Carpal tunnel syndrome and arthritis are two of the most common complaints I see as an orthopedic surgeon specializing in the hand and upper extremities. There are some common overlapping symptoms such as pain and aching with gripping, but the two conditions are vastly different
Carpal tunnel syndrome occurs when there is increased pressure on the nerve that gives sensation to most of the hand except your small finger. Think of the nerve (median nerve) as an electrical wire carrying impulses and it can be affected by external compression (such as crimping a wire). Symptoms include numbness, aching pain in the fingers and up the forearm, and pain that commonly wakes you up at night.
Arthritis, better known as osteoarthritis, is simply the loss of cartilage between the two bones that make up a joint (a joint is where motion occurs). Our joints rely on this layer of cartilage to create fluid motion and absorb shock stresses. As the cartilage wears out, increased friction occurs triggering pain, swelling, and decreased motion. I always tell my patients it is exactly like brake pads wearing out on your car.
Differentiating these conditions is usually easily obtained by history of symptoms, examination, and simple X-rays. Numbness, tingling and night pain are hallmarks of carpal tunnel. Arthritis usually can be localized to the base of the thumb where it attaches to the wrist or in the small joints of the fingers. Deformity and swelling of the joints occurs late in the arthritis process and may not be seen early on.
Treatment of both conditions starts with making the correct diagnosis and then first line treatment with specialized supportive bracing. Anti-inflammatory medications can help, but only use under the advice of your doctor if needed longer than a few days. Cortisone injections are very effective even though they often have a bad public reputation. Injections can especially control arthritis symptoms in the hand and wrist for many months or years prior to needing surgery. It is very important to see a hand specialist if numbness, tingling, or radiating pain in the hand are occurring because nerve damage can occur if left untreated for a long time.
Most importantly, remember that an orthopedic surgeon, in this case a hand and upper extremity surgeon, is best able to properly diagnose and offer non-operative treatments prior to doing any surgery.
Dr. Zimmer is the founding director of Ohio Hand Center with locations in Chardon, Mentor and Solon. For more information, or to make an appointment call 844-542-6363.