Conditions We Treat
Your hands and wrists are involved in almost everything you do, so when they hurt, the impact on daily life is immediate. Typing, cooking, picking up your child, even scrolling on your phone: all of it becomes difficult. Wrist and hand complaints account for a significant portion of upper limb problems, with carpal tunnel syndrome alone affecting around 3 to 6% of the adult population.
Carpal tunnel syndrome is the most common nerve compression condition we see. The median nerve gets squeezed as it passes through the narrow carpal tunnel at the wrist, leading to numbness, tingling and weakness in the thumb and first three fingers. De Quervain's tenosynovitis is another frequent complaint, especially among new parents. It causes sharp pain on the thumb side of the wrist and is triggered by repetitive gripping and lifting. We also treat general repetitive strain injuries from desk work, manual labour and sport.
The evidence for conservative management of wrist and hand conditions is strong. A 2019 randomised controlled trial published in JOSPT found that manual therapy for mild to moderate carpal tunnel syndrome was as effective as surgery at 12 months. For De Quervain's, a combination of manual therapy, activity modification and progressive loading exercises has been shown to produce good outcomes without needing cortisone injections in most cases.
One thing we always check is the neck and thoracic spine. The nerves supplying the hand originate in the cervical spine and travel through the shoulder and arm. Compression or irritation anywhere along this path can mimic or worsen hand symptoms. A condition called double crush syndrome occurs when the nerve is compromised at two points simultaneously, for instance at the neck and the wrist. This is why treating the wrist in isolation sometimes falls short.
Treatment typically includes mobilisation of the wrist, hand and cervical spine, nerve gliding exercises, soft tissue work to the forearm flexors and extensors and ergonomic advice. For carpal tunnel, we often recommend a wrist splint for sleeping to reduce overnight nerve compression.
Our approach combines hands-on treatment with practical rehab and ergonomic guidance. Whether you're dealing with carpal tunnel, De Quervain's or desk-related strain, we focus on resolving the root cause rather than just managing symptoms.
Located on Rivonia Road in Morningside, we serve patients from Sandton, Bryanston, Fourways, Randburg and surrounding areas.
Book an appointment at our Sandton practice and let us help you get your hands working properly again.
Yes. Chiropractors can treat mild to moderate carpal tunnel syndrome using wrist mobilisation, nerve gliding techniques and soft tissue therapy. A 2019 randomised controlled trial found that manual therapy was as effective as surgery at 12 months for mild to moderate cases, with the added benefit of being non-invasive.
Sustained wrist extension while typing, poor mouse positioning and repetitive clicking can overload the tendons and compress the median nerve at the carpal tunnel. Over time, this can lead to repetitive strain injury or carpal tunnel symptoms including pain, numbness and tingling.
De Quervain's is a painful condition affecting the tendons on the thumb side of the wrist. It typically develops from repetitive thumb and wrist movements. It is very common in new parents from lifting and holding their baby. Treatment includes thumb and wrist mobilisation, soft tissue work and activity modification.
Not necessarily. For mild to moderate carpal tunnel, conservative care is a reasonable first step. A 2019 study in the Journal of Orthopaedic and Sports Physical Therapy showed that manual therapy matched surgical outcomes at one year. Surgery is typically reserved for severe cases with muscle wasting or failed conservative care.
Night-time numbness in the fingers is a hallmark of carpal tunnel syndrome. The wrist naturally flexes during sleep, which increases pressure on the median nerve within the carpal tunnel. It can also result from nerve compression in the neck or thoracic outlet. A thorough assessment helps determine the source.
