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Economic Impact of Hand and Wrist Pain
The Bureau of Labor Statistics estimated just over 51,000 injuries or illnesses of the hand and wrist that resulted in time away from work in 2001. Over 26,000 of these were due to carpal tunnel syndrome while musculoskeletal disorders like arthritis contributed to over 23,000 incidences. If you are experiencing hand or wrist pain, you may be unsure how to tell if you have arthritis or carpal tunnel syndrome. Knowing the difference in symptoms of each disorder can help patients get the optimum care that they need in order to get back to work.
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Carpal Tunnel Syndrome
Approximately 27 days of work are lost to illness for patients with carpal tunnel syndrome. Carpal tunnel syndrome is a common problem where the median nerve in the arm becomes trapped in a 'tunnel' of bones and ligaments in the wrist. It is most often diagnosed in women age 30 to 50. Carpal tunnel syndrome is associated with other medical problems, including:
- rheumatoid arthritis
- hypothyroidism and other endocrine disorders
- patients on dialysis
Symptoms of carpal tunnel disease include numbness or tingling in the thumb and first fingers because these fingers are controlled by the median nerve. Patients may also experience pain that shoots from the hand to the arm and shoulder as well as weak grip strength. The little finger is not affected because it is not controlled by the median nerve. Burning pain occurs on the palm side of the hand. People may find themselves shaking their hand to try to improve sensation. Carpal tunnel syndrome often affects only the hand used most often, though some people may experience symptoms in both hands. Nerve study tests and physical examination by a medical professional are most helpful in diagnosing carpal tunnel syndrome.
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Rheumatoid and Osteoarthritis
Though patients with carpal tunnel syndrome often have arthritis pain too, the symptoms are very different. There are two main types of arthritis, osteoarthritis and rheumatoid arthritis. Arthritis affects the joints like those in the fingers, hands and wrist. People with arthritis experience symptoms different from carpal tunnel syndrome including:
- joint pain
- swollen, deformed joints
- stiffness in the morning
- warmth or redness around the joint
Osteoarthritis is associated with joint wear over time or after an injury to a joint. Rheumatoid arthritis is an autoimmune disease where the patient's immune system attacks the joints, leading to inflammation. People with rheumatoid arthritis will have abnormalities in blood tests that help to distinguish it from carpal tunnel syndrome or other forms of arthritis. Both osteoarthritis and rheumatoid arthritis can lead to deformities in the joints in the fingers that are not found in patients who only have carpal tunnel syndrome. Plain X-rays are helpful for diagnosing these bony changes in the joints and one way to tell if you have arthritis or carpal tunnel syndrome.
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What to Do with Hand and Wrist Pain
People experiencing hand or wrist pain should see their healthcare provider, especially if they are missing days of work due to the pain. An evaluation for the cause of the problem is needed so that the appropriate treatment can be started. Patients can expect X-rays or other imaging and bloodwork to help determine the cause of their symptoms.
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Number of nonfatal injuries associated with days away from work. U.S. Bureau of Labor Statistics. Accessed October 18, 2010. - http://www.bls.gov/iif/oshwc/osh/case/ostb1154.pdf
Days away from work are highest for carpal tunnel syndrome. U.S. Bureau of Labor Statistics. Accessed October 18, 2010. - http://www.bls.gov/opub/ted/2001/apr/wk1/art01.htm
CARPAL TUNNEL SYNDROME. The Merck Manual Online Library. Accessed October 18, 2010. - http://www.merck.com/mmpe/sec04/ch042/ch042f.html#sec04-ch042-ch042f-992
Carpal Tunnel Syndrome Symptoms. MayoClinic Online. Accessed October 18, 2010. - http://www.mayoclinic.com/health/carpal-tunnel-syndrome/DS00326/DSECTION=symptoms
Arthritis. MedlinePlus. Accessed October 18, 2010. - http://www.nlm.nih.gov/medlineplus/ency/article/001243.htm
Osteoarthritis. Arthritis Foundation. Accessed October 18, 2010. - http://www.arthritis.org/disease-center.php?disease_id=32