Do you experience hand pain and/or tingling you keep trying to “shake out”?

It’s very possible you may be suffering from a pinched nerve—in your wrist.

Having spent 23 years in the field of orthopedic physical therapy, I have treated my fair share of patients suffering from carpal tunnel syndrome—a problem where the median nerve becomes squeezed as it passes through the wrist’s bony “tunnel”. The symptoms of a narrowed carpal tunnel: numbness, tingling, or pain in the wrist, palm, thumb, and middle three fingers (and possibly the forearm) are often first noticed at nighttime. The discomfort may even be strong enough to wake you out of a deep sleep!

There are several reasons why the bony tunnel in your wrist may become narrowed enough to cause symptom-producing pressure on your median nerve including pregnancy, obesity, or direct trauma, but the most common cause is involvement in physical activities which require a sustained grip or a repetitive grasp.

In addition to the discomfort, carpal tunnel syndrome – CTS – can render you quite clumsy—dropping things and fumbling for accuracy when fine motor skills are required. If left untreated, CTS can result in permanent loss of strength in your affected hand(s). So this is not something you should ignore.

Clinically, I often find that one or more of the eight wrist bones (which together make up the “tunnel”) have mechanically “lost their way”, placing undue pressure on the median nerve. Another factor which can fan the flame of CTS (or even mimic it) is when the median nerve is compressed at another location somewhere between your neck and your finger tips. This more complex situation is known as double-crush syndrome.

Treatment of either CTS or double-crush syndrome should be sought from a skilled, hands-on practitioner who will evaluate and treat the bones, muscles, and nerves which play a part in the production of your symptoms, as well as advise you regarding any aggravating activities which you may be participating in. If you place your hands in good hands, 9 out of 10 times, surgery can be avoided.

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