Occasional tingling after holding a bent wrist for a while is not an emergency. But numbness that recurs most nights, lasts more than two weeks, or is accompanied by weakness deserves a proper diagnosis — because early CTS is reversible and advanced CTS is only partially so. The median nerve can be squeezed at the wrist, elbow, or neck, and each needs different treatment.
🚨 Make an Appointment If:
Numbness wakes you most nights or persists for more than two weeks
You drop objects, feel weak, or notice a hollow at the base of the thumb
Both hands are affected, or the numbness spreads beyond the hand
It started after a neck injury
You have diabetes, and the numbness is new or spreading
You are pregnant and the symptoms interfere with sleep or function
Why Early Diagnosis Matters
CTS affects 3–6% of adults, and the nerve compression is measured in months: mild, intermittent compression responds to splints and activity changes; severe, constant compression with muscle wasting may need surgery and does not fully reverse. The same logic applies to neck-related numbness. A nerve conduction study — the gold-standard test — takes under an hour and tells you exactly where the nerve is struggling.
What to Expect
History and examination: which fingers, when it happens, and provocative tests (Tinel's tap, Phalen's bend).
Nerve conduction study and EMG: measures signal speed across the wrist or elbow and localises the compression.
Blood tests: glucose/HbA1c and thyroid function when metabolic causes are possible.
Neck imaging: only if the examination suggests a neck origin.
Which Specialist to See
Start with a GP, who can run the clinical tests and arrange a nerve conduction study. From there, treatment is usually led by a physiotherapist or occupational therapist (splints, nerve-gliding exercises), with a hand surgeon or neurosurgeon involved if surgery is considered. An endocrinologist is relevant if diabetes or thyroid disease is the driver.
Urgency Guide
Prompt (days): weakness, dropping objects, thumb-muscle wasting, or numbness after a neck injury.
Within weeks: night-time numbness most nights, or symptoms persisting beyond two weeks of splinting.
Routine: mild, occasional tingling you want explained.
While you wait, the relief page covers night splinting and nerve-gliding exercises.
Questions the Doctor May Ask
Which fingers are numb, and is the little finger involved?
Does the numbness wake you at night, and does shaking the hand help?
Do you do repetitive wrist work, and has it changed recently?
Are you pregnant, diabetic, or on thyroid medication?
Is there any weakness, clumsiness, or neck pain?
What Happens If You Wait — and What You Can Do Now
Waiting two to four weeks with a night splint is the correct first step for mild CTS — many cases resolve with that alone. Waiting months without splinting is how mild compression becomes moderate and moderate becomes wasting. While you wait: wear the splint every night, keep the wrist neutral during the day, take breaks from repetitive tasks, and use the relief strategies. If weakness appears at any point, move the appointment up — that is the threshold where waiting stops being harmless.
How to Prepare for the Appointment
Note exactly which fingers are numb — this single detail is the most diagnostic piece of information you can bring. Record when it happens (night, during work, constant), what relieves it (shaking, splinting, position changes), and whether you have noticed weakness, dropping objects, or neck pain. Bring your job description or a list of repetitive hand activities, and mention pregnancy, diabetes, or thyroid conditions if relevant. This preparation lets the clinician go straight to the provocative tests and decide whether a nerve conduction study is needed on the first visit.
What the Tests Will Show
Tinel's sign (tapping over the wrist tunnel) and Phalen's test (holding the wrist bent for a minute) reproduce the numbness in most cases of carpal tunnel syndrome — they are quick, free, and surprisingly accurate. The nerve conduction study is the gold standard: it measures how fast the median nerve conducts across the wrist, localises exactly where the signal slows, and grades the severity, which directly guides treatment — mild compression is treated with splints, while severe compression may warrant surgery. Blood tests for glucose and thyroid function check the metabolic drivers. In most cases the diagnosis and its severity are clear after these steps.
Treatment Options at a Glance
Night splinting: the first-line treatment for mild CTS — try it for two to four weeks.
Activity and ergonomic changes: neutral wrist positions, micro-breaks, and reduced repetitive load.
Physiotherapy: nerve-gliding exercises and strengthening for wrist and neck causes.
Injections: corticosteroid injection into the tunnel for moderate cases.
Surgery: carpal tunnel release, highly effective, considered when weakness or severe compression is present.
⚠️ Medical Disclaimer: This site is for informational purposes only and does not constitute medical advice. Always consult a healthcare professional for medical concerns.