Tendonitis vs. Carpal Tunnel: Symptoms, Causes, Treatment

If your wrist has started sending you passive-aggressive messages in the form of pain, tingling, or stiffness,
you’re not alone. Two of the most common culprits are tendonitis and
carpal tunnel syndrome. They often show up together, they can both stem from overuse, and
they both make everyday tasksfrom typing to opening jarsway more annoying than they should be.

But here’s the key difference in one sentence: tendonitis affects the tendons that connect
muscle to bone, while carpal tunnel syndrome affects the median nerve as it passes through
a narrow tunnel in your wrist. Same neighborhood, different structures, different treatment plans.

In this guide, we’ll break down tendonitis vs. carpal tunnel in plain English: what each one is, how their
symptoms differ, what causes them, and how doctors typically treat them. We’ll also go through real-life
experiences and practical tips so you can better understand what might be going onand when it’s time to
get professional help.

Understanding the Basics: Tendon vs. Nerve

What is tendonitis?

Tendonitis (also spelled tendinitis) means inflammation or irritation of a tendonthose
tough, rope-like cords that attach muscle to bone. When a tendon is overloaded or repeatedly stressed, it can
become painful, swollen, and stiff. Tendonitis can happen almost anywhere in the body, but common spots
include the shoulder, elbow, knee, Achilles tendon, and wrist.

In the wrist and hand, tendonitis often shows up in people who do repetitive motions: typing, using tools,
playing racquet sports, or scrolling on a phone like it’s a full-time job. Over time, tiny microtears and
irritation in the tendon lead to inflammation and pain.

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is a nerve problem. The median nerve runs from
your forearm into your hand through a narrow passageway in your wrist called the
carpal tunnel. This tunnel is crowdedit also contains several flexor tendons.
When swelling, inflammation, or structural changes reduce the space in that tunnel, the median nerve gets
compressed.

That compression leads to the classic CTS symptoms: numbness, tingling, and weakness in the thumb, index,
middle, and part of the ring finger. Unlike tendonitis, carpal tunnel is a nerve compression syndrome, not
primarily a tendon problem.

Tendonitis vs. Carpal Tunnel: How Symptoms Feel Different

Because both conditions can cause wrist pain and discomfort, it’s easy to confuse them. But paying close
attention to the pattern of symptoms can offer some clues.

Common symptoms of tendonitis

• Pain located over a tendon, often on the front or back of the wrist or near the thumb.
• Pain that worsens with movement or when you use the affected muscle or tendongripping, lifting, or twisting.
• Localized swelling or warmth around the tendon.
• Stiffness, especially after rest or in the morning.
• Sometimes a creaking or grating sensation when moving the tendon.

In short, tendonitis usually screams, “It hurts when I use this specific part,” and the pain is often sharply
tied to a particular motion.

Common symptoms of carpal tunnel syndrome

• Numbness and tingling in the thumb, index, middle, and half of the ring finger.
• Symptoms that worsen at night or when the wrist is bent for long periods (like sleeping or holding a phone).
• Burning, “pins and needles,” or electric-shock sensations in the hand or fingers.
• Hand weaknesstrouble gripping, dropping objects, difficulty buttoning shirts or opening jars.
• A feeling of the hand “falling asleep,” especially when driving, reading, or typing.

The big giveaway? Tingling and numbness are nerve symptoms. Tendonitis usually doesn’t
cause persistent tingling, while numbness that consistently follows the median nerve pattern is a red flag
for carpal tunnel syndrome.

Causes and Risk Factors

What causes tendonitis?

Tendonitis is commonly linked to:

• Overuse and repetitive motion (typing, using tools, sports that involve gripping or swinging).
• Sudden increase in activityfor example, taking up pickleball intensely over one weekend after months of couch time.
• Poor technique or ergonomics, such as awkward wrist position while working or gaming.
• Age-related changes: tendons naturally become less elastic and more prone to injury over time.
• Systemic conditions like rheumatoid arthritis or diabetes, which can affect tendon health.

Essentially, tendonitis is your tendon’s way of saying, “I was not trained for this workload.”

What causes carpal tunnel syndrome?

