Carpal Tunnel Syndrome (CTS) involves the wrist (carpal) bones that form a tunnel-like structure through which several tendons and one nerve (the median nerve) pass into the hand. It occurs when the median nerve is compressed within this carpal tunnel. Symptoms may include tingling and numbness into the fingers, and possibly pain so intense it keeps you awake at night. There may be similar symptoms in the upper arm and shoulder, and even the neck. Oftentimes weakness can develop in the hand creating difficulty with gripping average things such as a glass of water. CTS is a common condition, often occurring because of repetitive motions such as working on a computer, sewing/knitting, or even playing music. It is more commonly seen in women 40 to 60 years of age than in men, and is far less common in young people. Some disease conditions that may narrow the carpal tunnel, such as osteoarthritis, may also cause CTS. The median nerve originates in the neck (cervical spine) and travels into the hand. Therefore, there is a direct connection between the neck, arm, and hand. It is impossible to use the hand without also involving the neck, thus, it may be that altered spinal movements created by strain, aggravate the condition. As chiropractors, we will examine the cervical spine as well as the upper extremity to determine the underlying cause of the condition. Treatment may involve spinal or extremity joint adjustments, modalities (such as ultrasound) to reduce inflammation, ergonomic assessment, and appropriate stretches and strengthening exercises.