Carpal Tunnel Syndrome vs. Cervical Radiculopathy - Understand the Key Differences

Understanding Carpal Tunnel Syndrome vs. Cervical Radiculopathy

Hand and arm pain, numbness, and tingling are common symptoms that can greatly impact daily life. Two conditions that frequently cause these troubling symptoms are carpal tunnel syndrome (CTS) and cervical radiculopathy.

While CTS and cervical radiculopathy share some similar symptoms, they have very different underlying causes. Understanding the distinction between these two conditions is crucial for proper diagnosis and treatment.

In this in-depth guide, we will compare carpal tunnel syndrome vs. cervical radiculopathy. We will explore their causes, risk factors, symptoms, diagnosis, treatment options, and prevention.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition caused by compression of the median nerve as it passes through the wrist. The carpal tunnel is a narrow passageway surrounded by bones and ligaments in the wrist. When the tissues become inflamed or swollen, they put pressure on the median nerve running through the carpal tunnel.

Common causes of carpal tunnel syndrome include:

• Repetitive hand motions
• Working with vibrating tools
• Wrist fracture or dislocation
• Obesity
• Fluid retention during pregnancy or menopause
• Developmental abnormalities of the wrist
• Medical conditions like diabetes, arthritis, or hypothyroidism

Anything that reduces the space inside the carpal tunnel or causes inflammation can compress the median nerve and lead to CTS. It is very common, affecting up to 10% of the population at some point.

Symptoms of Carpal Tunnel Syndrome

Common carpal tunnel syndrome symptoms include:

• Tingling, numbness or pain in the thumb, index, middle finger and thumb-side ring finger
• Numbness or weakness in the affected fingers
• Worsening symptoms at night
• Decreased grip strength
• Difficulty manipulating objects
• Pain or burning feeling traveling up to the wrist or forearm

Symptoms often start gradually and worsen over time. They usually begin in one hand but often affect both hands eventually.

Diagnosing Carpal Tunnel Syndrome

To diagnose carpal tunnel syndrome, a physician will begin by asking about symptoms and performing a physical exam of the hands and wrists. They will check for sensation changes and weakness in the median nerve distribution.

Diagnostic tests may include:

• Nerve conduction study - Measures how fast signals travel through the median nerve. Slow conduction indicates nerve compression.
• Electromyography - Evaluates muscles and nerve function.
• MRI - Provides images of the wrist to check for abnormalities.

These tests can help confirm carpal tunnel syndrome and rule out other conditions.

Treating Carpal Tunnel Syndrome

Mild cases of carpal tunnel may be treated conservatively with:

• Wrist splinting to keep the wrist in a neutral position
• NSAID medications to reduce inflammation
• Occupational therapy
• Reducing repetitive wrist activities

More severe cases often require surgery to relieve pressure on the median nerve. This involves cutting the ligament pressing on the nerve to open up space inside the carpal tunnel.

Recovery from carpal tunnel surgery focuses on hand therapy to regain strength and range of motion.

What is Cervical Radiculopathy?

Cervical radiculopathy refers to compression of a nerve root in the cervical spine. The cervical spine is the neck region. Nerves branch out from the spinal cord and exit the spine through spaces between the vertebrae.

When these openings narrow due to arthritis, herniated discs, or bone spurs, it can pinch the nerve roots. This causes pain, numbness, and weakness in the neck, shoulder, arm, and hand.

Causes of Cervical Radiculopathy

Common causes leading to nerve root compression in the cervical spine include:

• Degenerative disc disease
• Herniated or bulging discs
• Bone spurs (osteophytes)
• Spinal arthritis
• Inflammation

Injury, genetics, age-related wear and tear, and medical conditions like osteoarthritis can contribute to these issues.

Symptoms of Cervical Radiculopathy

Symptoms of a pinched nerve root in the neck may include:

• Neck pain
• Shoulder pain or weakness
• Pain, numbness, or tingling traveling down the arm into the hand / fingers
• Headaches
• Muscle weakness or atrophy in the arm/hand
• Decreased reflexes

Symptoms typically only affect one side of the body, depending on which nerve is compressed.

