Carpal Tunnel Syndrome

You shake your hand awake at night. The thumb-side fingers go fuzzy on the steering wheel. Carpal tunnel syndrome is real and common — and so is its impostor, a pinched nerve in the neck. Treating the wrist when the problem lives in the neck helps no one, which is why we test both. Every time.

What’s actually going on

The median nerve runs through a snug tunnel at the wrist alongside nine tendons. Swelling or thickening in that tunnel compresses the nerve, classically producing night-dominant tingling and numbness in the thumb, index and middle fingers — hand-shaking relief is almost a diagnostic sign of its own.

Common causes we see

• Repetitive hand use and vibration — keyboards, tools, trades
• Fluid shifts: pregnancy, thyroid conditions, diabetes
• Wrist position at night (we sleep curled like shrimp)
• Neck involvement — C6/C7 nerve irritation mimicking or compounding it (the 'double crush')

How we evaluate it

Wrist provocation tests (Tinel's, Phalen's, compression), median-nerve mapping — does the numbness truly spare the pinky? — plus full cervical and nerve-tension screening for the impostor. Severe or progressive cases get referred for nerve-conduction testing and a surgical opinion; thumb-muscle wasting is a now-referral, not a someday one.

How chiropractic care may help

For mild-to-moderate, exam-confirmed carpal tunnel: wrist and forearm joint mobilization, soft-tissue work along the forearm flexors, median nerve gliding exercises, night-splint guidance (cheap and often quietly effective), and workstation fixes. When the neck contributes, it gets treated too — that's the point of testing it. Many early cases improve conservatively; established severe compression is a surgical conversation we'll have honestly.

What to expect

Bring your work setup details — keyboard, mouse, tools. The fix that lasts usually includes the desk, not just the wrist.

Testing framework: standard median-nerve provocation testing; NCS referral thresholds per hand-surgery practice.