Carpal Tunnel Syndrome / Mouse Hand Physiotherapy near Prince Edward

The median nerve passes through a narrow tunnel at the front of the wrist together with the finger tendons. If pressure inside that tunnel rises, the nerve stops conducting normally and the thumb, index and middle fingers lose reliable sensation, classically waking people at night. Symptoms alone cannot diagnose it, because nerve compression at the neck or elbow and several medical conditions can feel similar; an in-person examination, and sometimes a nerve study arranged by a doctor, is how it is confirmed.

The classic account is numbness, altered sensation or tingling in the thumb, index and middle fingers, worse at night or when holding a phone or steering wheel, and relieved by shaking the hand. Later, some people notice weakness in the thumb, dropping things or losing fine dexterity. Other possible causes need to stay in view: neck nerve root irritation, nerve compression at the elbow, thyroid conditions, diabetes and pregnancy-related fluid changes can all look similar or coexist.

• Numbness or altered sensation in the thumb, index and middle fingers
• Tingling that wakes you at night and eases when you shake the hand
• Symptoms when holding a phone, a book or a steering wheel
• Weakness in the thumb, dropping small objects, or reduced dexterity
• Symptoms in both hands, or worse in the dominant hand

The main job is mapping where the nerve is affected. We check which fingers are involved and whether the distribution fits the wrist, the elbow or a neck nerve root, test sensation and thumb muscle power, and look for any thinning of the muscle at the base of the thumb. We examine wrist, elbow and neck movement, review your work setup and sleep position, and ask about health conditions that are associated with nerve symptoms.

• Your symptoms: which fingers, when they appear, and what relieves them
• Daily activities and function: writing, phone use, cooking, buttons, carrying
• Work or study setup: keyboard and mouse position, tool vibration, and repetition
• Sleep: how often symptoms wake you, and the position your wrist rests in
• Load and injury history: previous wrist injury or fracture, and recent changes in hand load
• Movement: wrist, forearm, elbow and neck range of motion
• Strength and control: thumb and grip strength, dexterity, and any muscle thinning at the thumb base
• Neurological screening: sensation testing by finger, muscle power, reflexes where indicated, plus medical history including thyroid, diabetes, pregnancy and medicines

For mild to moderate symptoms, a night splint holding the wrist in a neutral position is commonly used, alongside changes to the activities that provoke symptoms and, where appropriate, nerve and tendon gliding exercises. Depending on the assessment, hands-on treatment or acupuncture may be considered where you consent. Steroid injection and surgical release are medical options for persistent or more severe cases, decided with a doctor. We use no fixed routine, your preferences matter, and we adjust as you respond.

Practical adjustments usually help: keeping the wrist closer to neutral at the keyboard, breaking up long periods of gripping or phone holding, and wearing the splint consistently at night if one has been recommended. Contrary to popular belief, the link between ordinary keyboard use and this condition is not well established, so we look at your whole hand load rather than blaming the computer. You will also get a flare-up plan for a bad night or a heavy week of hand work. We review numbness pattern, night waking, grip and thumb strength at each visit and adjust from there.

Mild and intermittent symptoms are reasonable to start with a physiotherapy assessment. Arrange a prompt medical review if numbness has become constant rather than intermittent, if thumb strength is clearly reducing or the muscle at the base of the thumb looks thinner, if symptoms are not improving after several weeks of splinting and activity change, or if you have diabetes, thyroid disease or are pregnant and symptoms are escalating — nerve studies or an injection may need to be considered. Go to an emergency department the same day if the hand becomes cold, pale or blue, if numbness and weakness are spreading rapidly, or if hand symptoms appear suddenly alongside face or leg weakness or difficulty speaking.