Part 2: Are You Sure it’s Carpal Tunnel?

In part 1 we discussed the signs and symptom of median nerve irritation and how the carpal tunnel is one area where the nerve is vulnerable to compression. The most important thing for you to understand is that tingling or symptoms into your fingers doesn’t mean you have carpal tunnel syndrome. There are two major causes of tingling into your hand and they include median nerve irritation and spinal nerve irritation.

Median Nerve

The median nerve (or nerves that make up the median nerve) can be irritated anywhere along its path down the arm, not just at the carpal tunnel. The median nerve is formed by the nerves that come from your neck and travels down your entire arm to the hand. This is pictured below.

Marked with blue circles are the 4 common areas where the median nerve can be irritated and mimic the symptoms of carpal tunnel syndrome. The irritation comes from adhesion causing a nerve entrapment; we will go into more detail about this in part 3. As a patient you need to be aware that these areas need be properly evaluated before you consider more invasive therapies like injections or surgery.

Cervical Spine (neck)

Another source of your finger symptoms originates from your cervical spine (neck). As your spine wears out either from age, poor genetics, overuse, poor posture, or trauma, the spinal nerves that travel out of your neck and down arm become irritated and compressed causing symptoms into your fingers. The spinal nerves can become irritated from degenerative changes in your cervical spine, disc bulging, disc herniation or anything that takes up space in the canal and irritates the nerve. The location of your symptoms will be determined by which spinal nerve is being irritated. Below is a picture of a cross section of your spine.

This picture depicts how easy is for the nerve to be irritated from a disc herniation taking up space in the canal. The lower levels in your neck (which are the most common segments that degenerate) supply the skin of your fingers and will create tingling, numbing, burning, or pin and needle sensations into your fingers (similar to carpal tunnel symptoms). Nerve irritation at the spinal level needs to be ruled in or out by Dr. Phipps or an Integrative Diagnosis provider (more on this in part 4). Treatment for this is completely different than treatment for the median nerve and carpal tunnel; highlighting the importance of a proper diagnosis.

Median nerve entrapment and spinal nerve irritation at the cervical spine are two of the most common causes of symptoms into the hand and will mimic the symptoms of carpal tunnel syndrome. Disease processes like rheumatoid arthritis, diabetes, lupus, and hypothyroidism can also cause carpal tunnel syndrome. There are many other causes of symptoms into your fingers and any neurological sensation like numbness, tingling, burning, and pins and needles needs to be thoroughly investigated immediately. Ignoring this could lead to permanent damage and loss of nerve function.

In part 3 we will discuss the role adhesion plays in nerve irritation and creating symptoms into your hand and fingers and how this has likely been missed in your case.