Condition
Carpal Tunnel
Carpal tunnel is the search. The chart is often messier: night tingling, dropping a coffee cup, UD laptops, and scanning at a register. Dr. Richardson lists carpal tunnel among his extremity focuses. Wilmington desk workers and Newark hospital staff both show up with it.
We exam the wrist, the forearm, and the cervical spine. Taping and work-position changes matter as much as an adjustment. If weakness is progressing or thenar bulk is gone, that is a medical and surgical conversation we will not delay.
Pair with neck pain and nerve pain when symptoms also live above the elbow. Pair with neuropathy when the pattern is stocking-glove and metabolic, not a single tunnel.
The carpal tunnel is a narrow passage on the palm side of the wrist, floored by the wrist bones and roofed by a tough ligament. Nine flexor tendons and the median nerve share it, and there is no room for swelling. Anything that raises pressure inside — repetitive gripping, sustained wrist flexion, fluid retention in pregnancy, thyroid disease, or diabetes — compresses the nerve. Because the nerve carries sensation from the thumb through half the ring finger and powers the muscles at the base of the thumb, the symptoms follow a distribution that is genuinely specific if you look for it.
Our exam covers the whole nerve path rather than the wrist alone. That means cervical motion and nerve-root testing, checking the nerve where it passes between the scalene muscles at the neck and under the pectoralis minor at the shoulder, palpating the pronator teres in the forearm where the median nerve can also be caught, and only then the tunnel itself with Phalen's and Tinel's tests. We assess grip strength and look specifically at the thenar eminence, because visible wasting there changes the recommendation immediately.
For genuine tunnel cases caught before there is muscle wasting, conservative care is reasonable and well supported. Nerve-glide exercises restore the median nerve's ability to slide within its sheath, soft-tissue work through the forearm flexors reduces the tension pulling across the wrist, and neutral night splinting addresses the overnight pressure spike. Where the exam finds cervical involvement, treating the neck is not an add-on — it is often the part that makes the difference.
The workplace conversation is unavoidable and it is where a lot of Delaware cases live: register scanning, warehouse picking, hairdressing, assembly work, and long days on a laptop keyboard set at the wrong height. Adjusting keyboard and mouse position so the wrist stays neutral, breaking up sustained gripping, and rotating tasks does more over six months than anything done in the treatment room. We are direct about that rather than pretending visits alone will outrun eight hours a day of load.
The medical overlaps matter here more than on most pages. Thyroid disease, diabetes, rheumatoid arthritis, and pregnancy all cause or worsen carpal tunnel symptoms, and the first three need managing by a physician rather than by us. Pregnancy-related cases frequently resolve after delivery and are usually worth treating conservatively in the meantime.
Related conditions people search
Services that often help
Doctors to start with
Patients from Bear, Glasgow, and Pike Creek typically use Newark. Brandywine Hundred, Claymont, and Hockessin use Wilmington. Capital-area patients use Camden/Dover. Smyrna covers Route 13 and Saturday mornings.
FAQ
Can chiropractic replace carpal tunnel surgery?
Not when electrodiagnostic testing and a surgeon already say the tunnel needs release. Many “carpal tunnel” charts are neck or pronator. We exam before anyone sells you a wrist gadget.
Why do you check my neck for hand numbness?
Cervical nerves supply the hand. A double-crush pattern (neck plus wrist) is common in desk and warehouse work. Treating only the wrist fails those patients.
How do I know if it is my neck or my wrist?
The distribution of the numbness is the most useful clue. True carpal tunnel affects the thumb, index, middle, and half the ring finger, and spares the little finger entirely, because the median nerve does not supply it. Numbness that includes the little finger, or that travels above the wrist into the forearm, shoulder, or neck, is coming from further up. Symptoms that wake you at three in the morning and improve when you shake the hand out are classic tunnel. Symptoms that change when you turn your head are not.
What is a double crush?
A nerve compressed in two places along its length becomes symptomatic at a lower threshold than it would from either compression alone. A cervical nerve root that is mildly irritated at the neck plus a mildly tight carpal tunnel produces symptoms neither would produce by itself. It matters clinically because releasing only one of the two sites often gives partial relief, which is one common reason a technically successful wrist surgery leaves a patient still numb.
Do wrist splints work?
A neutral splint worn at night helps a good proportion of cases, and it is worth trying before anything invasive. Most people sleep with the wrist curled, which narrows the tunnel and raises the pressure inside it for hours at a stretch — that is why symptoms peak overnight. A splint that holds the wrist straight removes that. The splint does nothing for a neck-driven pattern, which is a useful diagnostic hint in itself.
When do I need surgery?
When there is measurable muscle wasting at the base of the thumb, constant rather than intermittent numbness, weakness that is progressing, or nerve conduction studies showing significant compression that has not responded to conservative care. Those cases do better with release than with more months of therapy, and delaying can leave permanent deficit. We say so plainly rather than selling another block of visits.