Carpal tunnel syndrome has unmistakable symptoms, including pain, tingling, and weakness in your hand and wrist. But when your elbow starts hurting, too, you might wonder if it's connected to your carpal tunnel syndrome. The short answer is yes, it can be.
Fortunately, treatments, including non-surgical options like arm massage tools or physical therapy, are available. Let's explore the connection between carpal tunnel syndrome and elbow pain so you can better understand and manage your symptoms effectively.
What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) is the most common nerve entrapment injury of the hand. Affecting up to 8% of the working population, CTS happens when the carpal tunnel, a small passageway through which the median nerve passes, becomes irritated and swollen. The median nerve helps you move your forearm and innervates most of your fingers. When the median nerve is compressed inside the tunnel, it causes pain, numbness, and tingling.
CTS mainly affects the thumb, index finger, middle finger, and half of the ring finger. At first, symptoms only show up at night, disrupting your sleep, and then seem to vanish during the day. But over time, you might notice these symptoms creeping in during the day, especially when drawing, typing, or even gaming.
In more severe cases, the discomfort can become constant, leading to hand weakness, clumsiness, and a loss of fine motor skills. You might start feeling your hand "fall asleep" and dropping objects. Eventually, you might even notice muscle atrophy in your thumb area.
What Causes Carpal Tunnel Syndrome?
Repetitive tasks involving excessive wrist flexion or prolonged wrist movements, such as sewing, packing, manufacturing, and playing musical instruments, significantly increase the risk of CTS. Workers who use vibrating hand tools or the computer for over five hours per day are also particularly susceptible.
CTS is more common in women than men, possibly due to their naturally narrower carpal tunnels. It can occur at any age but is more prevalent in people between ages 35 and 60. Plus, certain medical conditions such as diabetes, thyroid disease, arthritis, and obesity can increase your risk further.
How Carpal Tunnel Syndrome Causes Elbow Pain
While CTS mainly affects your hand and wrist caused by pressure around the median nerve, sometimes, you may also feel pain extending to your forearm and beyond the elbow. The median nerve runs from the neck down to the hand.
Pain signals can travel along the entire nerve length when the median nerve is compressed in the carpal tunnel. This means that discomfort originating in the wrist can radiate or shoot up the arm, potentially reaching the elbow and even the shoulder. Referred pain from CTS can sometimes be misattributed to other conditions, making it crucial to consider the entire length of the nerve pathway when diagnosing and treating pain.
If your job, exercise regimen, or daily routine strains your hands and wrists significantly, you could be more prone to CTS and elbow pain. Repeated use, excessive vibration, and direct trauma to your hands can all lead to nerve compression. Occupations such as corporate professionals, athletes, and musicians may run a higher risk due to the nature of their jobs.
Other Causes of Wrist & Elbow Pain
Several other conditions can also lead to discomfort in these areas.
- Tennis Elbow (Lateral Epicondylitis): Tennis elbow of the extensor tendon attached to the bony bump outside your elbow. It causes an aching or burning elbow pain that may shoot down to your forearm and hand.
- Bursitis: Bursitis is the inflammation of the bursae. It can cause swelling, pain, and tenderness at the back of the elbow.
- Arthritis: Arthritis can be related to an autoimmune disease that causes chronic inflammation in the joints or a degenerative joint disease resulting from the breakdown of cartilage.
- Thoracic Outlet Syndrome occurs when the blood vessels or nerves in the space between your collarbone and first rib become compressed. TOS can cause pain in your shoulders and neck and numb fingers.
- Ulnar Nerve Entrapment (Cubital Tunnel Syndrome): This condition involves compression of the ulnar nerve as it passes through the cubital tunnel at the elbow.
- De Quervain's Tenosynovitis: Repetitive hand or wrist movements, such as lifting a child or playing certain sports, can inflame the tendons on the thumb side of your wrist, leading to this painful condition.
If you experience CTS symptoms, contact your doctor. Understanding your symptoms and identifying the root cause is the first step toward prompt and effective treatment.
Diagnosing Carpal Tunnel Syndrome & Elbow Pain
Diagnosing CTS starts with an interview about your daily life and symptoms. Your doctor will ask about the nature, frequency, and duration of your symptoms, your daily activities, your job, hobbies, and any history of wrist injuries or conditions like diabetes or thyroid disorders.
Next comes the physical examination. Your doctor will carefully examine your hands, wrists, and arms. They'll check for swelling or tenderness in the wrist, weakness in the thumb and fingers, decreased muscle tone in the thenar muscles, and changes in sensation, including numbness or tingling in the fingers.
Electrophysiologic Studies
When CTS is suspected, your doctor may order electrophysiologic studies. Considered the gold standard in diagnosing CTS, these tests provide definitive evidence of nerve dysfunction and guide your treatment plan.
- Nerve conduction study. A nerve conduction study determines how efficiently a nerve conducts signals. Your nerves work like electrical cables, carrying messages between your brain and muscles. When a nerve isn't functioning correctly, it delays the transportation of these signals.
