What does it mean if you’re having numbness, tingling, dull, achy pain in your hand(s) and forearm. Carpal Tunnel Syndrome, Tennis Elbow, and de Quervain Tendonitis are commonly seen in primary care and pain management specialties. The symptoms of all three conditions present in similar ways; therefore, a thorough assessment must be performed. In order to rule out cervical neuropathic pain, a CT or MRI of the Cervical must be done. In this article, I will distinguish the characteristics between all three ailments. Carpal Tunnel Syndrome, Tennis Elbow, and de Quervain Tendonitis are treatable.

Carpal Tunnel Syndrome numbness, tingling, dull, achy pain in your hand(s) and forearm

1. Carpal Tunnel Syndrome 

Carpal Tunnel Syndrome presents as numbness and tingling pain in the wrist that radiates in the hand(s) and forearm(s). The sensations occur as a result of the median nerve  being compressed by swelling, trauma to the wrist, and cyst formation. This tends to occur when patients use repetitive hand movements (hair stylists, typists, mechanics, seamstresses, etc.). Numbness and tingling sensations occur in the 3rd, 4th, and 5th digits of the hand(s), wrist pain is present, and neuropathic pain travels up the forearm and stopping at the elbow. If not treated quickly, overtime, patients will lose the ability to work with small objects. They will have a decline in “pinch” movements, a decrease in grip strength, increase in hand weakness, increase in dropped objects. If this is happening to you, please contact your primary care physician for an appointment as soon as possible. Your physician may perform the following hand and wrist assessment: Tinel test (Tapping on the media nerve). If you experience an increase in tingling sensations, this is a positive sign for Carpal Tunnel. Phalen’s Maneuver (the bending of the hands with the wrist touching). An increase in tingling sensations during this test is a positive sign for Carpal Tunnel). The treatment plan may include NSAIDs (Ibuprofen, Aleve, Advil, Naproxen, etc.), a splint to be worn at bedtime to protect your wrist, and a referral to a hand surgeon for Carpal Tunnel Release Syndrome.

2. Tennis Elbow (Lateral Epicondylitis)

numbness, tingling, dull, achy pain in your hand(s) and forearmIf you’re having pain that occurs on the outer portion of the elbow and upper forearm, then you may have Tennis Elbow. It’s an inflammation of the tendons that connect the forearm muscles on the outer portion of the elbow. Not only does tennis elbow occur in patients who play tennis, it can also occur in patients who perform repetitive motions and forceful hand grips that increase tension in the forearm muscles. The best treatment plan is NSAIDs and a referral from your primary care physician for physical therapy (strengthening, massages, ice, heat, and TENS unit).

3. de Quervain Tendonitis (A.K. A. Thumb Texting Syndrome)

Thumb Texting SyndromeDoes the base of your thumb and palm ever feel sore after a long day of texting, after gripping heavy weights, or after performing any form of repetitive motion that involves using your thumb(s)? Do you have tightness in your forearm(s)? If so, you may have de Quervain Tendonitis, which occurs when the tenders around the base of the thumb and medial side of wrist become stiff. The pain in your palm, base of the thumb and joint, and forearms can be relieved by decreasing repetitive movements, receiving hand and forearm massages, stretching the palm of the hand and forearm, and taking NSAIDs.

References:

Jennings, C., and Faust, K. (2016). OrthoInfo: Carpal Tunnel Syndrome. Retrieved from https://orthoinfo.aaos.org/en/diseases–conditions/carpal-tunnel-syndrome/

Love You. (2019). Carpal tunnel syndrome infographic, health concept. flat design illustration. businessman. Businessman wrist pain. [Diagram].

Ben, J.B. (2019). Hand anatomy with red highlight on wrist pain. Wrist pain may cause from muscle strain, tendinitis, ligament sprain, arthritis, nerve entrapment or carpal tunnel syndrome disease. medical symptom.

Alila Medical Media. (2019). Tennis elbow condition labeled. [Illustration]

Mayo Clinic. (2019). Tennis Elbow. Retrieved from https://www.mayoclinic.org/diseases-conditions/tennis-elbow/symptoms-causes/syc-20351987

Academy of Orthopedic Surgeons. (2013). OrthoInfo: De Quervain’s Tendinosis. Retrieved from https://orthoinfo.aaos.org/en/diseases–conditions/de-quervains-tendinosis/

Ben, J.B. (2019). Hand anatomy with red highlight on wrist pain. Wrist pain may cause from muscle strain, tendinitis, ligament sprain, arthritis, nerve entrapment or carpal tunnel syndrome disease. medical symptom