Median nerve
Carpal Tunnel Syndrome — North Vancouver
Numb thumb at 3 a.m., a wrist that won't grip a coffee cup, pins and needles into the first three fingers. We treat the carpal tunnel and the whole nerve path that feeds it.
What it is
Understanding your carpal tunnel syndrome.
Carpal tunnel syndrome is what happens when the median nerve gets compressed as it travels through a narrow space at the front of the wrist. The classic symptoms — numbness or tingling in the thumb, index, middle, and half of the ring finger, sometimes waking you in the middle of the night — come from the nerve, not from the joint. Grip weakness, dropping objects, and a vague ache up the forearm are common companions.
Two things are worth knowing early. First, the median nerve runs from the neck to the fingertips, and compression anywhere along that path can cause symptoms that look like carpal tunnel. A 'double-crush' pattern — neck plus wrist — is common, and treating only the wrist when the neck is part of the problem is why some cases stall.
Second, conservative care works for a meaningful share of mild to moderate cases. Severe cases with significant thumb-muscle wasting or near-constant numbness are a different conversation and usually need a surgical consult sooner rather than later. The first assessment sorts out which category you're in.
What to expect
Mild and moderate cases often start easing within 4–8 weeks of a consistent program, especially when night splinting and nerve glides are layered together. Severe cases with sensory loss or thenar atrophy respond more slowly and may need surgical consult. Your physiotherapist will set the next milestone after the first assessment.
Get a plan
Not sure if we're the right fit?
Send us a quick note about what's going on. A physiotherapist — not a receptionist — will read it and reply with what they'd recommend. No commitment to book.
Common questions
About carpal tunnel syndrome.
Do I need nerve conduction testing before starting?+
Not always. A careful clinical assessment can identify median nerve involvement and rule out the more common mimics. Nerve conduction studies are useful when symptoms are severe, when the diagnosis is uncertain, or when surgical consult is being considered. We'll tell you when the referral makes sense.
Will splinting alone fix it?+
Often not, but it's an important piece. Night splinting keeps the wrist neutral during sleep, which is when many people unconsciously bend their wrists and re-aggravate the nerve. Combined with nerve glides and ergonomic adjustments, it's a strong first phase.
When is surgery the right call?+
Worsening sensory loss, visible wasting of the thumb-base muscles, near-constant numbness, or symptoms that haven't responded to a proper 6–12 week conservative trial — those are reasonable reasons to ask for a surgical opinion. We refer when the picture warrants it.
Could this be coming from my neck?+
It can be. A pinched nerve root in the lower cervical spine can produce arm and hand symptoms that overlap with carpal tunnel. Part of the first assessment is mapping the whole nerve path so we treat the right level.
Do you direct-bill extended health?+
Yes. Direct billing for most major extended-health insurers, plus ICBC and WorkSafeBC.
This page is for general information only and does not constitute medical advice, diagnosis, or treatment. Individual presentations vary — assessment findings and treatment plans differ from person to person. If you are experiencing severe symptoms, neurological changes (numbness, weakness, bowel or bladder changes), or a significant trauma, contact your physician or emergency services. Physiotherapy at Medstar Sport Physio & Health is provided by physiotherapists registered with the College of Physical Therapists of British Columbia (CPTBC).