Carpal tunnel syndrome and tennis elbow are distinct yet commonly misunderstood repetitive strain injuries affecting the arms and hands. Suppose you’ve ever experienced tingling, numbness, or pain in your wrist and fingers or felt discomfort around the outer part of your elbow. In that case, you might wonder whether carpal tunnel or tennis elbow is causing the trouble. Understanding the key differences between these conditions is crucial for proper diagnosis and finding effective remedies. Here we will talk about the difference between carpal tunnel vs tennis elbow, including the symptoms, diagnosis, and treatment!
Carpal Tunnel vs Tennis Elbow: What is?
Here we will learn about carpal tunnel syndrome and tennis elbow definitions!
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (CTS) is a medical condition that affects the hand and wrist, causing a range of symptoms due to median nerve compression. The median nerve is a major nerve that runs from the forearm into the hand, providing sensation to the palm side of the thumb, index finger, middle finger, and half of the ring finger. It also controls the movement of some muscles in the hand.
The transverse carpal ligament and the carpal bones on top of the narrow passageway in the wrist, known as the carpal tunnel, are strong bands of connective tissue. This tunnel houses the median nerve and nine flexor tendons that bend the fingers and thumb.
When there is excessive pressure on the median nerve within the carpal tunnel, it can lead to the development of carpal tunnel syndrome. The pressure usually results from inflammation or swelling of the tissues in and around the tunnel. The condition can affect one or both hands, and it’s more common in women than in men.
Tennis elbow, medically known as lateral epicondylitis, is a common condition that causes pain and inflammation in the outer part of the elbow.
Despite its name, it is not limited to tennis players; it can affect anyone who engages in repetitive arm motions or activities that strain the forearm muscles and tendons. It is, however, particularly common among tennis players, which is why it’s referred to as “tennis elbow.”
The condition occurs when the tendons that connect the forearm muscles to the bony prominence (lateral epicondyle) on the outside of the elbow become inflamed or damaged.
These tendons are responsible for extending the wrist and fingers, frequently involved in various activities, including gripping, lifting, typing, and tennis strokes.
Carpal Tunnel vs Tennis Elbow: Causes?
Here we will discuss the causes of carpal tunnel syndrome and tennis elbow!
Causes of Carpal Tunnel Syndrome
The exact cause of carpal tunnel syndrome is often not clear, but several factors can contribute to its development:
- Repetitive hand movements: Engaging in repetitive hand and wrist movements, such as typing, using a computer mouse, assembly line work, or playing musical instruments, can increase the risk of developing CTS over time.
- Hand and wrist position: Prolonged or repeated flexion and extension of the wrist can put pressure on the median nerve and contribute to the development of carpal tunnel syndrome. Maintaining awkward wrist positions for extended periods may also increase the risk.
- Anatomy: Some individuals may have a smaller carpal tunnel or anatomical variations predisposing them to developing CTS.
- Medical conditions: Certain health conditions can increase the risk of carpal tunnel syndrome, including diabetes, rheumatoid arthritis, hypothyroidism, obesity, and kidney failure.
- Pregnancy: Hormonal changes during pregnancy can lead to fluid retention and swelling, which may compress the median nerve and cause carpal tunnel symptoms. In most cases, these symptoms resolve after pregnancy.
- Wrist injuries: Fractures, sprains, and other injuries to the wrist can cause swelling and inflammation that compresses the median nerve.
- Family history: There may be a genetic predisposition to carpal tunnel syndrome, meaning it can run in families.
- Age and gender: CTS is more common in individuals over 30 and more prevalent in women than men.
- Obesity: Excess body weight may increase the risk of developing carpal tunnel syndrome.
Causes of Tennis Elbow
Despite its name, it is not exclusive to tennis players; it can occur to anyone who repeatedly uses their forearm muscles. The main causes of tennis elbow include:
- Repetitive arm movements: The most common cause of tennis elbow is repetitive forearm and wrist motion. This can happen in various activities, not just playing tennis, such as painting, typing, carpentry, gardening, and using tools.
- Overuse or strain: Repeatedly performing certain movements without adequate rest can lead to overuse and strain of the forearm muscles and tendons, resulting in inflammation and micro-tears in the tendons.
- Poor technique: In sports like tennis or golf, using incorrect technique or grip can place excessive stress on the forearm tendons, contributing to the development of tennis elbow.
- Age: While tennis elbow can affect people of all ages, it is more common in individuals between 30 and 50.
- Occupational factors: Certain professions that involve repetitive arm movements, forceful gripping, or working with vibrating tools can increase the risk of developing tennis elbow.
