Carpal Tunnel Syndrome Treatment in Palm Coast, FL

Waking at 2 a.m. to shake a dead hand back to life is not a quirk of how you sleep. It’s the most recognizable sign of carpal tunnel syndrome — a nerve being squeezed at the wrist, in a space with no room to give.

What carpal tunnel syndrome feels like

Nights come first. Patients describe waking with a hand that’s numb and buzzing, hanging it off the edge of the bed, shaking it out, flexing the fingers until sensation crawls back. Some do this several times before morning, and some have quietly relocated to a recliner over it. It happens because the wrist curls in sleep, narrowing an already tight space.

The daytime pattern follows:

• Numbness and tingling in the thumb, index, middle, and half the ring finger
• Buzzing that starts while driving, holding a phone, or reading a paper
• Aching that travels up the forearm, occasionally as far as the shoulder
• Dropping things, and a weakening pinch grip — keys, buttons, a coffee cup lid
• A hand that feels swollen when it visibly isn’t

When it’s been present a long time, the numbness stops coming and going and simply stays. That’s a different stage, and it changes the recommendation.

What’s actually happening at your wrist

The carpal tunnel is a narrow passage on the palm side of the wrist, floored and walled by the small carpal bones and roofed by a thick ligament stretched across them. Nine tendons that bend your fingers pass through it, and so does the median nerve.

It’s a rigid space. Anything that raises the pressure inside — swelling of the tendon sheaths from repetitive gripping, fluid retention in pregnancy or thyroid disease, inflammation from rheumatoid arthritis, or simply a tunnel that was narrow to begin with — presses on the softest structure in there, which is the nerve. Sustained compression first disrupts the nerve’s signaling, producing intermittent numbness. Left long enough, it damages the fibers themselves, and the muscle at the base of the thumb that the nerve supplies begins to waste.

How we find the source

The important question is whether the compression is at the wrist at all. Dr. Manuel López, a board-certified pain management and rehabilitation physician, works through:

• Mapping the numbness finger by finger, checking whether the little finger is spared
• Provocative testing at the wrist to reproduce your symptoms
• Strength and bulk at the base of the thumb, which grades how advanced things are
• A neck and elbow exam, since a cervical nerve root or the ulnar nerve can produce a similar-sounding hand
• Nerve conduction studies, which confirm the diagnosis and, importantly, its severity

Severity is what steers the plan, so it’s established before anything is recommended.

How we treat it

Mild and intermittent cases often respond to splinting at night and changing what the hand is asked to do. When symptoms persist and testing confirms the median nerve at the wrist:

A precisely placed injection around the nerve inside the tunnel can settle the swelling compressing it, and the response also confirms the diagnosis. It suits confirmed cases where surgery isn’t wanted or isn’t yet warranted. Advanced compression is a different conversation, and Dr. López will route you to a hand surgeon rather than delay it.

When to seek care promptly

Seek care immediately for sudden, severe hand numbness or weakness, particularly after an injury or a fall on the wrist, and for a hand that becomes cold, pale, or discolored. Get evaluated promptly for numbness that has become constant, for visible flattening of the muscle pad at the base of the thumb, and for a grip that keeps failing — those signal compression far enough along that waiting has a cost.

Sort out where the nerve is actually being squeezed

Not every numb hand is a wrist problem, and the ones that are respond well to being confirmed. Dr. López and the Seaside Spine and Pain Center team can settle it.

Call (386) 222-7746 or request an appointment.