How do I know if it's tennis elbow, radial tunnel or carpal tunnel?

In short

Where it hurts tells them apart. Carpal tunnel syndrome usually causes numbness and tingling in the thumb, index and middle fingers. Tennis elbow hurts at the bony bump on the outside of the elbow. Radial tunnel pain sits just below it, in the upper forearm, and usually leaves the hand alone. Those two are easily confused.

By The Hand and Wrist Institute Medically reviewed by John T. Knight, MD Reviewed November 4, 2026 Updated November 2, 2026How we write and review

Call (817) 382-6789 to have this looked at, or book online with Dr. Knight.

Carpal tunnel: the fingers

Start with where you feel it. Carpal tunnel syndrome is a nerve squeezed at the wrist. Its signature is numbness and tingling in the thumb, index and middle fingers, often waking you at night.¹

Tennis elbow and radial tunnel: the outer elbow and forearm

Find the bony bump on the outside of your elbow. Tennis elbow hurts right there, where the forearm muscles attach.² Radial tunnel syndrome is a nerve squeezed a little lower, and it causes pain without numbness or weakness.³ Dr. Knight places that pain in the upper forearm, just below the bump. Because the two sit so close together, tennis elbow and radial tunnel can be misdiagnosed as each other, which is why Dr. Knight examines where the tenderness actually sits. Dr. Knight explains radial tunnel syndrome in What is radial tunnel syndrome and how is it treated?.

Getting it sorted out in Southlake and Plano, Texas

Telling tennis elbow, radial tunnel and carpal tunnel apart is an examination, so it is worth one visit rather than weeks of guessing. Dr. Knight examines the arm at our Southlake office, open weekdays, and our Plano office, open Tuesdays. Nerve testing, when it is needed, is arranged by Dr. Knight and done outside the office. Each one has its own page: radial tunnel syndrome, tennis elbow and carpal tunnel.

In Dr. Knight's words

"Usually carpal tunnel involves numbness and tingling in the thumb, index and middle fingers. Radial tunnel usually does not affect the hand, but has pain in the upper forearm just below the bony prominence on the outside of the elbow, where tennis elbow occurs. But tennis elbow and radial tunnel can be sometimes misdiagnosed as one another."

When to call us

• Numbness in the thumb, index or middle finger.
• Outer elbow or forearm pain that has not settled with rest.
• Treatment for tennis elbow has not helped, which can point to radial tunnel.