Carpal tunnel syndrome: numb fingers at night, and where the problem sits
Numbness or tingling in the thumb, index and middle fingers that wakes you at night and eases when you shake the hand is the classic account of carpal tunnel syndrome. The nickname "mouse hand" is common, though the link with ordinary keyboard use is weaker than most people expect.
What is actually going on
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 those fingers lose reliable sensation. 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.
How it usually behaves
- 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
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 exist alongside it.
What an assessment looks at
The main job is mapping where the nerve is affected. That means checking which fingers are involved and whether the distribution fits the wrist, the elbow or a neck nerve root; testing sensation and thumb muscle power; and looking for any thinning of the muscle at the base of the thumb. Wrist, elbow and neck movement are examined, your work setup and sleep position reviewed, and health conditions associated with nerve symptoms asked about.
What a plan may involve
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. There is no fixed routine, your preferences matter, and the plan is adjusted as you respond.
What you can do day to day, and how progress is judged
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 the whole hand load is worth looking at rather than blaming the computer. A plan for a bad night or a heavy week of hand work is worth having. Numbness pattern, night waking, grip and thumb strength are reviewed at each visit.
When to have it looked at medically
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 or 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.
If this sounds like your situation, WhatsApp or call us to arrange an assessment.
Hand numbness, tingling at night or a weakening grip? We assess where the nerve is irritated, check sensation and strength, and discuss splinting, exercise and when to see a doctor.
Wrist pain from typing, lifting, training or a fall on the hand? We work out which structure is involved, screen for anything that needs a doctor, and build a graded plan with you.
Lower back pain that limits sitting, bending, work or sleep? Our Yau Ma Tei physiotherapists assess your symptoms, movement and daily load, then agree an individual plan with you.
Neck pain, a stiff neck or headaches linked to neck tension? Our Yau Ma Tei physiotherapists assess your symptoms, movement, work setup and sleep before agreeing a plan with you.