Carpal tunnel syndrome is caused by increased pressure in the carpal tunnel that compresses
the median nerve. Factors that can contribute include:

• Repetitive or sustained wrist flexion or extension (bent-wrist positions over time).
• Swelling of tissues from inflammation, arthritis, or tendon problems in the tunnel.
• Hormonal and fluid changes, such as pregnancy, menopause, or thyroid issues.
• Underlying medical conditions like diabetes, rheumatoid arthritis, and obesity.
• Anatomical factorssome people simply have a smaller, tighter carpal tunnel.

Contrary to popular belief, computer use alone isn’t always the sole cause, but it can definitely aggravate
existing problems, especially if your posture and workstation setup aren’t doing you any favors.

Diagnosis: How Doctors Tell Them Apart

Because tendonitis and carpal tunnel can overlap in the wrist, self-diagnosing can be tricky. A healthcare
professionaloften a primary care doctor, orthopedist, neurologist, or hand specialistwill usually:

• Take a detailed history of your symptoms, job, hobbies, and when the pain started.
• Perform a physical exam:
  • For tendonitis: pressing along the tendon and asking you to move against resistance to reproduce pain.
  • For CTS: specific tests like Phalen’s maneuver (bending the wrist) or Tinel’s sign (tapping over the nerve) to trigger tingling.
• Order imaging or tests if needed:
  • Ultrasound or MRI in some tendon cases.
  • Nerve conduction studies and electromyography for suspected carpal tunnel syndrome.

In many cases, your description of symptoms plus a focused exam is enough to point strongly toward tendonitis
versus carpal tunnelor reveal that you might actually have a mix of both.

Treatment Options for Tendonitis

The good news: many tendonitis cases improve with conservative (nonsurgical) care. Common
approaches include:

RICE and activity modification

• Rest: giving the tendon time off from the activity that triggered it.
• Ice: 15–20 minutes several times a day to reduce pain and swelling.
• Compression: a soft wrap or brace if recommended.
• Elevation: keeping the wrist elevated when swollen.

Medication and therapy

• Over-the-counter pain relievers like ibuprofen or naproxen (if safe for you) can reduce inflammation and discomfort.
• Physical or occupational therapy to:
  • Improve strength and flexibility of the muscles and tendons.
  • Correct posture and movement patterns that overload the tendon.
  • Teach you safer ways to perform repetitive tasks.
• Bracing or splints to temporarily support the tendon while it heals.

Injections or surgery (for severe cases)

For stubborn tendonitis that doesn’t respond to rest, therapy, and medications, your doctor might consider:

• Corticosteroid injections to calm inflammation around the tendon.
• Other procedures, such as platelet-rich plasma (PRP) injections in select cases.
• Surgery to repair a severely damaged or torn tendon, though this is relatively uncommon for typical wrist tendonitis.

Treatment Options for Carpal Tunnel Syndrome

Because carpal tunnel involves nerve compression, the goal is to relieve pressure on the median nerve.

Conservative treatments

• Wrist splints, especially at night, to keep the wrist in a neutral position and reduce pressure on the nerve.
• Activity changes to avoid prolonged wrist flexion or extension and improve ergonomics.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) for short-term symptom relief.
• Corticosteroid injections into the carpal tunnel to reduce swelling and improve symptoms, at least temporarily.

When is surgery recommended?

If symptoms are severe, persist despite conservative care, or if there is clear nerve damage or muscle
weakness, doctors may recommend carpal tunnel release surgery. During this procedure, the
surgeon cuts the ligament forming the roof of the tunnel to create more space for the median nerve.

Many people experience significant relief after surgery, but recovery can take weeks to months. Hand therapy
is often helpful for regaining strength and function.

Prevention and Everyday Habits

You can’t bubble-wrap your wrists, but you can lower your risk of tendonitis and carpal tunnelor prevent
flare-upsby building better habits:

• Set up an ergonomic workspace: keep wrists in a neutral, straight position; adjust keyboard and mouse height; consider a supportive chair and desk setup.
• Take microbreaks every 30–60 minutes to stretch fingers, wrists, and shoulders.
• Vary your tasks so you’re not repeating the same motion for hours.
• Strengthen and stretch your forearm and hand muscles as part of a regular routine.
• Manage underlying conditions such as diabetes, thyroid disease, or inflammatory arthritis with your healthcare provider’s guidance.
• Listen early: if your wrist or hand is sending “something’s off” signals, don’t ignore them for months.

