As a hand therapist, one of the most frequent referrals we receive is for hand pain. Reports show the x-rays are okay, no specific injury is recalled, but "it just hurts sometimes." There can also be numbness, tingling, or a pins and needles feeling, so the thought is it must be carpal tunnel.

Although carpal tunnel is the most common nerve compression, it isn't the only thing that can cause the sensory changes or paresthesia that I mentioned above. It is a frequent assumption that when the hand or wrist hurts, the problem must be in this area. Unfortunately, that's not always the case, and the simple answer to this conundrum is our nerves. 

Nerves are our messaging system; they run throughout our body to receive input from our senses and help the brain respond to the world. The problem is that nerves travel through muscles, across joints, and into some tight spaces to receive and carry their information. On these paths, they can become compressed and irritated. It is this nerve irritation that takes us back to the hand pain conundrum. 

The challenge with any nerve is that it doesn't always hurt at the site of compression. The pain can be felt in a completely different location. For example, a nerve squeezed in the neck can cause pain in the arm or when compressed at the elbow, hurt in the hand. This is when your physician or therapist can help. There are special tests and tools that can help locate the problem area and then determine the cause. This is the key to getting better, to know where the pain is coming from. So, the next time someone tells you their hand hurts, it may not be just another case of carpal tunnel.