Hand & Wrist Surgery, Orthopedic Surgery

June 28, 2021

Is it Carpal Tunnel Syndrome or Wrist Arthritis?

Woman holding wrist

Chronic or recurring wrist pain can be debilitating, particularly if you work with your hands, type, or require a lot of wrist movement and strength for your daily activities.  Wrist pain is often caused by either arthritis or carpal tunnel syndrome—but it can be challenging to determine which problem is the culprit.

The cause of your wrist pain is a decisive factor in how it needs to be treated.  The pain of carpal tunnel syndrome is related to nerve compression, while arthritis pain is due to damage to the joint.  There are some distinguishing differences between the two conditions, and your physician can perform tests to determine your diagnosis and the best treatment option for you.

What is Arthritis of the Wrist & Hand?

Arthritis is the inflammation of joints triggered by wear and tear to the bones and cartilage.  The main symptoms of wrist arthritis include pain, tenderness, inflammation, redness, stiffness, warmth at the joint, and decreased range of movement.

There are two main types of arthritis:

  • Osteoarthritis is caused by repeated wear and tear and grinding in the joints after the cartilage has been damaged or worn away.  This most often occurs in older individuals or those who perform tasks that require extensive use of the wrist and hand joints.
  • Rheumatoid arthritis, a degenerative disease, can affect the wrist and hand as well.  This is an immune disorder that causes the body to attack the joints.  It is often accompanied by visible swelling and twisting or distortion of the joints.

As mentioned above, both forms of wrist and hand arthritis have symptoms in common, including pain, swelling, and difficulty with movement.  However, osteoarthritis is usually felt in the joints closest to the ends of the fingers.  The discomfort may go away after moving around and using the joint.  Rheumatoid arthritis is more likely to affect the wrists, with pain that lasts longer in the mornings and is more difficult to alleviate with movement.

Some people who have wrist arthritis will develop carpal tunnel syndrome, but this doesn’t happen to everyone.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome occurs when the median nerve that runs from the shoulder to the hand is compressed or pinched.  This nerve runs through the wrist’s carpal bones, where the “tunnel” is narrow.

The carpal tunnel also contains nine tendons.  Any inflammation of these tendons or damage to the bones can cause compression of the median nerve, which leads to pain, tingling, and other symptoms.  With carpal tunnel syndrome, the pain is often worse later in the day and at night.  Tingling or burning sensations can even wake some people at night.

Certain risk factors increase your odds of developing carpal tunnel syndrome.  These include:

  • Repetitive wrist motions, including typing, woodworking, and painting
  • Manual labor or repeated use of vibrating power tools
  • Genetic tendency
  • Obesity
  • Diabetes
  • Hypothyroid disease
  • Broken or strained wrist
  • Wrist arthritis

While pain, stiffness, and tenderness can be signs of carpal tunnel as well as arthritis, there are additional symptoms that are specific to carpal tunnel.  these include tingling, numbness, burning, muscle weakness (especially at the base of the thumb), a feeling like electric shocks or pins and needles, difficulty with fine motor skills, and lack

What are Some Treatment Options for Wrist Pain?

Some treatments can help alleviate pain caused by carpal tunnel and mild to moderate wrist arthritis.  These include:

  • Anti-inflammatory medications (NSAIDs), including ibuprofen
  • Steroid injections
  • Physical therapy and exercises to strengthen the joints and minimize pressure on the nerves
  • Compensating movements and behaviors to avoid aggravating the condition
  • Splinting
  • Hot or cold therapy (talk to your doctor about which is appropriate for you)
  • Immunosuppressive drugs (for rheumatoid arthritis)

In more severe cases of wrist arthritis or carpal tunnel syndrome, surgery may be needed.  The procedures are different depending on whether you have carpal tunnel syndrome or arthritis.

What is Carpal Tunnel Relief Surgery

During carpal tunnel relief surgery, the surgeon increases the size of the opening in the carpal tunnel.  Then, they sever the transverse carpal ligament.  These procedures relieve the pressure on the nerve, bringing relief in a few weeks.

Carpal tunnel relief surgery is usually an outpatient procedure done under local or regional anesthesia.  It can be done with an open incision or arthroscopically, depending on what you and your surgeon decide is the best option for you.

What is Wrist Arthritis Surgery?

If your wrist arthritis is severe, there are surgical options.  For example, proximal row carpectomy surgery allows you to retain wrist movement by removing three small bones to relieve pain.  This works for certain types of wrist arthritis, but not all.

Wrist fusion surgery is an option for more severe or widespread arthritis.  This procedure fuses the wrist’s bones to the hand and forearm.  The fusion eliminates pain but also immobilizes the wrist, which can interfere with some activities.

The most extreme surgical option is wrist replacement.  The arthritic bone is removed, and a metal, nylon, or plastic implant is put in its place.  It is a complex surgery that is only performed in a handful of situations.

Which Do I Have: Carpal Tunnel or Wrist Arthritis?

While there are differences between carpal tunnel syndrome and wrist arthritis, there are a lot of similarities, too.  The best way to be sure which condition you have is to see an orthopedic specialist who can also suggest ways to treat it.

Your doctor may order x-rays to look for signs of arthritis.  Nerve induction tests will help them decide whether or not you have median nerve compression and the severity of the problem.  From there, a path can be charted toward pain relief and improved function.

The orthopedic surgeons at Arkansas Surgical Hospital are experienced at treating both wrist arthritis and carpal tunnel syndrome using the latest technologies and surgical procedures.  Contact us today to schedule an appointment for an evaluation of your wrist pain.

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