Diagnosing Cervical Radiculopathy

Cervical radiculopathy is diagnosed through a medical history, physical exam, and tests such as:

• Spinal X-ray - Checks for bone spurs or narrowing between vertebrae.
• MRI - Provides images of soft tissues like discs, muscles, and nerves.
• CT myelogram - Uses dye to highlight the spinal cord and nerves.
• EMG - Records electrical signals in muscles to check nerve function.

These imaging and nerve tests can help pinpoint the compressed nerve root causing symptoms.

Treating Cervical Radiculopathy

Mild cases of cervical radiculopathy may improve with:

• Over-the-counter anti-inflammatories
• Ice/heat
• Rest
• Immobilizing neck collar
• Physical therapy

More severe cases often require surgery to relieve pressure on the nerve. This may involve removing a disc fragment or bone spur putting pressure on the nerve root.

Recovery focuses on stretching, strengthening exercises, and optimizing posture to prevent recurrence.

Key Differences Between Carpal Tunnel Syndrome and Cervical Radiculopathy

While carpal tunnel syndrome and cervical radiculopathy can cause similar hand and arm symptoms, there are key differences between these two conditions:

Location

• Carpal tunnel syndrome involves compression at the wrist joint.
• Cervical radiculopathy involves compression of a nerve root in the cervical spine.

Cause

• Carpal tunnel syndrome is often caused by repetitive motions, fluid retention, wrist trauma/fractures, or medical conditions.
• Cervical radiculopathy is commonly caused by spinal disc herniations or bone spurs in the neck.

Risk Factors

• Carpal tunnel risk factors include repetitive work, obesity, female gender, older age, wrist injury, and conditions like diabetes or arthritis.
• Cervical radiculopathy risks include history of neck injury, genetics, spinal arthritis, and older age.

Symptoms

• Carpal tunnel syndrome mainly causes pain, numbness, and tingling in the thumb, index, middle, and thumb-side ring finger.
• Cervical radiculopathy can cause symptoms spreading into the shoulder, arm, forearm, and back of the hand in addition to the fingers.

Diagnosis

• Carpal tunnel syndrome is diagnosed with nerve conduction tests, EMG, and sometimes MRI of the wrist.
• Cervical radiculopathy requires neck MRI or CT scans, X-rays, and EMGs to pinpoint the compressed nerve root.

Being aware of these key differences can help doctors correctly identify and treat the underlying cause of a patient's hand and arm symptoms.

Preventing Carpal Tunnel Syndrome and Cervical Radiculopathy

While some risk factors for carpal tunnel and cervical radiculopathy cannot be avoided, certain lifestyle measures can help reduce your chances of developing them.

Preventing Carpal Tunnel Syndrome

• Use ergonomic wrist pads and equipment setups
• Take breaks from repetitive tasks frequently
• Stretch wrists and hands often
• Wear splints to keep wrists neutral
• Maintain a healthy body weight
• Treat medical conditions like diabetes, hypothyroidism, and arthritis

Preventing Cervical Radiculopathy

• Use proper posture and ergonomics when working
• Strengthen neck muscles with exercise
• Avoid lifting heavy objects improperly
• Manage arthritis with medication, weight loss, and joint protection
• Use a cervical pillow to maintain neck alignment when sleeping
• Treat injuries promptly to prevent chronic issues

Implementing healthy work habits, managing medical conditions, strengthening muscles, and utilizing proper biomechanics can help keep both carpal tunnel syndrome and cervical radiculopathy at bay.

The Takeaway

Carpal tunnel syndrome and cervical radiculopathy are two distinct conditions that can cause pain, numbness, and tingling from the shoulder down through the arm and hand. Understanding the key differences in their causes and presentation is vital for prompt, accurate diagnosis and treatment.

Being aware of risk factors and utilizing preventative strategies for both conditions can also help reduce an individual's chances of developing them. Seeking prompt treatment and tailored rehabilitation can then help resolve symptoms and restore function if they do occur.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.