"Carpal Tunnel" It Wasn't!

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Medical Author: William C. Shiel Jr., MD, FACP, FACR

The other day I was flying across the country and exited the in-flight lavatory to find my flight attendant standing in the back kitchen.  She was holding an ice pack over her wrist. She spontaneously blurted out in explanation, "My carpal tunnel is acting up". She then showed me where she was having pain and tenderness along the tendon of the thumb side of her wrist.

Carpal tunnel syndrome is numbness, tingling pain, and weakness in the thumb, index and middle fingers as a result of irritation of the median nerve being irritated at the wrist.

In fact, as I next explained to her, she did not have carpal tunnel syndrome at all. She was suffering from a common form of inflammation of the tendon (tendinitis) that extends the thumb called DeQuervain's tendinitis. Her treatment for the acutely injured tendon was correct (rest and ice), but her diagnosis was not.  If her symptoms persisted, they could be completely cured by simple splinting and possibly by a cortisone injection.

Why does it matter what the diagnosis is?  An incorrect diagnosis, even by a patient, can be a serious error. Incorrectly diagnosing oneself can delay appropriate care, lead to inappropriate ingestion of medications, and even encourage a doctor to order an unnecessary and potentially painful or harmful procedure or test. This is particularly true for conditions involving the muscles and joints.