This article was written by Airrosti’s Dr. Denyse Rowland-Jones, DC. She explains the difference between two common causes of wrist pain: carpal tunnel syndrome and pronator teres syndrome.


Too often we assume our hand or arm pain isn’t serious and will eventually go away with rest, but what if your wrist pain is a sign of something else? Here’s how to determine the potential cause of your wrist pain, along with a few tips to prevent and alleviate the pain.

Wrist pain often appears as a symptom of median nerve entrapment syndrome. The median nerve is a long nerve that starts in the neck and branches into the arm, passing through the carpal tunnel of the wrist and into the hand. Median nerve entrapment syndromes are conditions where the median nerve becomes compressed and irritated by another part of the arm. Because the median nerve runs down the full length of the arm, there are many distinct places this nerve can be compressed, but the two most common median nerve entrapment syndromes are carpal tunnel syndrome (CTS) and pronator teres syndrome (PTS). Both syndromes have similar symptoms, such as wrist and hand pain, decreased grip strength, and a tingling or numbing sensation in the hand. Sometimes the pain can be so bad that even tasks as simple as driving becomes a challenge.

Although the signs and causes of both CTS and PTS are similar, there are subtle variances between the two syndromes and their indicators that will ultimately affect how your pain is diagnosed and treated.

Carpal Tunnel Syndrome (CTS)

Carpal tunnel syndrome is the most common case of median nerve entrapment syndrome. CTS develops when the median nerve within the carpal tunnel becomes compressed and causes pain and swelling in the wrist. Other symptoms include hand pain, and sometimes pain or numbness in the fingers. The fingers affected by CTS include the thumb, index, middle, and ring fingers. Since the median nerve does not extend to the pinky, your pinky finger should not be affected.

Pain from carpal tunnel syndrome will be felt exclusively in the wrist and hand since the location of compression is in the carpal tunnel within the wrist. These symptoms are usually more painful at night but can also be present during the day while doing daily activities like writing or driving. People in jobs that involve repetitive wrist movements like manufacturing, construction, or typing for extended hours are at a higher risk of carpal tunnel syndrome.

Pronator Teres Syndrome (PTS)

Pronator teres syndrome is not as common as carpal tunnel syndrome but is often confused with CTS due to the similarity of symptoms.  PTS occurs when the pronator teres muscle, a muscle that sits just below the elbow, becomes inflamed and compresses the median nerve.  The symptoms of PTS include an aching pain in the forearm, tenderness on the palm side of the elbow, and weakness in the affected arm and hand.  Some people also experience numbness, tingling, and pain in the palm, thumb, and index finger. Although both carpal tunnel syndrome and pronator teres syndrome include hand, wrist, and finger pain, any pain that is localized in the forearm is only seen in pronator teres syndrome.

Like carpal tunnel syndrome, PTS is caused by repetitive arm movements. Overuse and excessive exercise can irritate the pronator teres muscle and cause PTS symptoms.  Most often, jobs or sports that require overhand movements such as baseball or football are at a high risk of developing PTS.

Relieve & Prevent Wrist Pain

If you’re currently suffering from wrist pain and want to alleviate your symptoms, or if you’re just trying to prevent these common syndromes from developing, here are a few simple tips to alleviate any wrist pain and prevent them from worsening.

1) Wrist Splinting at Night

Wrist splinting at night can help those who already have mild or moderate symptoms of carpal tunnel syndrome. When you’re asleep at night, your wrist might bend at awkward angles or be compressed by your own body weight. If you have carpal tunnel syndrome, your wrist pain is likely to get worse at night due to these unconscious movements. By using a wrist splint when you sleep, you can reduce some of the symptoms of carpal tunnel syndrome and avoid adding unnecessary pressure to your wrist.

2) Arm & Wrist Strengthening Exercises

By strengthening your arms and wrists, you’re providing a challenge for your muscles and making them more injury-resistant. Build up the muscles in your arms and wrists with these easy strengthening exercises.

Pronation w/ band

Pronation W/ BandPronation w/ Band 2

  • Secure an elastic band near the floor and support your forearm on a table or armchair with your elbow bent at 90 degrees.
  • Your hand must be palm up with the elastic crossing over your palm and under your thumb.
  • Rotate your hand to palm down against the elastic resistance.
  • Return to the starting position.
  • Complete 5 – 10 repetitions.

 Wrist Flexion

 Wrist Flexion 1Wrist Flexion 2

  • Place an elastic band under your foot or another heavy object.
  • Hold the band in your hand with your palm facing up and place your forearm on a table with the hand off the edge of the table.
  • Flex the wrist upward without moving the forearm.
  • Return to the starting position.
  • Complete 5 – 10 repetitions.

*Discontinue these exercises if you’re feeling any tingling, numbness, or increased pain.*

Typically, your dominant wrist is stronger than your non-dominant wrist. Since your dominant wrist is used for most daily activities, it gets plenty of exercise throughout the day while your non-dominant hand is not getting that same challenge. A great exercise to do is use your non-dominant hand to do daily tasks that are normally reserved for the dominant hand. These tasks include writing, eating, cooking, and brushing your teeth. Over time, your non-dominant wrist will become stronger and these tasks will be easier to perform.

3) Lacrosse Ball Exercises

One last exercise you can try is massaging and stretching your forearm flexors. Massaging with a is an effective way to target those smaller muscles with precision, which can reduce muscle stiffness and pain. You can start rolling the forearm flexors using the video below as a guide. Follow up by stretching the forearm flexors freely. If you feel increased pain, numbness, or a tingling sensation from rolling or stretching, stop and contact your Airrosti Provider or Primary Care Physician.

We Fix Wrist Pain Fast

Wrist pain can put a fast halt to your daily activities, making something as simple as holding a toothbrush or typing on the computer a daunting task. If you’ve taken preventative measures, tried at-home exercises and stretches, and your wrist pain is still giving you trouble, contact an Airrosti Provider today and get treated. We treat these and many other common injuries and typically resolve most of our cases within 3.2 visits (based on patient-reported outcomes). Our providers can find the root cause of your problem and treat it directly at the source to get you back to your pain-free life.

Read our Medical Disclaimer here.