It's hard to imagine, but the chances that your doctor will give you a carpal tunnel misdiagnosis are high. (That means telling you that you have carpal tunnel, when you actually don't.) According to a report by the National Institutes of Health (NIH), the rate of diagnosing your symptoms as carpal tunnel (when it's something else ) is over 83%.

The common "next-step" is for doctors to advise patients with severe symptoms to have carpal tunnel surgery. But why have this surgery when you don't have carpal tunnel syndrome?

You might think, “My doctor doesn’t misdiagnose!” And maybe you're one of the lucky ones where this is true. But the high rate of carpal tunnel misdiagnoses forced the NIH in 2010 to warn doctors. The warning asks doctors to double check their findings due to the huge (and unnecessary) jump in surgeries as a result of a carpal tunnel misdiagnosis. 

• FIND OUT: do you have carpal tunnel? No strings attached self-test.

Along with the American Academy of Orthopedic Surgeons, the NIH told doctors to advise patients to use all non-surgical options first to treat their hand problems before considering surgery. Carpal tunnel release surgery is a huge commitment of time, money, and pain. Yet, it often fails - largely because the patient never had carpal tunnel to start with! 

That's why the NIH announcement was an important milestone for all doctors and patients.

If you have finger, hand, or wrist pain or numbness, your first step might be to search the internet for what’s causing the discomfort. You soon realize it looks like carpal tunnel symptoms. And it’s the overwhelming probability given how many people actually have this disorder. 

However, you might instead have wrist flexor tendinitis - a condition that's 10 times more prevalent.

A surprising finding by the NIH is that your own doctor may not recognize the difference between these two conditions. It’s a big problem because:

• If the doctor can misdiagnose carpal tunnel as wrist tendonitis, then the carpal tunnel syndrome goes untreated and worsens.
  
  
• If the doctor can misdiagnose tendonitis as carpal tunnel syndrome, then surgery is usually recommended. But it will fail because there is no carpal tunnel to begin with. 

Therefore, a carpal tunnel misdiagnosis by your doctor can result in needless pain, suffering, lost job time, and even unnecessary surgery.

Carpal tunnel syndrome and wrist tendinitis are very similar. In fact, carpal tunnel syndrome essentially IS wrist flexor tendinitis that’s focused inside the wrist joint. 

Both conditions can be painful. Also, both cause numbness, tingling (or "pins & needles"), burning, and loss of pinch and grip strength. However, that’s where the similarities end.

You can tell the difference between carpal tunnel syndrome and wrist tendonitis relatively easily. This way you can double-check your doctor to insure he/she didn't give you a carpal tunnel misdiagnosis.

For testing carpal tunnel syndrome, use the Phalen, Tinel, and Durkan tests. These are the exact same tests an experienced doctor uses in the office. The illustration above shows how they're performed.

Phalen test: Bend your affected hand 90 degrees. Hold it for 60 seconds. (You can push against a a wall to hold it.) It's positive for carpal tunnel syndrome if you feel symptoms in your fingers like numbness, tingling or pain.

Tinel test: Use your opposite forefinger to vigorously tap the wrist crease on the affected hand. Tap hard several times. If it makes your fingers tingle or reproduces your symptoms, then it's positive for carpal tunnel syndrome.

Durkan test: Use your opposite thumb to press the area of your palm as shown above. Press hard, and hold it for 60 seconds. A positive sign for carpal tunnel syndrome is when symptoms like pain, tingling, or numbness are felt in the fingers.

For wrist tendonitis: Perform the percussion test as shown in the picture above. Tap your affected forearm from you wrist to half-way up your forearm. Tap hard, and up and down as well as left to right. Essentially, tap you entire lower forearm vigorously. You're positive for wrist tendonitis if you feel symptoms either where you're tapping or in your hand.

See this link for a step-by-step tutorial about how tell the difference.

Carpal tunnel syndrome and wrist tendinitis start with one basic problem: inflammation of wrist and forearm tendons. However, they are different disorders because of what causes them to be painful.

Wrist tendonitis: In wrist tendinitis the tendons or their sheaths (coverings) are inflamed. They swell with fluid and irritate tiny nerve endings around them. Therefore, it's overall inflammation and swelling that causes the symptoms of tendonitis.

Carpal tunnel syndrome: In carpal tunnel syndrome, the tendons also swell with fluid. However, the swelling happens ONLY deep inside the wrist joint. The swelling exerts pressure directly on the adjacent median nerve, and crushes it.  Therefore, it’s that direct nerve compression that causes the symptoms of carpal tunnel syndrome. 

So you can see how confusion about which condition you have can arise. As a result, a doctor can easily be confused and make a carpal tunnel misdiagnosis and call it wrist tendinitis, or vice versa.

Okay, so the underlying pathology of these two conditions is similar. And their symptoms are nearly identical. Therefore, it’s easy to see how one condition can be confused with another. But doctors are supposed to know the difference, right?

Sadly, many don’t.

A knowledgeable and experienced carpal tunnel doctor uses the simple tests above to differentiate between carpal tunnel and wrist tendinitis. They're well-documented ways to diagnose one or the other, and have been used successfully for decades.

In fact, the National Institutes of Health showed the above tests are more reliable in determining carpal tunnel than expensive, electrodiagnostic tests like EMG. Best of all, you can perform these exact same tests on yourself. 

Now for the good news: if your self tests indicate carpal tunnel syndrome or wrist tendinitis then you can begin treating immediately. The National Institutes of Health and the American Academy of Orthopedic Surgeons suggest taking 4 distinct and simultaneous actions.

These actions will most likely get rid of symptoms and avoid long term suffering. The actions are known as B.R.E.M. which means Brace, Rest, Exercise, Massage.

Wear a wrist brace while you sleep. Indeed, make sure it’s a certified carpal tunnel brace (for either carpal tunnel syndrome or tendonitis). Generic pharmacy braces can do more harm than good because they're made to treat conditions like arthritis, sprains, etc. Also, never wear a brace while you work. That only makes your tendons fight the brace, irritating them even more.

An exercising and stretching routine for your fingers is crucial. For instance, do them for 30 seconds every 30 minutes you work. Such “mini-breaks” for doing stretching exercises relieve tendon stresses and promote blood flow. You can find fast and effective stretching exercises here.