One nerve, one tunnel, at the base of your palm.
The median nerve passes through a narrow tunnel at the front of the wrist, sharing that space with the tendons that bend your fingers and a thick band of ligament across the top. When those contents swell, or the wrist spends hours held at an extreme angle, pressure in the tunnel rises and the nerve stops conducting properly. That is why the symptoms are so specific: the thumb, index, middle, and half of the ring finger, and almost never the little finger.
The wrist is not the only place that nerve can be squeezed. It travels from the neck, through the shoulder and forearm, before it ever reaches your hand, and a restriction anywhere along that path can produce hand symptoms or make a mild wrist problem feel severe. Testing the whole route is why two people with identical numbness can need very different treatment.
Carpal tunnel has a signature.
Which fingers, and when, is what separates nerve compression at the wrist from tendon pain, arthritis, or a problem coming from your neck.
Numbness That Wakes You
Hands going dead in the middle of the night, and you hang them over the side of the bed or shake them out to get feeling back.
Thumb, Index, and Middle Fingers
Tingling and numbness across the thumb side of the hand, with the little finger usually spared entirely.
Hands That Go Dead at Work
Symptoms build after an hour at a keyboard, on a trigger, gripping a wheel, or holding tools above shoulder height.
Dropping Things
A coffee cup, a screwdriver, your keys. The nerve supplies the feedback your grip depends on, and that feedback has faded.
Clumsy Fingers
Buttons, zippers, and small parts get harder, and your handwriting starts to change without you deciding to change it.
Aching Wrist and Forearm
A dull ache travelling up from the wrist into the forearm, worse after a long day of repeated gripping.
Take the pressure off, then change what raised it.
Treatment starts with the nerve. Manual therapy at the wrist, palm, and forearm frees the tissue crowding the tunnel, and nerve glide work restores the median nerve's ability to slide rather than tether as your wrist, elbow, and shoulder move. We treat the neck and shoulder as well when testing shows the nerve is being irritated further up the line, which is common in desk workers and in trades who work with their arms overhead.
Then we deal with the cause, because a nerve that gets some relief and then goes back to eight hours in the same position will flare again. That means wrist positioning at night, keyboard and tool grip changes, hand, forearm, and shoulder strengthening so the small muscles stop overworking, and a straight conversation about which parts of your job can be adjusted. If surgery does turn out to be the right call, this same work protects the result afterwards.
No referral needed. Most insurances accepted. Doors open at 5:00 AM, so you can be seen before work.
What our patients say.
"EXCELLENT!!! Professional, thorough, informed, good communicators, clean well equipped business, nice people"Mark R. · Google Review
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No referral needed. Most insurances accepted. Doors open at 5:00 AM.
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