Wrist Pain – Carpal Tunnel or Tendinitis?

carpal tunnel syndrome

If you work at a computer all day you may – like so many of us – fear the dreaded carpal tunnel syndrome. Carpal tunnel syndrome is only one of several possible causes of wrist pain. In this post, I’ll go over the basics of carpal tunnel syndrome including how it makes your wrist hurt, and how to distinguish this condition from tendonitis. I’ll even throw in some prevention tips.

Clarifying Carpal Tunnel Syndrome

Pain due to carpal tunnel syndrome can happen when pressure is put on a nerve in your wrist. This nerve is called the median nerve, and is one of three that traverse under a band of strong connective tissue known as the carpal tunnel. The carpal tunnel band (which has a fancy name I won’t burden you with here) runs perpendicular to the nerves underneath it.

As with all nerves in the human body, the median nerve communicates feelings and movement impulses, in this case, to the hand.

The median nerve is located on the palm side of your wrist. It affects the thumb side of your wrist and hand. Specifically, the median nerve helps you turn your forearm in, and spread out your thumb (away from the palm.) It also helps flex the thumb, index and middle fingers.

When the median nerve is pressured, you might experience numbness, tingling and/or weakness on the thumb side of your hand, plus those first 2 fingers. The location is specific because the median nerve serves just that area – only. (The other two wrist nerves, i.e., the ulnar and radial, supply signals to different areas of the wrist and hand.)

Regardless of location, numbness, tingling and weakness are classical signs of nerve disruption. In the case of median nerve pressure, wrist or forearm muscles might be affected, as well.

Carpal Tunnel Syndrome or Wrist Tendinitis?

Carpal tunnel syndrome is often mistaken for other wrist pain diagnoses. Perhaps the most common of these are tendinitis of the wrist. But the two conditions are different. They affect different structures that may lead to wrist pain, and their symptoms are not the same.

With carpal tunnel, you’ll likely get the nerve symptoms mentioned above. In the case of tendinitis of the wrist, you may experience symptoms of inflammation like redness, swelling or pain.

Either way, if the symptoms really bother you, get them checked by an orthopedic M.D. Generally speaking, getting symptoms checked early can only help you, especially in terms of managing long term pain and dysfunction.

The doc might give you a nerve conduction test, especially if you’ve got those tingling, numbness and weakness type symptoms. A nerve conduction test is the best way to figure out if you’ve got carpal tunnel syndrome. And having one as soon after you start noticing the nerve symptoms is generally the best idea.

Inside the Carpal Tunnel – A Delicate Balance of Structures

carpal tunnel syndromeThe carpal tunnel is quite narrow. This means that the three nerves located on the inside have to fit together snugly.

It’s a delicate balance for the nerves in the tunnel to stay close to – but not actually touch – one another. That said, when the structures inside the tunnel fit well and don’t bump into each other, you likely will not experience wrist pain or strain. When they do, symptoms may ensue.

Change the Following Work Habits

A number of habits we computer user may have can precipitate a bout of carpal tunnel syndrome. If you repeatedly do any of the following, you may want to reconsider how your hands and forearms interact with your desk, mouse and/or keyboard.

Contact Stress

Resting your wrist on the edge of your desk, especially when you do concentrated mousing work, and especially when the edge is sharp, is associated with a carpal tunnel syndrome risk factor known as contact stress.

Poor Wrist Positioning

Do you type with misaligned wrists? (Think “clawed” position of hands and shoulders…) If so, this is another way you may be upping your carpal tunnel risk.

Generally, posture experts and ergo consultants like to see wrists in “neutral.” You’ve achieved neutral wrist posture when your hands and fingers are extensions of the forearm. (Your wrist will be bent neither forward or back.) But you might experiment with your keyboard in “negative tilt,” where the numbers on your keyboard are higher than the space bar. This gives a bit more support to the wrist joint.

To get a negative tilt on your keyboard, you can purchase a keyboard tray. The keyboard tray should be one that at least has that negative tilt adjustment. The below Amazon ads (DISCLOSURE: I am an affiliate.) are all tilt adjustable. The 3M is a good brand, as is Kensington.

Limited Shoulder Motion

Let’s face it. Computer work is sedentary – with a capital S. When you’re stuck in a “hunchback” position all day, it’s really easy to forget that certain body parts – like shoulder blades – can actually move. Chances are, if your shoulder blades are misaligned, you’re also working with way too much tension in the forearm, wrist, hand and fingers. This extra tension is a compensation, because your shoulder blades are stuck, and as a result, your forearms and wrists don’t get the support they need for free and easy movement, so they work harder.


Another carpal tunnel risk factor is repetitive motion. This means constant keying and/or mousing. Interestingly, carpal tunnel syndrome happens more in females than males. Could this be because, typically, more women hold office support positions and therefore, do more keying than men? I’m not sure, but pregnant women are at an even higher risk, plus the software development field has WAY more men than women. So possibly not.

Either way, you should understand your carpal tunnel syndrome risk.

Actionable Science

Research suggests two important things I’d like to leave you with. First, an ounce of prevention is worth a pound of cure.

Start implementing better habits now, and also consider purchasing workstation accessories to help you avoid pressure at the wrists. Don’t wait until you get those nerves symptoms, because at that point, it may be too late. Research says that once you have these, there’s little you can do to relieve the pressure on the wrist that started the whole thing in the first place.

Which leads me to my second research based tidbit.

Studies show that  a combination of a vertical mouse and a wrist rest works best for prevention. The vertical mouse places your forearm, wrist, hands and fingers in the handshake position which tends to be much less stressful on those joints. Use a wrist rest to help prevent excessive contact stress (which we discussed above.)

As far as vertical mice go, they come in a variety of feature packages. One high quality brand is Evoluent. With Evoluent vertical mice, you just need to pick the one corresponding to your dominant hand and all will likely be taken care of. No need to figure out which bell or whistle is right for you. It’s all in the design.

Prevent Carpal Tunnel with the Evoluent Vertical Mouse (DISCLOSURE: I am an affiliate.)

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