Ep 37: Numb Fingers? How to Test Yourself for Carpal Tunnel Syndrome at Home

Are your fingers going numb at night? That tingling sensation might be carpal tunnel syndrome. As a board-certified hand therapist, I've seen countless patients suffering needlessly because they didn't recognize the early warning signs or were using the wrong treatment approaches.

The carpal tunnel houses the median nerve, which supplies sensation to your thumb, index, middle, and half of your ring finger. When compressed, this nerve creates that characteristic numbness and tingling many mistake for poor circulation. But you don't need to wait for a doctor's appointment to start investigating your symptoms.

This episode walks you through simple self-tests you can perform right now. Learn how the Phalen's Maneuver and Tinel's Sign can help identify potential carpal tunnel syndrome, and why those drugstore wrist braces might actually be making your condition worse. I'll show you how to modify existing braces and explain why custom orthoses provide superior relief without putting harmful pressure on the nerve.

Most importantly, I share why early intervention is crucial for avoiding surgery. Through proper splinting, nerve flossing techniques, and avoiding common mistakes like massaging the affected area, many patients can find significant relief without surgical intervention. Remember, no two hands are identical, and personalized treatment yields the best outcomes.

Whether you work at a computer all day, perform repetitive hand movements, or simply wake up with numb fingers, this episode provides the knowledge you need to take control of your hand health. Share this with anyone experiencing hand numbness or tingling – you might just save them from unnecessary pain and surgery.

Chapters

• 0:00 Introduction to Carpal Tunnel Syndrome
• 1:27 Self-Testing Methods at Home
• 2:43 Professional Testing and Diagnosis
• 3:01 Proper Bracing and Treatment Options
• 5:15 Early Intervention and Episode Closing

Transcript

Speaker 1: 0:01

Okay, we're having fun. Now, Welcome back to the Hand-to-Shoulder Solution. Giving Pain the Middle Finger. I'm your host, carl Petito. I'm an occupational therapist and a board-certified hand therapist, as well as a certified ergonomics assessment specialist. I specialize in the rehab of the hand to the shoulder and I want to talk today about carpal tunnel syndrome. I want to talk about how you can test yourself at home to see if you're having symptoms of carpal tunnel syndrome. You can test yourself at home to see if you're having symptoms of carpal tunnel syndrome.

Speaker 1: 0:30

First and foremost, there's a thick, heavy nerve, the median nerve, that travels through the carpal tunnel and when that is compressed in that tunnel in your wrist it causes numbness and tingling and or deep aching throughout the thumb side of the hand. So it plugs into or affects the thumb, the index finger, the long finger and half of the ring finger. And looking at the skeleton, I can show you the carpal bones. These bones, there's eight of them. They form a bit of a concave shape when you look down at the palmar surface. So if you look at your palm, you look at the heel of your palm. That's where your carpal tunnel is. There's a thick, heavy ligament that goes over the top forms the roof of your palm. That's where your carpal tunnel is. There's a thick, heavy ligament that goes over the top forms the roof of the tunnel. Now that wide, flat nerve, which is about as wide as a pen or pencil and about as thick as a noodle, goes through there and it's pretty close to the skin. It's pretty superficial and that gets compressed in the tunnel. So all right.

Speaker 1: 1:25

So here's a couple of orthopedic tests. The first one is called Phalen's Maneuver, where you'll bend your elbow and then bend your wrist toward your palm and hold that for 30 seconds. If that increases numbness and tingling in the thumb side of your hand, that's a positive test. Another one is called Tenelle's. So you tap there on the heel of your palm, on the tunnel, and if that sends a zinger through the thumb side of your hand, that's a positive test. Also, what I do in the office is manual occlusion or just some light manual pressure there over the tunnel to see if that causes increase in symptoms. I'll also screen the neck and I'll put both hands on top of the patient's head and press down firmly, not very aggressive but firmly. If that increases symptoms then most likely they're having a compressed nerve at the neck. I'll also do what's called spurlings and I'll tilt the head and then put over pressure and see if that increases the problems. And really the gold standard is nerve conduction study, where you go to a different office and a study will be performed to actually measure the speed at which electrical impulses travel through the nerve and see where they slow down. In a nutshell, to see where they slow down and see where the nerve might be compressed.

Speaker 1: 2:48

A lot of patients are wearing nighttime splints and over the counter braces. If you have seen the previous episode about cautions regarding over the counter braces, they have stiffener bars and that puts pressure directly on the carpal tunnel. So remember the heel of your palm. That's where the carp tunnel is and the nerve lives in there. So we don't want pressure on the nerve. When you cross your leg and your foot goes to sleep, that's because of pressure on the nerve. Now what you should have is a nice custom orthosis fabricated to position the wrist in just slight flexion and a little bit of ulnar deviation moved toward your little finger, and that would end with nothing touching the carpal tunnel. Nothing should be touching that area.

Speaker 1: 3:31

Sometimes when a patient comes in, they have the over-the-counter brace. With them I can use a pair of needle-nose pliers, get in that little pocket that this is in in the brace and slide that out, and then I tell patients to just wear that brace, loose-fitting, just enough to block sleeping like this. Because, remember, that's Phelan's maneuver, that's the orthopedic test to see if that nerve is pinched there. So it's provoking that a little bit. Also back here extreme wrist extension, sleeping like this or sleeping with a hand under the head where it's putting pressure on that. If you have a thick, bulky nylon brace that will remind you not to keep that wrist compressed under your head, it'll block extremes of flexion and extension. So either or it if it's an over-the-counter brace and it's that thick, bulky nylon, then this can just be slid out of there so nothing is pushing on the carpal tunnel and where the brace just snugs, just tight enough so it doesn't slide around or the the best option is to get a custom orthosis which is covered by insurance. I make them in the office, different kinds of orthotics molded from this material that I make a template, heat it up in hot water, mold it on the patient, put padding in Velcro straps and it's ideal because it's molded directly to the patient. No two hands are the same. No, two people are the same, so two people are the same.

Speaker 1: 4:56

So for carpal tunnel syndrome, we really want to make sure you get this taken care of sooner rather than later. The sooner that you get this looked at, the sooner you'll be able to avoid surgery. So in therapy we do a lot of things from nerve flossing techniques which we've talked about in other episodes. We do the custom splinting which I just talked about. Also, manual wrist traction we use cold laser. One thing you don't want to do, which I've mentioned in almost every episode, is not to rub the wrist anywhere. Rubbing this area puts direct pressure on the nerve. It makes things worse. So thank you for sharing this. Thank you for liking the video. Thank you for subscribing. It supports the channel. It's my mission to bring information to people so they better understand their body and they know what to do when. Please share this with other people who are having numbness and tingling with inside their hand. Thank you.