Carpal Tunnel vs Tendonitis: What Is the Difference?

Carpal tunnel syndrome and wrist tendonitis are recurring wrist conditions in people who use their fingers or wrists daily. If you’re a cashier or a grocery store clerk, know that you can develop either of the conditions anytime. 

Carpal tunnel and tendonitis can lead to chronic pain in the wrist and hand. It may also cause tingling in the fingers, making it hard to continue your work. 

Many people think both conditions are two names of the same issue, but they do differ in terms of symptoms. Your healthcare provider can quickly diagnose whether you have carpal tunnel syndrome or tendonitis. 

However, if you want to learn how to differentiate between both, keep reading this post till the end. We will also tell you about two surgical alternatives that can treat both these conditions in less pain. 

What Is Wrist Tendonitis?

Tendons are dense connective tissues that attach muscles to bones. These tendons help in the mobility of the joint, ensuring smooth muscle contraction and relaxation. Any inflammation or irritation in the tendons is known as tendonitis.

Our wrist has many tendons, categorized into two groups: flexion and extension. The former is when the hands are curled downward, and the latter is the opposite of flexion, referring to raising the hand’s back side.

The flexor tendons are present in the wrist’s underside or palm area. They include flexor carpi ulnaris (FCU), flexor carpi radialis (FCR), and palmaris longus (PL). Meanwhile, the extensor tendons are on the wrist’s backside where the knuckles are. They are divided into six groups, differentiated by Roman numbers: I, II, III, and continued. 

Every group or compartment is like a tunnel containing one or more extensor tendons. 

Causes of Wrist Tendonitis 

Inflammation in your wrist tendons can occur anytime due to many reasons. These include the following:

• Repetitive motion injuries, including writing, typing, texting, or playing a musical instrument
• Trauma
• Weak wrists 
• Damaged wrist ligaments
• Improper bone positioning in the wrist
• Arthritis 
• Diabetes 
• Increased BMI or overweight individuals 

Symptoms of Wrist Tendonitis

Wrist tendonitis causes instant pain in the affected tendon. If left untreated, the pain can get worse with activity. Some common wrist tendonitis symptoms include:

• Swelling in the tendons
• Redness or bruising
• Popping or clicking sounds when moving wrists

What Is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow pathway in the back of the wrist (near the palm). It consists of ligaments, tendons, and bones, allowing the nine flexor tendons and the median nerve to pass into the palm through the wrist. 

Carpal tunnel syndrome affects the median nerve in the wrist, making it irritated, swollen, and inflamed. Carpal tunnel syndrome is a painful nerve condition that affects 20% of adults, around one million in the USA annually. 

It develops due to repetitive trauma disorders, such as posture, vibration, or force. People employed as cashiers, grinders, drivers, grocery store clerks, assembly line employees, meat packers, and writers are more prone to carpal tunnel syndrome. 

Causes of Carpal Tunnel Syndrome

Carpal tunnel syndrome can be caused due to local, regional, and systemic factors. Below are the most common causes of this wrist condition:

• Trauma
• Osteoarthritis
• Gout
• Diabetes
• Obesity
• Low thyroid
• Pregnancy
• Rheumatoid arthritis (RA)
• Tumors that compress the median nerve
• Inflammation in tendons and synovium (surrounding sheaths)
• Autoimmune disorders like lupus, sarcoidosis, and scleroderma

Symptoms of Carpal Tunnel Syndrome

Carpal tunnel syndrome leads to different symptoms in every individual, depending on the severity of the nerve compression. In most cases, the symptoms may gradually develop in both wrists, fingers, and thumb. 

Some people may also experience burning pain and headaches with carpal tunnel syndrome. Other symptoms of this condition include: 

• Sudden pain or numbness in the wrist that goes away with shaking the hand 
• Needle sensations in fingers and wrists, also called nighttime pins
• Clumsiness in hands
• Weakness in wrists or hands
• Swelling in the hand and fingers 

Carpal Tunnel vs Tendonitis: The Differences

The differences between both carpal tunnel and tendonitis are quite visible by now. Yes, both conditions have similar symptoms, but they usually vary in terms of the causes. 

Tendonitis occurs due to inflammation in the wrist tendons, while carpal tunnel syndrome’s symptoms result from the compression of the median nerve in the wrist. You can easily differentiate between both conditions from the pain location. 

Wrist tendonitis is indicated by pain on the wrist’s top and muscle weakness. On the other hand, carpal tunnel syndrome occurs in the palm side of the wrist, causing numbness and tingling in the thumb and middle and index fingers. 

Treatment Options for Carpal Tunnel and Tendonitis

The treatment for both carpal tunnel and tendonitis is almost similar. They are treated with conservative care to either relieve the tendon inflammation or the nerve compression.

Conventional Methods

The first-line treatment for carpal tunnel and tendonitis includes:

• • A Splint. Limit your work when you experience slight pain or discomfort in your wrists, and opt for a splint. 

• Anti-Inflammatory Medications. Your doctor may suggest quality turmeric and fish oil medications to relieve the inflammation. Never use nonsteroidal anti-inflammatory drugs (NSAIDs) without your doctor’s prescription, as Aleve and Motrin can lead to heart attack or gut damage.

• Physical Therapy. You may be advised to stretch your tight muscles and strengthen the wrist joint. For carpal tunnel syndrome, carpal bone mobilization, nerve glides, and yoga may give short-term benefits. 

• Injections. If none of the above methods work, the doctor may opt for steroid injections to reduce the inflammation. Some helpful options include Hydrocortisone, Dexamethasone, and Betamethasone. It’s worth noting that steroid injections can damage your tendons, so they are administered with great care.

Surgery

Wrist tendonitis rarely requires any surgery, but it is the last resort for carpal tunnel syndrome if conservative care fails. 

The surgery for carpal tunnel syndrome involves cutting the carpal tunnel’s roof that’s made of the transverse carpal ligament. This relieves the compressed median nerve. The surgery can be performed open, using a cutting instrument, or endoscopically. 

Nerve hydro dissection is a modern solution that cuts the transverse ligaments to free up the scar tissue around the median nerve. 

Orthobiologic Methods

For persistent pain in carpal tunnel syndrome and tendonitis, orthobiologic treatments like cell-based therapies (stem cell therapy) and PRP therapy are the best solutions. At CELLAXYS, our board-certified surgeons perform these methods with great care and supervision. 

• Cell-based Therapies. This procedure involves extracting healthy cells from the patient’s adipose (fat) tissues (Minimally Manipulate Adipose Tissue Transplant MMAT) or bone marrow (Bone Marrow Concentrate BMAC) and reinjecting them into the injury site. Cell-based therapies take about 1.5 to 2 hours to complete.
  
• Platelet-rich Plasma (PRP) Therapy. In PRP, the surgeon takes the patient’s blood sample, separates platelets from it, and reinjects them into the injury site. Platelets are the healing components of our body, releasing 10 growth factors, attracting healing cells, and producing web-like scaffolding called fibrin. PRP takes 45 minutes and is a popular treatment for spine, sports, and orthopedic injuries. 

Cell-based therapies and PRP are outpatient procedures, meaning you can go home right after the treatment. People with carpal tunnel syndrome or wrist tendonitis report quick recovery with less pain.