Is it carpal tunnel or tendonitis?

Numbness and tingling point to carpal tunnel syndrome. Pain that gets worse when a tendon moves points to tendonitis. Carpal tunnel is a nerve problem, so it changes feeling in a fixed set of fingers, mostly the thumb, index and middle fingers. Tendonitis is a tendon problem, so it hurts over the tendon and flares with use. Both can ache in the wrist, which is why the pattern of symptoms, and a clinician's examination, decides the question.

Numbness points to the nerve, and pain alone does not

Carpal tunnel syndrome is excessive pressure on the median nerve at the wrist ¹. Its classic sign is numbness and tingling, mainly in the thumb, index, middle and ring fingers, and often at night ².

Tendonitis is inflammation of a tendon, the cord that joins muscle to bone. The NHS lists its main symptoms as pain in a tendon that gets worse when you move, difficulty moving the joint, a grating or crackling feeling, and swelling ³. None of these is numbness. If numbness is your main complaint, a nerve problem is more likely than tendonitis.

Pain is where the two overlap. The NHS Inform leaflet on carpal tunnel says people may feel pain in the hands, sometimes the wrist or forearm, and sometimes further up the arm ⁴. So an ache in the wrist does not on its own mean carpal tunnel, and it does not rule it out.

The fingers that go numb are the clearest clue

The median nerve supplies feeling to the skin of the thumb, index finger, middle finger and half of the ring finger ⁵. If the numbness falls in that set, carpal tunnel is the leading cause to check. A tendon problem is felt over the tendon itself, and numbness is not on the NHS list of tendonitis symptoms ³.

If the numbness is in the ring and little fingers instead, the ulnar nerve is the one to check ⁶, and it can be squeezed at the elbow. That comparison has its own page: carpal tunnel or cubital tunnel syndrome.

Tendonitis can follow overuse, but the typing link to carpal tunnel is weaker

Tendinitis can occur as a result of injury or overuse ⁷. Typing is one repetitive task, so a tendon ache that starts when your workload rises fits tendonitis. That source describes the risk in general terms and does not show how often typing causes tendonitis.

For carpal tunnel, the typing evidence is weaker. Studies have not proved that typing, mouse use or other repeated movements cause carpal tunnel syndrome ⁸. A typing history therefore does not decide between the two, and the symptom pattern matters more.

A clinician's examination settles it

No single test is decisive for carpal tunnel, so clinicians combine the history with the examination. Individual tests such as Phalen's are useful but imperfect.

A clinician who suspects tendonitis looks for swelling, tenderness and pain when the tendon moves. A clinician who suspects carpal tunnel tests sensation and grip, and may order nerve tests. The two can be present together, so the examination checks both the wrist and the tendons.

What to do now

1. Note the fingers that go numb, and whether it happens at night.
2. Note the spot that hurts and the movement that sets it off.
3. Reduce the repeated movement for a few days and see whether an ache eases. This is a reasonable first step for an ache, but not for numbness that persists.
4. See a GP if the symptoms get worse or do not go away. The NHS gives that advice for carpal tunnel ⁹.

While you find out, cutting keystrokes helps. Dictation for RSI and carpal tunnel covers how voice can take over some of the typing load. For the full set of causes, see hand and wrist pain from typing, and for the nerve itself, the carpal tunnel syndrome guide. Our accessibility and health overview covers the wider subject. If the pain sits at the base of the thumb, the de Quervain's comparison is the next question to check. The median nerve and tendinitis entries define the two terms used here.