and hand.
The condition may be due to injury, overuse, or underlying health issues. It may cause tingling, numbness, or weakness in the hand.
Arthritis is a disorder of the joints that may be due to cartilage breakdown or an autoimmune condition. Symptoms can include pain and stiffness in the joints and a reduced range of movement.
Medications, nerve gliding exercises, and surgery can help treat CTS in some cases.