Carpal Tunnel Syndrome
Most people with carpal tunnel syndrome notice it first at night, waking up with a hand that is tingling or numb and needing a good shake before it feels normal again.
During the day, symptoms tend to show up during activities that involve holding something for a while, driving, typing, or gripping. Over time, if the underlying cause is not looked at, the numbness and weakness can become more persistent and harder to shift.
The good news is that it often responds well to the right treatment, and surgery is far from the inevitable outcome many people assume.
What is carpal tunnel syndrome? The carpal tunnel is a narrow channel on the underside of your wrist, formed by the bones of the wrist on one side and a band of fibrous tissue on the other. Several tendons pass through it, along with the median nerve, which supplies sensation and movement to the thumb, index, middle, and part of the ring finger. When the space inside the tunnel becomes compressed, that nerve gets squeezed. The result is the tingling, numbness, and weakness that characterise the condition.
Symptoms are often worse at night and first thing in the morning. Many people instinctively shake their hands to get some relief, which helps temporarily. Over time, if the underlying cause is not addressed, the weakness and sensory changes can become more persistent and harder to reverse.
Why does it happen?
Carpal tunnel syndrome is often associated with repetitive hand and wrist movements, particularly tasks involving prolonged gripping, keyboard work, or vibrating tools. It can also develop during pregnancy, where fluid retention increases pressure within the tunnel. Thyroid conditions, inflammatory conditions affecting the tendons, and certain systemic health conditions can also play a role. In some cases there is no single obvious cause, which is part of why a proper assessment is so useful.
One thing that surprises many people: the problem is not always in the wrist. The median nerve travels all the way from the neck through the shoulder, arm, and into the hand. Compression or irritation anywhere along that route can produce symptoms that feel exactly like classic carpal tunnel syndrome. The thoracic outlet, an area between the collarbone and the first rib in the upper chest, is one particular site where the nerve can be compressed and is frequently overlooked. Without a proper assessment, it is easy to treat the wrist when the issue is actually originating further up.
How we approach it at Brixton Therapy Centre
The starting point is an osteopathic assessment. Our osteopaths will look not just at the wrist itself, but at the neck, upper back, and shoulder, to understand where the compression is most likely coming from. This matters because the right treatment depends entirely on where the problem originates. Treating a wrist when the underlying issue is in the thoracic outlet or neck would not resolve things, and could leave you no better off.
Once the assessment has established what is going on, treatment is shaped to your specific presentation. That typically involves hands-on work to restore movement and reduce tension across the relevant areas, alongside practical guidance on the day-to-day habits and positions that may be aggravating things. If your symptoms developed during pregnancy, our pregnancy osteopaths are well placed to help.
Ready to book your appointment?
We offer a range of treatments to help you feel your best. Book online,
call us or visit our centre to schedule your appointment.
You do not need a diagnosis to come in
Carpal tunnel syndrome is not always formally diagnosed before people come to see us, and that is absolutely fine. If you are getting tingling, numbness, or weakness in the hand and fingers, particularly if it is disturbing your sleep or affecting what you can do, that is reason enough to come in. Our osteopaths will assess what is driving it from scratch. If it turns out to be something other than carpal tunnel syndrome, that information is just as valuable, and still something we can help with.
Questions People Ask Us
Is carpal tunnel syndrome always caused by a problem in the wrist?
Not necessarily. The median nerve runs from the neck all the way down into the hand, so compression at any point along that path can produce symptoms that feel like classic carpal tunnel. The thoracic outlet, the area between the collarbone and the first rib, is one commonly overlooked site. This is one of the reasons that a thorough assessment before any treatment begins is so important.
Can osteopathy help if I have already been told I might need surgery?
It is worth having a proper assessment before committing to surgery. Many people with carpal tunnel symptoms find that conservative treatment, including osteopathy, brings meaningful relief. We often say: start with the least invasive option first. If osteopathy does not resolve things, surgery remains on the table. But it does not work the other way round, and if it turns out that the symptoms are originating higher up in the neck or thoracic outlet, you may be able to avoid surgery altogether. An assessment will tell you which situation you are in.
Should I be wearing a wrist splint?
Splints can help manage symptoms in the short term, particularly at night, by keeping the wrist in a neutral position and reducing pressure on the nerve while you sleep. They can be a useful stopgap, but they are not a substitute for identifying and addressing the cause. Your osteopath will advise you once they have a full picture of what is going on.
My symptoms come and go. Does that mean it is not serious?
Carpal tunnel symptoms often fluctuate, particularly in the early stages. Intermittent tingling and numbness that settles on its own can still be worth investigating, because the pattern tends to worsen over time if the underlying cause is not addressed. Coming in while symptoms are variable is often better than waiting until they become constant.
Related Conditions
Thoracic outlet syndrome: often confused with carpal tunnel syndrome because both can cause tingling, numbness, and weakness in the hand and fingers. Understanding the difference matters, since the two conditions are approached quite differently in treatment.
Still Not Sure?
If you're in pain and wondering whether we can help, that's exactly why we're here. You don't need to know what the problem is. You don't need a referral. You just need to take the first step. Book online today or call 020 7733 9944 to speak to us.