Trucker MD
Carpal tunnel syndrome and tendonitis, what’s the diff?

By John McElligot, MD

I think I have carpal tunnel syndrome, mostly in my right hand but a little in the left. Numbness, tingling, pain that shoots up my inside forearm and toward the elbow. It really hurts when I grip the wheel or my coffee cup. It has been going on for a long time but just got worse. I went to the work comp doc last week and was diagnosed with “sprained wrist.”

The cause of carpal tunnel syndrome is difficult to establish as work-related for drivers. This is because, right off the bat, risk factors such as obesity, diabetes, hypothyroidism and repetitive motion must be ruled out. I will caution you that a workers’ compensation doctor will usually not confirm causality. And that’s because the definition of repetitive motion is doing something six times per minute in a manner that would cause thickening of the carpal ligament of the wrist.

Whether this is your first episode or is recurrent episodes, you need to get evaluated and treated. The longer you let the pain persist, the more likely you are to develop chronic carpal tunnel syndrome. And even with surgery you may not be relieved of all the pain.

My husband is a truck driver, and we think he has carpal tunnel syndrome from his fingers being wrapped around the steering wheel so much. How do you make sure that’s what it is?

The cause of chronic carpal tunnel syndrome can be varied and complex and difficult to diagnose. First you’ll need to establish the diagnosis with a nerve conduction study. If confirmed and risk factors are identified, then appropriate therapy and hand/wrist splints are recommended. Also, steroid injections and/or surgery can be done to treat the problem.

What are some risk factors for carpal tunnel syndrome?

One of the risk factors is obesity, especially in patients with bilateral carpal tunnel syndrome because the fat deposits in the wrist compress the median nerve and cause symptoms in the hands and fingers with repetitive gripping. Other risk factors are diabetes, hypothyroidism, and scar tissue from previous surgeries coexisting with any of the above listed risk factors.

I am a driver. Years ago I had carpal tunnel syndrome bad. It got better and I thought I was healed, but now I have problems again. Is this possible?

Recurrence of symptoms in a previously diagnosed patient with carpal tunnel syndrome is not uncommon.

I thought I had carpal tunnel syndrome, but the work comp doc says it is tendonitis. What is the difference?

The difference is that tendonitis is the inflammation of a tendon, and carpal tunnel syndrome is compression and inflammation of a median nerve.LL

John McElligott is an MD, Fellow of the American College of Physicians, and medical director of the St. Christopher Truckers Development and Relief Fund. This column is the opinion of the writer and does not necessarily reflect the opinions of Land Line Magazine or its publisher.