Arthritis, Carpal Tunnel Syndrome or Both?
Learn how to differentiate between these common causes of hand pain.
By Linda Rath | Dec. 12, 2022
Both arthritis and carpal tunnel syndrome can cause hand pain, but they target different parts of your hands and generally have different symptoms. Unlike arthritis, which affects joints, carpal tunnel is a nerve disorder. It occurs when the median nerve in the hand is squeezed as it travels through the carpal tunnel, a narrow passageway in the wrist that also contains the tendons that bend some fingers. The passageway is formed by two rows of small wrist bones — one on the upper side of the wrist and one on the lower side of the hand. A ligament stretches over them like a canopy, creating a tight, rigid space with little room to expand. If the tunnel narrows or the tissue around the tendons swells, the median nerve gets pinched. This can lead to numbness, tingling and sometimes electric shock-like pain in the wrist and first three-and-a-half fingers. The pinkie and half of the ring finger are spared in carpal tunnel because they’re served by the ulnar nerve, not the median nerve.
Carpal tunnel usually starts gradually, without any known injury or clear cause. Symptoms may come and go at first but become more constant over time and are often worse at night.
In time, pain and tingling may radiate up the arm toward the shoulder, and your hand may become so weak or numb you have trouble holding a book, driving or grasping small objects.
Arthritis Is a Joint Problem
Osteoarthritis (OA), rheumatoid arthritis (RA) and psoriatic arthritis (PsA) all can affect your hands — most often the base of your thumb where it meets your wrist, as well as your knuckles and the second and top finger joints. The most common symptoms are morning stiffness, swelling and an aching joint pain, especially after you use your hands more than usual. In time, the tissue surrounding the joints may become red and tender to the touch. Your joints can also lose their shape and alignment as the tendons surrounding the bones weaken.
With OA, bony nodules (Bouchard’s nodes) can form at the middle joint of the finger or at the joint nearest the tip (Heberden’s nodes). About 25% of people with RA also develop harmless nodules on the fingers and knuckles as well as other parts of the body. RA nodules can range from pea- to lemon-size. They may develop more quickly, especially on your hands, if you take methotrexate to treat your arthritis.
RA differs from other forms of arthritis — and from carpal tunnel — in that it is almost always symmetrical; if you have joint pain and swelling in the thumb joint in one hand, the same joint will be affected in the other hand.
Busting the Biggest Carpal Tunnel Myth
Carpal tunnel often has no single identifiable cause, but anatomy (having a small carpal tunnel), being overweight, being a middle-aged woman and having a health condition such as diabetes, Raynaud’s syndrome or RA may be contributing factors.
Arthritis or Carpal Tunnel Syndrome?
There are clear differences between carpal tunnel syndrome and arthritis, including the parts of the hands that are affected, the kind of pain they generate and why you might have trouble performing daily activities (numbness and muscle weakness with carpal tunnel; pain and deformities with arthritis). You may be able to relieve early-stage carpal tunnel pain by “flicking,” or shaking out, your hands, which reduces compression of the median nerve. This motion is sometimes used to help diagnose carpal tunnel.
For people who have both arthritis and carpal tunnel syndrome, the differentiations are not so neat. Wrist RA is a major risk factor for carpal tunnel, mainly because inflammation can narrow the carpal passageway and damage the median nerve. If you have both conditions, they can be treated at the same time and often with the same therapies. These include splints, which support, protect and help align weak, painful wrists and fingers, physical therapy, hand-specific exercises, including squeezing a small ball several times a day and yoga poses that strengthen and stretch the upper body.
Other common treatments include short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) and in some cases corticosteroid injections into the joint or median nerve. These therapies offer temporary pain relief but aren’t a permanent fix for either RA or carpal tunnel and should be used sparingly. Surgery is a last resort for both carpal tunnel and hand RA.
Both arthritis and carpal tunnel syndrome can cause hand pain, but they target different parts of your hands and generally have different symptoms. Unlike arthritis, which affects joints, carpal tunnel is a nerve disorder. It occurs when the median nerve in the hand is squeezed as it travels through the carpal tunnel, a narrow passageway in the wrist that also contains the tendons that bend some fingers. The passageway is formed by two rows of small wrist bones — one on the upper side of the wrist and one on the lower side of the hand. A ligament stretches over them like a canopy, creating a tight, rigid space with little room to expand. If the tunnel narrows or the tissue around the tendons swells, the median nerve gets pinched. This can lead to numbness, tingling and sometimes electric shock-like pain in the wrist and first three-and-a-half fingers. The pinkie and half of the ring finger are spared in carpal tunnel because they’re served by the ulnar nerve, not the median nerve.
Carpal tunnel usually starts gradually, without any known injury or clear cause. Symptoms may come and go at first but become more constant over time and are often worse at night.
In time, pain and tingling may radiate up the arm toward the shoulder, and your hand may become so weak or numb you have trouble holding a book, driving or grasping small objects.
Arthritis Is a Joint Problem
Osteoarthritis (OA), rheumatoid arthritis (RA) and psoriatic arthritis (PsA) all can affect your hands — most often the base of your thumb where it meets your wrist, as well as your knuckles and the second and top finger joints. The most common symptoms are morning stiffness, swelling and an aching joint pain, especially after you use your hands more than usual. In time, the tissue surrounding the joints may become red and tender to the touch. Your joints can also lose their shape and alignment as the tendons surrounding the bones weaken.
With OA, bony nodules (Bouchard’s nodes) can form at the middle joint of the finger or at the joint nearest the tip (Heberden’s nodes). About 25% of people with RA also develop harmless nodules on the fingers and knuckles as well as other parts of the body. RA nodules can range from pea- to lemon-size. They may develop more quickly, especially on your hands, if you take methotrexate to treat your arthritis.
RA differs from other forms of arthritis — and from carpal tunnel — in that it is almost always symmetrical; if you have joint pain and swelling in the thumb joint in one hand, the same joint will be affected in the other hand.
Busting the Biggest Carpal Tunnel Myth
Carpal tunnel often has no single identifiable cause, but anatomy (having a small carpal tunnel), being overweight, being a middle-aged woman and having a health condition such as diabetes, Raynaud’s syndrome or RA may be contributing factors.
Arthritis or Carpal Tunnel Syndrome?
There are clear differences between carpal tunnel syndrome and arthritis, including the parts of the hands that are affected, the kind of pain they generate and why you might have trouble performing daily activities (numbness and muscle weakness with carpal tunnel; pain and deformities with arthritis). You may be able to relieve early-stage carpal tunnel pain by “flicking,” or shaking out, your hands, which reduces compression of the median nerve. This motion is sometimes used to help diagnose carpal tunnel.
For people who have both arthritis and carpal tunnel syndrome, the differentiations are not so neat. Wrist RA is a major risk factor for carpal tunnel, mainly because inflammation can narrow the carpal passageway and damage the median nerve. If you have both conditions, they can be treated at the same time and often with the same therapies. These include splints, which support, protect and help align weak, painful wrists and fingers, physical therapy, hand-specific exercises, including squeezing a small ball several times a day and yoga poses that strengthen and stretch the upper body.
Other common treatments include short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) and in some cases corticosteroid injections into the joint or median nerve. These therapies offer temporary pain relief but aren’t a permanent fix for either RA or carpal tunnel and should be used sparingly. Surgery is a last resort for both carpal tunnel and hand RA.