Carpal Tunnel vs. Cervical Radiculopathy: Why is My Hand Numb? (Hyderabad Guide)

The "IT Professional's Dilemma": Wrist or Neck?

In my practice in Hyderabad, specifically around the IT hubs of Hitech City and Gachibowli, "hand numbness" is one of the most common complaints I hear. Many patients walk in convinced they have Carpal Tunnel Syndrome because they spend 10+ hours a day typing.

However, nearly 30-40% of the time, the problem isn't in their wrist at all—it's in their neck.

This condition is called Cervical Radiculopathy (a pinched nerve in the spine), and treating the wrist won't fix it. Understanding the difference is crucial for getting the right treatment and avoiding unnecessary procedures.

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome occurs when the median nerve gets compressed as it passes through the narrow "carpal tunnel" in your wrist.

• Primary Cause: Repetitive wrist motion (typing, mouse use), fluid retention, or anatomical narrowness.
• Key Symptoms: Numbness or tingling in the thumb, index, and middle fingers.
• Night Pain: Often wakes you up at night with a need to "shake out" your hand.

What is Cervical Radiculopathy?

Cervical Radiculopathy happens when a nerve root in your neck (cervical spine) is compressed or irritated, usually by a herniated disc or bone spur.

• Primary Cause: Cervical Spondylosis, slip disc, or poor neck posture ("Text Neck").
• Key Symptoms: Pain that radiates from the neck down the arm into the hand.
• Positional Pain: Moving your neck in certain ways (like looking up and to the side) often triggers the pain.

Comparison: How to Tell the Difference

Here is a quick guide to help you distinguish between the two:

Can You Have Both? (Double Crush Syndrome)

Yes. It is possible to have compression at both the neck and the wrist. This is known as Double Crush Syndrome. The nerve, being compromised at the neck, becomes more susceptible to pressure at the wrist. This makes accurate diagnosis by a Spine Specialist even more critical.

Simple Home Self-Checks

Disclaimer: These tests are for educational purposes. Only a doctor can provide a medical diagnosis.

1. Phalen’s Maneuver (For Carpal Tunnel)

Press the backs of your hands together at chest level, with your fingers pointing down. Hold for 60 seconds.

• Positive Sign: Tingling increases in the thumb/index fingers.

2. Spurling’s Test (For Cervical Radiculopathy)

Tilt your head back and to the side of the pain.

• Positive Sign: Pain shoots down your arm (stop immediately if this happens).

Treatment Pathways

For Carpal Tunnel

• Mild: Wrist splints (especially at night), ergonomic adjustments, and nerve gliding exercises.
• Severe: Carpal Tunnel Release Surgery, a quick procedure to cut the ligament and free the nerve.

For Cervical Radiculopathy

• Mild: Physiotherapy, neck posture correction, medications.
• Severe: If there is significant weakness or intractable pain, Cervical Disc Replacement or Keyhole Surgery may be needed.

When to See a Doctor? (Red Flags)

Do not ignore hand numbness if:

• You notice muscle wasting (the fleshy part of your thumb looks thinner).
• Your grip is weak (you drop cups or keys).
• The numbness is constant, not just intermittent.
• You have trouble with fine motor tasks like buttoning a shirt.

Conclusion

Whether it's your wrist or your neck, living with numbness affects your productivity and quality of life. The right diagnosis is the first step to recovery.

Confused about your symptoms? Book a consultation with Dr. Sayuj Krishnan for a comprehensive nerve and spine evaluation.