Cervical Radiculopathy vs. Carpal Tunnel Syndrome: What’s Causing Your Arm or Hand Symptoms?

Tingling in your fingers? Numbness in your hand? Pain shooting down your arm?

Most people assume one thing: carpal tunnel syndrome.

But here’s the surprise — many arm and hand symptoms actually start in the neck, not the wrist.

Two common conditions often get confused:

• Cervical Radiculopathy (a nerve issue coming from the neck)

• Carpal Tunnel Syndrome (a nerve compression at the wrist)

They can feel very similar. But they are very different problems — and they require different treatment approaches.

Let’s break it down clearly.

What Is Cervical Radiculopathy?

Cervical radiculopathy happens when a nerve in the neck becomes irritated or compressed.

Your spinal cord runs through your neck. From it branch nerves that travel down into your shoulders, arms, and hands. If one of these nerves is compressed — by a disc bulge, arthritis, inflammation, or poor spinal alignment — it can cause symptoms anywhere along that nerve’s pathway.

That means the pain may not stay in the neck. It can travel.

Common Causes:

• Disc bulges or herniations

• Degenerative arthritis in the neck

• Poor posture (especially forward head posture)

• Long hours at desks or commuting

• Trauma (car accidents, falls, sports injuries)

Common Symptoms:

• Shooting pain down one arm

• Tingling or numbness in fingers

• Weakness in the arm or hand

• Neck stiffness

• Pain that worsens when turning or extending the neck

The key idea: the problem starts in the neck, even if you feel it in your hand.

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is different. It happens when the median nerve is compressed at the wrist.

The carpal tunnel is a small passageway in the wrist. The median nerve runs through it along with tendons that control finger movement. When the tunnel becomes crowded or inflamed, pressure builds up on the nerve.

This is often linked to repetitive hand movements.

Common Causes:

• Repetitive typing or mouse use

• Wrist positioning during work

• Pregnancy-related swelling

• Diabetes

• Arthritis in the wrist

• Inflammation from overuse

Common Symptoms:

• Numbness or tingling in the thumb, index, and middle finger

• Symptoms worse at night

• Shaking the hand brings temporary relief

• Weak grip strength

• Dropping objects

The key idea: the problem starts at the wrist, not the neck.

Similarities Between Cervical Radiculopathy and Carpal Tunnel

This is where things get tricky.

Both conditions can cause:

• Tingling in the fingers

• Numbness

• Arm discomfort

• Weakness

• Symptoms that worsen with repetitive activity

Because the symptoms overlap, many people self-diagnose incorrectly.

We regularly see patients who were told they had carpal tunnel — but the true source was actually coming from the neck.

That’s why proper diagnosis matters.

Key Differences

Here’s a simple comparison:

Feature	Cervical Radiculopathy	Carpal Tunnel Syndrome
Source of problem	Neck (cervical spine)	Wrist
Neck pain present?	Often yes	Usually no
Pain shoots down arm?	Common	Rare
Symptoms worse at night?	Sometimes	Very common
Affects which fingers?	Depends on nerve root	Thumb, index, middle finger
Relief from shaking hand?	No	Often yes

If symptoms change when you move your neck, that’s a big clue the issue may be cervical.

How Are These Conditions Diagnosed?

A proper diagnosis includes more than just asking where it hurts.

1. Detailed History

We ask:

• When did symptoms begin?

• What makes them worse?

• Does neck movement change the symptoms?

• Are symptoms worse at night?

• Is there weakness?

Patterns matter.

2. Physical Examination

For cervical radiculopathy, we test:

• Neck mobility

• Reflexes

• Muscle strength

• Sensation in different dermatomes (nerve patterns)

• Spurling’s test (neck compression test)

  
  

For carpal tunnel, we perform:

• Tinel’s test (tapping over the wrist nerve)

• Phalen’s test (holding wrists in flexion)

• Grip strength testing

  
  

3. Imaging and Studies (If Needed)

For cervical radiculopathy:

• X-rays

• MRI (to evaluate discs and nerve compression)

For carpal tunnel:

• Nerve conduction studies (EMG)

• Ultrasound in some cases

The goal is to determine where the nerve is being irritated.

Treating the wrong area won’t fix the problem.

Can You Have Both?

Yes — and this is important.

It’s called Double Crush Syndrome.

If a nerve is irritated in the neck, it becomes more sensitive further down the arm. Even mild compression at the wrist can then trigger symptoms.

So someone may have:

• Mild cervical nerve irritation

• Mild wrist compression

• But strong symptoms overall

That’s why a full spine and extremity evaluation is essential.

How Chiropractic Care Helps Cervical Radiculopathy

When symptoms are coming from the neck, chiropractic care focuses on:

1. Spinal Adjustments

Gentle adjustments improve spinal alignment and reduce pressure on irritated nerves.

2. Reducing Inflammation

Improving movement reduces inflammation around nerve roots.

3. Postural Correction

Many radiculopathy cases stem from forward head posture — especially in adults aged 30–45 who work at desks and commute daily.

Correcting posture reduces long-term nerve stress.

4. Disc Support Strategies

Specific exercises and traction methods may help reduce disc pressure.

5. Strengthening and Stabilization

We strengthen deep neck stabilizers to prevent recurrence.

How Chiropractic Care Helps Carpal Tunnel Syndrome

When the problem is at the wrist, care looks different.

1. Wrist Adjustments

Small joint restrictions in the wrist can increase tunnel pressure.

2. Soft Tissue Therapy

Reducing tension in forearm muscles decreases pull on the tendons that run through the tunnel.

3. Ergonomic Correction

Keyboard, mouse, and desk positioning are reviewed.

4. Nerve Mobility Exercises

Specific movements help improve median nerve glide.

5. Addressing the Entire Chain

Even in carpal tunnel cases, we still evaluate the neck. A healthy spine supports healthy nerves.

When Should You Get Checked?

If you are experiencing:

• Persistent tingling in fingers

• Arm pain that doesn’t improve

• Weak grip strength

• Nighttime numbness

• Neck stiffness combined with arm symptoms

It’s time for a professional evaluation.

The earlier nerve issues are addressed, the better the outcomes.

Final Thoughts

Cervical radiculopathy and carpal tunnel syndrome can look similar — but they are very different conditions.

One starts in the neck. One starts at the wrist.

And sometimes both are involved.

Getting the diagnosis right is the most important step toward recovery.

At The Well Adjusted Chiropractic Centre, we perform thorough assessments to determine the true source of your symptoms. Whether your nerve irritation is coming from the cervical spine, the wrist, or both, chiropractic care offers safe, non-invasive treatment options that support long-term nerve health.

If you’ve been living with numbness, tingling, or arm pain, don’t ignore it.

Your nerves are talking.

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