Numbness, tingling or pain in the hand and wrist — often worse at night, often from repetitive work.
What it typically feels like
Pins and needles in the thumb, index and middle fingers
Waking in the night needing to shake the hand out
A weakening grip, dropping things
Pain at the base of the thumb on gripping or twisting
Hand and wrist symptoms come in a few recognisable patterns, and which one you
have changes what helps.
Carpal tunnel syndrome is nerve compression at the wrist. The classic
pattern is numbness and tingling in the thumb, index and middle fingers, worse
at night, often relieved by shaking the hand.
De Quervain’s tenosynovitis is tendon irritation at the thumb side of the
wrist — sharp pain gripping, twisting or lifting, very common in new parents.
RSI covers the broader ache and fatigue from repetitive work.
The forearm and neck connection
Wrist symptoms very often come from further up. Tight forearm muscles can
compress the nerve on its way to the hand, and nerve irritation in the neck can
produce symptoms felt entirely in the hand. Treating the wrist alone, when the
restriction is in the forearm or neck, is why some people get nowhere.
Assessment works out where along the chain the problem actually sits.
What treatment involves
Soft tissue work through the forearm and the muscles around the wrist, releasing
trigger points that refer into the hand, and mobility work — plus attention to
the neck and shoulder if that is where it originates.
Persistent numbness, weakness, or wasting of the muscle at the base of the
thumb needs a medical opinion, not massage. Nerve compression left long
enough causes lasting damage.
What is actually in the wrist & hand
Eight small bones, a dense bundle of tendons, and a nerve running through a tunnel with no room to spare — all of it doing repetitive work for hours at a time.
Carpal tunnel
A narrow passage at the front of the wrist, floored by bone and roofed by a tough band of ligament. The median nerve and nine tendons share it, and the space cannot expand.
Median nerve
Supplies sensation to the thumb, index, middle and half the ring finger. That distribution is the giveaway: numbness in those fingers and not the little finger points at this nerve.
Wrist flexor and extensor tendons
Cross the wrist inside sheaths. Repetitive work thickens and irritates the sheath, which both hurts and takes up room that the nerve cannot spare.
Base of thumb
A saddle joint doing an enormous amount of work. A common site of pain in anyone who grips, lifts children, or spends the day on a phone.
Why it goes wrong
Symptoms that wake people at night and ease when they shake the hand out are the classic pattern, and they point at pressure on the nerve rather than at the muscles. Tightness through the forearm and at the wrist can add to that pressure, which is where soft tissue work helps — but persistent numbness, weakness or wasting at the base of the thumb needs a medical opinion, not massage.
This page describes what is common, not what you have. The only way
to know is to have it assessed — and your first session includes a
full assessment, so you leave knowing what is actually going on.