Tingling, numbness, and hand pain—these are hallmark symptoms of carpal tunnel syndrome (CTS), a condition caused by pressure on the median nerve in the wrist. But what if you’ve been told you have carpal tunnel, yet treatments aren’t working?
It’s not uncommon to be misdiagnosed, especially when other conditions mimic the same symptoms. In fact, two medical issues are frequently confused with CTS, potentially delaying proper treatment.
Let’s explore two conditions that are often misdiagnosed as carpal tunnel syndrome and how to tell them apart.
1. Cervical Radiculopathy (Pinched Nerve in the Neck)
What It Is:
Cervical radiculopathy occurs when a nerve in the neck (cervical spine) becomes compressed or irritated—often due to herniated discs, arthritis, or bone spurs.
Also read: Things to Avoid with Degenerative Disc Disease
Why It’s Confused with CTS:
The affected nerves travel from the neck down into the arms and hands, causing symptoms like:
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Numbness or tingling in fingers
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Arm or shoulder pain
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Muscle weakness in the hands
These overlap heavily with carpal tunnel symptoms.
Key Differences:
| Feature | Carpal Tunnel Syndrome | Cervical Radiculopathy |
|---|---|---|
| Origin | Wrist/hand | Neck/spine |
| Pain Location | Wrist, palm, first 3 fingers | Neck, shoulder, upper arm, hand |
| Trigger | Wrist movement, repetitive use | Neck posture, head turning |
| Relief | Wrist splints, hand therapy | Physical therapy, spinal decompression |
Pro Tip: If your symptoms include shoulder or neck pain, ask your doctor to evaluate your cervical spine with imaging (MRI or X-ray).
2. Thoracic Outlet Syndrome (TOS)
What It Is:
TOS occurs when nerves or blood vessels between the collarbone and first rib are compressed. It’s commonly seen in people with poor posture, trauma, or repetitive overhead movements.
Why It’s Misdiagnosed as CTS:
Like CTS, TOS causes:
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Numbness or tingling in the hands or fingers
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Arm fatigue
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Weak grip strength
Since both involve nerve compression affecting hand sensation, doctors can easily confuse one for the other—especially in early stages.
Key Differences:
| Feature | Carpal Tunnel Syndrome | Thoracic Outlet Syndrome |
|---|---|---|
| Cause | Compression in wrist | Compression in neck/shoulder region |
| Symptoms Worsen With | Wrist use (typing, driving) | Raising arms above head |
| Other Signs | No swelling | Possible arm discoloration, swelling |
| Diagnostic Test | Nerve conduction studies | Adson’s test, imaging of thoracic outlet |
Symptoms like tingling, pain, and weakness are non-specific, and most people assume it’s a wrist problem. Busy clinics may rely on quick exams without full neurologic assessments.
Important Note: Electromyography (EMG) and nerve conduction studies can help differentiate between wrist-based and spine-based nerve compression.
Why Getting the Right Diagnosis Matters
A misdiagnosis doesn’t just waste time—it can worsen the condition.
Risks of Misdiagnosis:
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Unnecessary surgery (e.g., carpal tunnel release)
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Ongoing pain and dysfunction
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Missed opportunity to treat the real problem early
Correct Diagnosis = Correct Treatment. If therapy or splints aren’t helping, seek a second opinion from a neurologist, spine specialist, or physical medicine physician.
FAQs: What People Also Ask
What are symptoms that mimic carpal tunnel syndrome?
Cervical radiculopathy and thoracic outlet syndrome both mimic CTS with similar symptoms like hand numbness, tingling, and weakness.
How do doctors tell the difference between CTS and similar conditions?
They use a combination of physical exams, patient history, and diagnostic tools like EMG, MRI, or provocative tests (like the Adson’s test for TOS).
Can carpal tunnel be misdiagnosed on an EMG?
Yes. EMG accuracy depends on technique and timing. A false negative can occur if the test is done too early or on a mild case.
Final Thoughts: Trust Your Symptoms, Not Just the Diagnosis
Carpal tunnel syndrome is common—but it’s not always the correct label. If you’ve been diagnosed with CTS but your symptoms don’t improve, it’s worth asking: Could it be something else?
Recognizing cervical radiculopathy and thoracic outlet syndrome as look-alike conditions can mean the difference between months of frustration and real, lasting relief.
Your hands deserve more than guesswork. Get evaluated, ask questions, and advocate for clarity in your care.
Also read: How to Tell If a Sinus Infection Has Spread to the Brain
