When pain, tingling, numbness, and/or weakness occurs in the hands or wrist, many people assume it is caused by carpal tunnel syndrome. Although carpal tunnel syndrome is a common disorder, there are several conditions that can trigger nearly identical symptoms.

See What Is Carpal Tunnel Syndrome?

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This guide discusses the most common causes of hand and wrist pain that may potentially be mistaken for carpal tunnel syndrome.

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Keep in mind that carpal tunnel syndrome is much more common than many of these conditions. For example, the estimated prevalence for carpal tunnel syndrome among manual labor workers may be as high as 20%,1Dale AM, Harris-adamson C, Rempel D, et al. Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies. Scand J Work Environ Health. 2013;39(5):495-505. while prevalence for Reynaud’s syndrome is estimated to be about 5% in the general population.2Garner R, Kumari R, Lanyon P, Doherty M, Zhang W. Prevalence, risk factors and associations of primary Raynaud's phenomenon: systematic review and meta-analysis of observational studies. BMJ Open. 2015;5(3):e006389.

See Treatment Options for Carpal Tunnel Syndrome

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Hand and Wrist Pain from Nerve Problems

Carpal tunnel syndrome is caused by impingement of the median nerve, but damage or impingement of other nerves can also cause symptoms in the hand.

Cervical radiculopathy
Several nerve roots that originate in the cervical spine—particularly C6 and C7—innervate the hand and fingers. If they become impinged from a degenerated or herniated disc, stenosis, or cervical osteoarthritis, the resulting pain and numbness can be very similar to carpal tunnel syndrome.

See Is My Shoulder Pain Caused by a Neck Injury?

Cubital tunnel syndrome
The ulnar nerve passes over the outside of the elbow, runs down the arm, and into the outside of the hand; this is the nerve that causes a “funny bone” reaction when it is struck at the elbow.

Repeated use or pressure on the elbow can cause inflammation that affects this nerve, which can cause symptoms of pain and tingling in the hand, similar to carpal tunnel syndrome. However, carpal tunnel syndrome symptoms occur in the thumb, index, and middle fingers, whereas ulnar nerve symptoms typically affect the ring and pinky fingers.

Thoracic outlet syndrome
This is a rare condition in which the space between the collarbone and upper ribs is unusually narrow, causing compression of the blood vessels and nerves that run through this space. This compression can result in pain, numbness, or weakness in the hands, as well as pain in the neck and shoulders.

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Diabetes
Approximately 60 to 70 percent of people with diabetes will eventually develop form of neuropathy, or nerve damage, according to the National Institute of Diabetes and Digestive and Kidney Diseases.3"Nerve Damage (Diabetic Neuropathies)." National Institute of Diabetes and Digestive and Kidney Diseases. November 2013. This nerve damage can happen anywhere, but tends to affect the extremities (hands and feet) first.

See Soft Tissues of the Wrist

  • 1 Dale AM, Harris-adamson C, Rempel D, et al. Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies. Scand J Work Environ Health. 2013;39(5):495-505.
  • 2 Garner R, Kumari R, Lanyon P, Doherty M, Zhang W. Prevalence, risk factors and associations of primary Raynaud's phenomenon: systematic review and meta-analysis of observational studies. BMJ Open. 2015;5(3):e006389.
  • 3 "Nerve Damage (Diabetic Neuropathies)." National Institute of Diabetes and Digestive and Kidney Diseases. November 2013.

Dr. Naomi Feuer is a neurologist at NewYork-Presbyterian Hospital. She has more than 10 years of clinical experience and specializes in diagnostic testing, nerve testing, pain management, and physical therapy. Dr. Feuer serves as Assistant Clinical Professor of Neurology and Neuromuscular Disease at Weill Cornell Medical Center.

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