Quick Summary
Night-time hand tingling or a weaker grip? Carpal tunnel syndrome affects the median nerve at the wrist. Our New Malden physiotherapists assess the pattern of your symptoms and help you choose appropriate support, exercises or medical review.
Understanding Carpal Tunnel Syndrome
The median nerve passes through a narrow tunnel into the hand. Pressure on it can affect sensation in the thumb, index, middle and part of the ring finger. Persistent compression may affect thumb strength. Not all hand tingling comes from the wrist, so the symptom pattern matters.
How we assess your symptoms
We discuss sleep disturbance, finger distribution and daily tasks, then examine sensation, thumb strength and relevant movement. Constant numbness or weakness may need GP or hand-specialist review and nerve tests. A suitable night splint may be discussed; scans are not automatically required.
Image: BruceBlaus / Blausen Medical — Carpal Tunnel Syndrome · CC BY 3.0. Adapted and annotated.
Do You Experience These Symptoms?
- Tingling or numbness in the thumb-side fingers, often at night.
- Aching in the hand or wrist; shaking the hand may briefly help.
- Dropping objects or difficulty with small movements when symptoms progress.
An assessment helps guide your next step, based on your symptoms, health and goals.
What may contribute?
Pregnancy-related fluid changes, some medical conditions and previous wrist injuries can contribute. Repeated loading may aggravate symptoms, but there is not always an obvious trigger. A work or hobby history helps identify practical changes without assuming your job is the only cause.
A treatment plan built around you
Hands-On Manual Therapy
Gentle hands-on treatment may address associated forearm discomfort, but massage cannot reliably remove pressure on the median nerve. We avoid prolonged pressure directly over a sensitive nerve.
Is Shockwave Suitable?
Shockwave is not routinely recommended for carpal tunnel syndrome. Your assessment will guide appropriate rehabilitation, symptom management and whether medical or specialist review is needed. We will explain why each proposed treatment fits your symptoms before you decide whether to proceed.
Targeted Exercise Programme
Where suitable, carefully dosed tendon or nerve movements accompany activity changes. Stop an exercise that increases lasting tingling. Splint advice and review of changing strength are more important than repeatedly stretching through numbness.
When to Seek Urgent Medical Help
While most symptoms are not serious, urgent medical attention is required if you experience any of the following:
- Go to A&E immediately after an injury if a joint is deformed or the hand or finger is cold, pale or blue, or has severe loss of sensation. For other severe swelling or inability to use the arm, seek urgent assessment through NHS 111.
- A hot, red, rapidly swollen joint with fever needs urgent medical assessment. Arrange prompt review for persistent numbness, increasing weakness or loss of dexterity.
Your questions answered
Can pregnancy cause carpal tunnel symptoms?
Yes. Fluid changes can contribute, and symptoms may improve after birth. Persistent numbness or weakness still needs assessment; pregnancy massage is not treatment for nerve compression.
When might surgery be discussed?
A GP or hand specialist may discuss injection or decompression if symptoms persist or nerve function is affected. Early assessment helps identify when rehabilitation alone is insufficient.
Which appointment should I book?
Choose a Physiotherapy Initial Assessment for new, persistent or uncertain symptoms. We will assess what is limiting you, explain the options and agree the next steps. If you already have a diagnosis, bring any relevant scan report or specialist advice.
Visit J&J Therapy on the ground floor of CI Tower, New Malden. Book an assessment or call our reception team on 07935 869938 if you are unsure which service to choose.
Related conditions
Cubital tunnel syndrome · Repetitive strain injury
Sources and further reading
This page is for general information only and does not replace professional medical advice.
Information updated 15 October 2026. General information to support informed choices; it is not a diagnosis or a personalised treatment plan. Suitability and any need for referral are assessed individually. Seek urgent medical help for the warning signs listed above.