Wrist Pain: Carpal Tunnel or Something Else?
Wrist pain is one of the most common complaints among people who type, text, lift, or use their hands repetitively throughout the day. The first assumption many people (and even some providers) make is carpal tunnel syndrome—but in reality, wrist pain isn’t always coming from the wrist itself.
A frequent misdiagnosis of carpal tunnel syndrome is actually thoracic outlet syndrome, a condition that originates higher up in the shoulder and neck. Let’s break down the difference between these two conditions and how massage therapy can help with both.
Carpal Tunnel Syndrome (CTS)
What it is: Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the carpal tunnel in the wrist. This tunnel is formed by bones and ligaments, and swelling or tightness in the area can reduce space for the nerve.
Common symptoms:
Numbness, tingling, or “pins and needles” in the thumb, index, and middle fingers.
Wrist pain that may radiate into the hand or forearm.
Weak grip strength or difficulty holding objects.
Symptoms that worsen at night or with repetitive wrist use.
How massage can help:
Reduces tension in the wrist flexor muscles and tendons that crowd the carpal tunnel.
Improves circulation to decrease inflammation in the area.
Restores mobility in the forearm and hand to relieve nerve compression.
Thoracic Outlet Syndrome (TOS)
What it is: Thoracic outlet syndrome occurs when nerves or blood vessels are compressed in the space between the collarbone and first rib (the “thoracic outlet”). Even though the compression is happening in the upper chest/neck area, symptoms often appear further down the arm and wrist, which is why it’s so often mistaken for carpal tunnel syndrome.
Common symptoms:
Numbness or tingling in the hand or fingers (similar to CTS).
Pain or heaviness in the shoulder, arm, or wrist.
Symptoms that worsen with poor posture, lifting, or carrying heavy loads.
Sometimes swelling, discoloration, or temperature changes in the arm.
How massage can help:
Releases tightness in the scalene muscles of the neck, pectorals, and upper back that may compress nerves and blood vessels.
Improves posture by addressing muscle imbalances in the shoulders and chest.
Relieves secondary muscle tension down the arm and wrist caused by nerve irritation.
Why Carpal Tunnel Is Often a Misdiagnosis
Because CTS and TOS share overlapping symptoms—especially tingling, numbness, and weakness in the hand—it’s easy to confuse one for the other. The difference is in the source of compression:
CTS: compression at the wrist.
TOS: compression in the neck/shoulder region.
This is why treating only the wrist sometimes doesn’t resolve symptoms—because the real problem is further upstream.
The Role of Massage Therapy
Massage therapy takes a whole-body approach, looking beyond just the site of pain. By assessing whether symptoms may be coming from the wrist, the forearm, or higher up in the neck and shoulders, massage can:
Decrease nerve compression by relaxing tight muscles and fascia.
Improve circulation and lymphatic flow to reduce inflammation.
Support posture and alignment to prevent recurring compression.
Restore mobility in the wrist, forearm, shoulder, and neck.
Don’t Ignore Wrist Pain
If you’ve been experiencing numbness, tingling, or weakness in your hands, don’t assume it’s only carpal tunnel. An accurate understanding of what’s causing your symptoms is key to finding lasting relief.
Massage therapy can be an effective, non-invasive option for both carpal tunnel syndrome and thoracic outlet syndrome, and it can complement other care such as physical therapy, ergonomic adjustments, or medical treatment if needed.
Ready to find relief? Schedule a massage session and let’s work on restoring ease and mobility in your hands, wrists, and beyond.