When to See a Doctor

It’s time to seek medical advice if:

• Wrist or hand pain has lasted more than a few weeks and isn’t improving with rest.
• You have persistent numbness or tingling, especially at night or in the median nerve pattern.
• You notice weakness, dropping objects, or difficulty performing fine motor tasks.
• Swelling, redness, or warmth is severe, or you suspect an acute injury or infection.

Early evaluation can prevent long-term nerve damage and help you avoid chronic pain. And remember: this
article is for information and education onlyit’s not a substitute for personal medical advice, diagnosis,
or treatment from a qualified professional.

Real-Life Experiences and Lessons Learned

Medical definitions are helpful, but real life is messy. Many people only figure out the difference between
tendonitis and carpal tunnel the hard waythrough trial, error, and a lot of late-night wrist shaking.

The “weekend warrior” tendonitis story

Imagine someone who works at a desk all week and decides that Saturday is “home improvement day.” They spend
eight hours gripping power tools, painting, and lifting boxes without any warm-up. Sunday morning, their wrist
feels like it’s been hit with a tiny hammer every time they twist a doorknob or pick up a mug.

That patternsharp pain with specific movements, tenderness over a narrow area, and soreness
that worsens with useis classic for tendonitis. Rest, ice, temporary bracing, and a more gradual approach to
DIY projects usually help. The big lesson here is pacing: tendons hate sudden “from zero to hero” bursts of
activity.

The “my hand falls asleep at night” carpal tunnel story

Another common experience: someone wakes up at 3 a.m. with their hand completely numb from the thumb to the
ring finger. They shake it out, it tingles, then slowly comes back to life. At first, it’s once a week. Then
it’s every night. They start dropping their phone and notice that holding the steering wheel makes their
fingers feel buzzy and weird.

This is the kind of story doctors hear all the time with carpal tunnel syndrome. The nerve
doesn’t like being squished for hours while the wrist is bent during sleep. Wearing a night splint, adjusting
wrist position during the day, and addressing swelling or medical conditions often make a big difference.
When they don’t, that’s when a specialist starts talking about injections or surgery.

When both conditions tag-team your wrist

To make things more interesting, some people have tendonitis and carpal tunnel at the same time.
For example, repetitive work might inflame the flexor tendons running through the carpal tunnel. As they swell,
they increase pressure on the median nerve. The result: a mix of pain with movement (tendon) and numbness or
tingling (nerve).

In real life, this often shows up in people whose jobs or hobbies demand fine hand workhair stylists,
assembly line workers, gamers, musicians, and yes, heavy computer users without good ergonomics. Treatment
may include both anti-inflammatory strategies for the tendons and nerve-focused care, such as splinting and
nerve gliding exercises, under professional guidance.

Practical self-care lessons from experience

People who successfully get on top of tendonitis or carpal tunnel tend to learn a few key habits:

• They respect early warning signs. Mild soreness, fatigue, or occasional tingling is treated as a signal to modify, not ignore.
• They modifynot quitactivities. Instead of giving up a favorite hobby, they adjust technique, use better tools, or take more breaks.
• They get serious about ergonomics. Small changes like raising a chair, using a vertical mouse, or using a wrist rest can be game changers.
• They commit to simple exercises. A few minutes a day of stretching and strengthening can be more powerful than occasional bursts of “I’ll fix this on the weekend.”
• They ask for help sooner. When numbness, weakness, or persistent pain appears, they don’t wait months to talk to a healthcare provider.

Over time, many people find that understanding the difference between tendonitis and carpal tunnel helps them
advocate for the care they need. Instead of just saying, “My wrist hurts,” they can describe whether the main
problem is movement-related pain, tingling and numbness, or both. That kind of detail can speed up diagnosis
and get them on the right treatment path faster.

The Bottom Line

Tendonitis and carpal tunnel syndrome may share the same zip codeyour wristbut they affect different
structures and often need different treatment strategies. Tendonitis focuses on irritated tendons; carpal
tunnel centers on a compressed nerve. Both are common, both are treatable, and both are easier to manage when
you catch them early and listen to what your body is trying (sometimes loudly) to tell you.