- Lack of forearm strength and flexibility: Inadequate strength and flexibility in the forearm muscles can make the tendons more susceptible to injury.
- Previous injuries: Prior injuries to the elbow or surrounding areas can weaken the tendons and increase the likelihood of developing tennis elbow.
- Genetics and predisposition: Some individuals may have a genetic predisposition to developing conditions like tennis elbow.
Carpal Tunnel vs Tennis Elbow: Symptoms?
Here we will discuss the symptoms of carpal tunnel syndrome and tennis elbow!
Carpal Tunnel Syndrome Symptoms
The carpal tunnel comprises bones, ligaments, and tendons that protect the median nerve and the flexor tendons responsible for finger movement. The symptoms of Carpal Tunnel Syndrome can vary in severity and may include:
- Numbness and Tingling: The most common symptom is a feeling of numbness and tingling in the thumb, index finger, middle finger, and the thumb side of the ring finger. This sensation may extend up the arm and be more pronounced during activities that involve bending the wrist, like typing or holding a phone.
- Pain and Discomfort: Individuals with CTS often experience pain in the hand and wrist. The pain may radiate up the forearm or even into the upper arm. It can be a dull ache or a sharp, shooting pain.
- Weakness: As the condition progresses, weakness in the hand and a decreased ability to grip objects may occur. This can challenge simple tasks, like holding a cup or buttoning a shirt.
- Burning Sensation: Some people with CTS may report a burning sensation in their fingers or hands.
- Nighttime Symptoms: Symptoms of CTS are often more pronounced at night, and individuals may wake up with numbness or pain that can disrupt sleep.
- Hand Clumsiness: Carpal Tunnel Syndrome can lead to a loss of coordination and agility in the hand, making it difficult to perform fine motor tasks.
- Symptoms in Both Hands: CTS affects both hands in many cases, although one hand may be more affected.
Tennis Elbow Symptoms
Despite its name, tennis elbow is not exclusive to tennis players and can affect anyone who engages in activities that strain these tendons. The symptoms of tennis elbow typically include:
- Pain: The primary symptom is pain outside the elbow, specifically around the bony bump called the lateral epicondyle. The pain may radiate down the forearm, sometimes reaching the wrist.
- Weakness: You may experience weakness in your grip strength, making it difficult to hold objects or perform daily tasks that involve gripping and lifting.
- Stiffness: The affected elbow may feel stiff and less flexible than usual, particularly after rest or waking up in the morning.
- Worsening Pain with Activity: Pain tends to worsen when performing activities that involve gripping, twisting the forearm, or lifting objects, especially if they require the use of the affected arm.
- Painful Wrist Movements: Certain wrist movements, such as extending the wrist backwards or turning it outward, may exacerbate the pain in the elbow.
- Painful Activities: Common activities that can trigger or worsen tennis elbow symptoms include playing racquet sports, using hand tools, typing on a keyboard for extended periods, carrying heavy objects, and repetitive gripping motions.
Carpal Tunnel vs Tennis Elbow: Test?
Here we will discuss carpal tunnel syndrome and tennis elbow testing procedures!
Carpal Tunnel Test
The Carpal Tunnel Test is a series of diagnostic assessments used to evaluate the presence and severity of carpal tunnel syndrome (CTS), a condition characterized by compression of the median nerve as it passes through the carpal tunnel in the wrist. A healthcare professional performs this test, such as a doctor or a physical therapist. Here are some common tests used to assess carpal tunnel syndrome:
The doctor taps lightly on the median nerve at the wrist to see if it causes tingling or numbness in the fingers. A positive Tinel’s sign is indicative of carpal tunnel syndrome.
The patient flexes the wrist and holds it bent for about a minute. Symptoms like tingling or numbness in the fingers during or after this manoeuvre may suggest carpal tunnel syndrome.
Median Nerve Compression Test
The healthcare provider may apply pressure to the median nerve in the carpal tunnel to see if it elicits symptoms.
Nerve Conduction Studies (NCS)
This test measures the speed and strength of electrical signals as they travel through the nerves. It helps confirm the presence and severity of carpal tunnel syndrome.
Often done in conjunction with NCS, EMG evaluates the electrical activity of muscles and helps assess nerve damage.
Tennis Elbow Test
The tennis elbow test is a simple assessment used to diagnose or evaluate lateral epicondylitis, a common condition that causes pain and tenderness in the outer part of the elbow. It develops due to excessive or repeated strain on the forearm muscles, which is why it is frequently associated with sports like tennis (hence the name). However, it can also result from other activities or jobs that require constant gripping and wrist extension. The tennis elbow test has different variations, but one commonly used method is the “Cozen’s Test.” Here’s how it is performed:
- The patient sits or stands with their forearm resting on a table or their lap and their palm facing downward (pronated position).