During a nerve conduction study, your doctor tests various points along a single nerve. If there is a significant delay at any location, it indicates where the nerve is being compressed. These tests can also determine if you have muscle damage, indicating the severity of your condition.
- Electromyography, or EMG, involves inserting a fine needle electrode into specific muscles to record electrical activity. It helps identify any muscle damage or nerve dysfunction contributing to symptoms.
Imaging Tests
Imaging tests like an X-ray or MRI are only done to rule out other causes of wrist pain.
How Carpal Tunnel Syndrome is Managed
It's common to start with non-surgical treatments, especially if you don't have any significant muscle damage. These treatments aim to reduce pressure on your affected nerve and alleviate symptoms.
Conservative Treatment
Mild to moderate cases can be adequately managed with conservative measures.
- Resting your wrist: In the early stages, you can take time off from activities that caused your symptoms.
- Wrist splints: Wearing wrist splints, particularly at night or during symptom-provoking activities, helps keep your wrist neutral, relieving pressure on the median nerve. Regular use during the day is generally not recommended to prevent wrist stiffness. For best results, you'll have to wear the splint for up to 12 weeks.
- Foam rolling: Using an arm massage tool on your forearm can loosen tight muscles, improve blood circulation, prevent scarring, and promote joint mobility. Just a few minutes of foam rolling daily can significantly reduce wrist pain from carpal tunnel syndrome and speed up recovery.
- Cold therapy: Applying ice to your wrist for several minutes a few times daily can help reduce inflammation and relieve pain.
- Nonsteroidal anti-inflammatory drugs: OTC drugs like ibuprofen and naproxen can make the early days of carpal tunnel easier to bear.
- Corticosteroid injections: A single steroid injection can provide significant pain relief from CTS symptoms. Studies show that 76% of patients experience improvement six weeks after an injection.
- Physical therapy: Physical therapy for CTS involves targeted exercises to stretch and strengthen your wrist and hand muscles. You'll learn techniques like wrist stretches, median nerve gliding exercises, and ergonomic adjustments to manage pain, improve nerve mobility, and preserve wrist function. For best results, physical therapy is typically combined with other treatment modalities such as splinting, foam rolling, cold therapy, and steroid shots.
Surgical Options for Severe Carpal Tunnel Syndrome
Suppose your CTS or elbow pain is severe, and you experience no improvement after three months of conservative therapy. In that case, your orthopedic surgeon may switch gears toward a surgical approach. The surgical procedure involves decompressing your nerve by cutting the ligament and pressing on the median nerve. This broadens the space around it, eliminating any contributing factors causing compression.
While surgical treatments can require significant recovery time, they can significantly alleviate or entirely erase symptoms in severe CTS or elbow pain cases. Studies show that carpal tunnel release surgery has up to a 90% success rate in resolving pain, numbness, and paresthesias.
Carpal Tunnel Syndrome vs. Cubital Tunnel Syndrome
Cubital tunnel syndrome shares symptoms similar to CTS but is a separate condition. It results from the compression of the ulnar nerve in the elbow. It can be caused by frequent elbow bending, leaning on the elbow, arthritis, bone spurs, and previous injuries. In many cases, the exact cause is unknown.
This underlines why it's so important to have a doctor pinpoint the exact root of your pain. Your recommended therapies could differ depending on which nerve is causing you trouble.
Treatment for Cubital Tunnel Syndrome
Treatment for cubital tunnel syndrome involves:
- Avoiding activities that irritate the ulnar nerve.
- Using elbow splints or pads.
- Taking anti-inflammatory medications.
- Performing nerve gliding exercises.
If more conservative treatments don't provide relief, surgery may be necessary.
Preventing Nerve Syndromes
Preventive measures for both CTS and cubital tunnel syndrome include:
- Maintaining your flexibility and strength.
- Avoiding prolonged pressure on your affected areas.
- Warm up sufficiently before you begin repetitive activities or exercises.
Understanding your symptoms will help you determine the best course of action. And don't ever ignore your pain—get it checked out so you can start on the path to recovery as soon as possible.
Frequently Asked Questions
How can I treat carpal tunnel syndrome (CTS) in the elbow?
First, stop any activities that aggravate the condition and rest. Wearing a splint or foam elbow brace at night could help limit movement and reduce irritation. Protective elbow pads may also be beneficial against chronic irritations.
How do cubital tunnel and carpal tunnel syndromes differ?
Both conditions result in hand and wrist numbness or tingling and hand pain. The critical difference is in the location of your pain. CTS affects your thumb, index, and long fingers, while cubital tunnel syndrome primarily impacts your ring and little fingers.
What causes carpal tunnel flare-ups?
Several factors can cause a flare-up, including repetitive hand movements, extended or flexed wrist periods, inflammatory joint conditions, and hormonal or metabolic changes like menopause, pregnancy, or a thyroid imbalance.
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