George Krucik, MD, MBA
Multiple sclerosis and carpal tunnel syndrome are two very different diseases, each with a distinct pathophysiology. However, when multiple sclerosis affects the part of the nervous system responsible for arm and hand function, its symptoms can appear remarkably similar to carpal tunnel syndrome.
Two Different Diseases
Multiple sclerosis is a disease that occurs when the immune system attacks the myelin, or covering of the nerve fibers in the brain and spinal cord. As the myelin becomes compromised, the nerve signals grow abnormal and the clinical symptoms can manifest as sensory and motor dysfunctions. In the early stages of multiple sclerosis these dysfunctions may be similar symptomatically to other conditions. When the dysfunctions occur in the hand and arms they may appear to be symptoms of carpal tunnel syndrome. Carpal tunnel syndrome is a focal compression of the median nerve inside the wrist. Nerve compression produces abnormalities in the nerve signals which manifest as sensory and motor dysfunctions.
Numbness and Tingling
Abnormal sensory feelings, known as parasthesias, are common occurrences with multiple sclerosis. They can be localized to the legs and arms and when the parasthesias are in the forearm they may appear as carpal tunnel syndrome. Sometimes the arms can feel like they are going to sleep and touch sensation also may be compromised. These symptoms are similar to the symptoms of carpal tunnel syndrome. Like carpal tunnel syndrome, multiple sclerosis parasthesias can come and go. Generally numbness occurs in the arms or legs on one side of the body or the bottom half only.
Weakness and Stiffness
People with multiple sclerosis may experience weakness or loss of strength and dexterity in the arms and hand. These symptoms are similar to those of carpal tunnel syndrome and can even be accompanied with stiffness, another symptom common to both diseases. As with the numbness, weakness typically occurs on one side of the body or the bottom half only.
Pain, Burning, Itching
Uncomfortable feelings of pain, burning or itching can manifest in the arms as well as the legs, face and trunk. When localized to the arm, these feelings can mimic symptoms of carpal tunnel syndrome. Multiple sclerosis pain can be extremely varied and often is difficult to describe. Yet many of the pain feelings can appear similar to those of carpal tunnel syndrome in that they can be chronic or acute and constant or intermittent. The pain also can range from dull, aching pain to shooting, electric shock-like sensations, just as in carpal tunnel syndrome.