Carpal Tunnel Syndrome: Why Your Hand Goes Numb (and What Actually Helps)
That pins-and-needles feeling that wakes you at night, or the numbness that creeps in while you're driving or scrolling your phone, is one of the most common reasons people come to see us. More often than not, the culprit is carpal tunnel syndrome. The good news is that, caught early, it usually responds really well to treatment or we can refer to the correct specialist.
What is carpal tunnel syndrome?
The carpal tunnel is a narrow passage on the palm side of your wrist. Your median nerve, along with the tendons that bend your fingers, runs through it. When that tunnel gets crowded and the nerve is put under pressure, you get the classic symptoms: numbness, tingling, and sometimes pain in the thumb, index, middle, and half of the ring finger.
It tends to build slowly, which is part of why people put up with it for so long before getting it looked at.
The signs to watch for
A few things that point towards carpal tunnel:
Numbness or tingling in the thumb and first few fingers (the little finger is usually spared)
Symptoms that are worse at night, often waking you up
A need to shake the hand out to "wake it up"
Weakness or clumsiness, like dropping things or struggling with buttons and jar lids
Symptoms that flare with driving, phone use, or holding a book
If any of that sounds familiar, it's worth getting assessed sooner rather than later. Nerves don't love being under pressure for long stretches, so early treatment tends to give the best results.
What causes it?
Often there's no single cause, but a few things can crowd the tunnel or irritate the nerve: repetitive hand use, prolonged gripping or vibration, fluid changes in pregnancy, and conditions like diabetes or thyroid problems. Sometimes it's simply the shape of your wrist. The reassuring part is that the cause doesn't usually change how well it responds to good hand therapy.
How we help
This is where hand therapy really comes into its own, because there's a lot we can do before surgery is ever on the table.
Treatment often includes a night splint to keep the wrist in a neutral position while you sleep (which is when symptoms tend to bite). We'll also look at nerve gliding exercises to keep the median nerve moving freely, activity and posture tweaks to take pressure off the wrist, and strategies to settle things down day to day. For many people, that combination is enough to turn symptoms around.
If the nerve compression is more advanced, we'll work alongside your GP or a hand surgeon to make sure you get the right next step, and we're here to guide your recovery if surgery does end up being the best option.
Don't wait it out
The biggest mistake we see is people pushing through for months or years, hoping it settles on its own. Early on, carpal tunnel is very treatable. Left too long, the nerve can be harder to bring back, so if your hand keeps going numb, it's a sign worth listening to.
We're based on the North Shore and see carpal tunnel every week. If your hand's been tingling, aching, or waking you at night, get in touch and we'll help you work out what's going on and what to do about it.
This article is for general education and isn't a substitute for individual medical advice. If you're experiencing hand numbness or pain, please see a hand therapist, GP, or appropriate health professional for an assessment specific to you.