- The examiner stands before the patient and stabilizes the arm by holding the wrist.
- The examiner asks the patient to make a fist while keeping their wrist in a neutral position (neither flexed nor extended).
- The patient is then asked to extend their wrist against resistance as if trying to lift the back of their hand.
- If the patient experiences pain or tenderness on the outer part of the elbow during this maneuver, it may indicate lateral epicondylitis (tennis elbow).
Carpal Tunnel vs Tennis Elbow: Treatment?
Here we will discuss carpal tunnel syndrome and tennis elbow treatment procedures!
Carpal Tunnel Syndrome Treatment
Treatment for carpal tunnel syndrome can vary depending on the severity of the condition. Here are some common treatment options:
- Rest and activity modification: Avoid activities that worsen the symptoms and take regular breaks if you perform repetitive tasks with your hands.
- Wrist splints: Wearing a wrist splint at night can help keep the wrist in a neutral position, relieving pressure on the median nerve and reducing symptoms.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications like ibuprofen or naproxen can help reduce pain and inflammation in the wrist.
- Corticosteroid injections: In more severe cases, a doctor may administer corticosteroid injections into the carpal tunnel to reduce inflammation and relieve symptoms.
- Physical therapy: Specific exercises and stretches can help improve wrist strength and flexibility, reducing the impact of carpal tunnel syndrome.
- Ergonomic adjustments: Make ergonomic changes to your workspace, keyboard, and mouse setup to reduce strain on your wrists during activities.
- Lifestyle changes: Maintaining a healthy lifestyle, including regular exercise and a balanced diet, can contribute to overall wrist health.
- Cold therapy: Applying ice packs to the affected wrist may help reduce inflammation and alleviate symptoms.
- Ultrasound therapy: Some healthcare providers may use ultrasound therapy to promote healing and reduce inflammation in the carpal tunnel area.
- Acupuncture: Some people find relief from carpal tunnel symptoms through acupuncture treatments.
- Medications for underlying conditions: If CTS is related to rheumatoid arthritis or diabetes, managing those conditions effectively may help alleviate carpal tunnel symptoms.
Tennis Elbow Treatment
The treatment for tennis elbow typically involves a combination of self-care measures, physical therapy, and, in some cases, medical intervention. Here are some common approaches to treating tennis elbow:
- Rest: Rest your affected arm adequately and avoid activities that worsen the pain. Continuing to use the affected arm excessively may delay the healing process.
- Ice: Applying ice to the affected area for about 15–20 minutes several times daily can help reduce inflammation and alleviate pain. Be sure to wrap the ice pack in a cloth to avoid direct contact with the skin.
- Pain relief medications: Over-the-counter pain relievers like ibuprofen or acetaminophen can help reduce pain and inflammation. Always follow the recommended dosage and consult your doctor for any underlying health conditions or concerns.
- Physical therapy: A physical therapist can design a specific exercise program to strengthen the forearm muscles and improve flexibility. Eccentric exercises, where you slowly lower your wrist against resistance, are often effective for tennis elbow.
- Brace or support: Wearing a counterforce brace or strap around the forearm, just below the elbow, may help alleviate tension on the affected tendons.
- Corticosteroid injections: In more severe cases, a doctor may administer corticosteroid injections into the affected area to reduce inflammation and pain. However, these injections are generally used sparingly due to potential side effects.
- Extracorporeal shockwave therapy (ESWT): This non-invasive treatment uses shockwave pulses to stimulate healing and reduce pain in the affected area.
- Platelet-rich plasma (PRP) therapy involves injecting concentrated platelets from your blood into the affected area to promote healing.
- Ultrasound therapy: It uses high-frequency sound waves to promote blood circulation and accelerate the healing process.
- Surgery (in rare cases): If conservative treatments do not improve the condition after several months, your doctor may recommend surgery to remove damaged tissue or repair the affected tendons.
In conclusion, Carpal Tunnel Syndrome and Tennis Elbow are distinct medical conditions, though both involve the upper limb and can cause pain and discomfort. Carpal Tunnel Syndrome primarily affects the wrist and hand, resulting from pressure on the median nerve, often due to repetitive motions or prolonged wrist flexion. On the other hand, Tennis Elbow, also known as lateral epicondylitis, targets the outer part of the elbow, caused by overuse of the forearm muscles. While they share similarities in repetitive strain injuries, their symptoms, locations, and causes differ significantly, necessitating proper diagnosis and tailored treatment approaches for effective management.