Is My Hand Pain from Carpal Tunnel Syndrome or Something Else?

We all wake up sometimes with a numb and tingly hand. But ongoing hand pain and numbness can be a disabling problem that requires diagnosis and treatment.

Here are 3 of the main causes of hand pain and numbness—and tips for how you can tell them apart.

See What Causes Hand Pain and Numbness?

Carpal tunnel anatomyThe median nerve can be irritated in the carpal tunnel at the wrist or at its origin in the cervical spine.
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Carpal Tunnel Syndrome

Carpal tunnel syndrome

When hand pain is experienced, it's common to first suspect carpal tunnel syndrome. This condition is caused by the narrowing of a bony passageway in your wrist, which irritates or compresses the median nerve that runs through it.

Symptoms tend to be in the thumb, index finger, or middle finger, along the path of the median nerve. The pain may wake you up at night or be worse in the morning. In the early stages, shaking your hand may bring relief.

See Cubital Tunnel Syndrome

Rheumatoid arthritis

Another possible cause of hand pain and numbness is rheumatoid arthritis.

Hand pain from rheumatoid arthritis tends to be different from carpal tunnel syndrome in 2 main ways:

  1. It causes pain and stiffness in the large knuckles or joints of the wrist, rather than along a nerve path.
  2. Its pain is symmetrical, meaning it will affect both hands simultaneously.

Read more about hand rheumatoid arthritis on

Cervical radiculopathy caused by spine conditions

While it may not seem obvious, your hand pain and/or tingling may actually be caused by a problem in your neck.

The nerves that give sensation to your hands originate in your cervical spine. When one or more of the 8 nerve roots that exit the cervical spine become irritated, it causes pain and other neurological symptoms down the nerve path. This is known as cervical radiculopathy.

See Cervical Spine Anatomy and Neck Pain

The most common conditions that can trigger radiculopathy include:

Cervical radiculopathy pain can be mildly achy or sharp and stabbing. It can also cause numbness and/or pins-and-needles tingling sensations. Symptoms can affect different sections of the hand depending on what level of the spine is the source of the irritated nerve.

See Radiculopathy, Radiculitis and Radicular Pain

Since carpal tunnel syndrome and cervical radiculopathy can both affect the median nerve, it’s important to note one key difference: Carpal tunnel syndrome pain will only affect the hand and wrist. Cervical radiculopathy from the C6 spine level (where the median nerve originates) will often cause pain and symptoms along the arm and in the bicep, as well as in the hand.

See Spinal Cord and Spinal Nerve Roots

Aside from these 3 causes, hand pain can also be caused by a variety of other conditions, including diabetes and nutritional issues.

See Nutrition and Diet Tips

The best way to tackle hand pain that doesn’t resolve is to see your doctor, who can diagnose the correct cause and start a treatment plan. Many conditions that cause hand pain are more easily treated if they’re caught early.

See Diagnosing Cervical Radiculopathy vs. Other Causes of Hand Pain

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Getting the Right Diagnosis for Numb Fingers

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Dr. Larry M. Parker, Orthopedic Surgeon, Huntsville, AL, 35801
Post written by Dr. Larry M. Parker, MD