Tingling in the thumb and first two fingers
Usually worst at night or first thing in the morning, and shaking the hand out eases it for a bit.
Carpal tunnel syndrome usually starts as pins and needles in the thumb, index and middle fingers. It often wakes you at night, and shaking the hand out helps for a while. Over time, typing, holding a phone or gripping a steering wheel can bring it on within minutes. Some people start dropping things.
The median nerve passes through a narrow channel at the wrist, the carpal tunnel, on its way to the thumb side of the hand. Pressure inside that channel is a common part of the picture. The nerve can also become sensitive along its route through the forearm. Tight forearm flexors then keep it irritated with ordinary daily use.
I use dry needling, a form of acupuncture, on the forearm muscles that reproduce your symptoms. The wrist and finger flexors, along with the pronator teres near the elbow, can crowd the median nerve before it ever reaches the wrist. I needle them so the nerve has space to move as you grip and type. When the median nerve at the wrist is irritable by itself, I add electroacupuncture. Fine needles sit beside the nerve near the wrist crease with a gentle current, aiming to help settle how it signals.
Most people have tried a night splint, medication for pain and swelling, time away from the keyboard and sometimes a steroid injection. These can calm night symptoms, but the tingling often returns once a full workweek starts again. A splint protects the wrist while you sleep, yet it doesn’t reach tight forearm muscles crowding the nerve higher up. Surgery is the right step for some people, and your hand surgeon is the one to make that call. If physical therapy or chiropractic care was part of your plan, dry needling will be new to you. New York doesn’t let physical therapists or chiropractors offer it.
I ask which fingers go numb, when it wakes you, and what your hands do all day. Then the exam:
I work alongside hand surgeons, neurologists and primary care doctors. If anything I find suggests checking back in with one of them, I’ll let you know and share my findings.
No. Your hand surgeon or neurologist diagnoses carpal tunnel and decides on splints, injections or surgery. I work alongside that plan, treating the forearm muscles and the median nerve’s signaling.
It can help, and treatment is usually a combination because muscle tightness and nerve irritation often appear together. Relaxing the forearm flexors eases the squeeze on the median nerve higher up the arm. Electroacupuncture is added when the nerve at the wrist stays reactive.
A nerve conduction test measures how a signal travels at one moment in time. A nerve can be sensitive to pressure and wrist position and still test normal. Tight forearm muscles don’t show up on these tests either.
That depends on severity and on how your median nerve responds: some hands do well with two sessions a week for six weeks, others need three a week for four. Close spacing keeps input on the nerve while you keep working. Once nights and typing hold their gains, I taper the schedule.
Both can cause tingling in the hand, and sometimes both are involved. Which fingers tingle, and whether turning your head changes it, helps tell them apart. The neck is part of every first exam, and I include it in treatment if it’s contributing.
Get medical care promptly if hand weakness is worsening quickly or numbness is constant and spreading. The same applies if the muscle at the base of your thumb looks like it’s shrinking. New neck pain with arm weakness also needs prompt evaluation.
Adults with pelvic floor, nerve and orthopedic pain, along with neurological conditions. Most of my patients come to me after other care hasn't fully settled things. If you're looking for general wellness acupuncture, I'm not the right fit.
We review your history and what you've already tried. I assess the muscles and nerves involved, and you're treated the same day.
It depends on the condition. Pelvic and orthopedic plans usually run 4 to 6 weeks. Neurological plans are usually 2 visits a week for 6 weeks or 3 a week for 4. After that, visits space out so the changes hold. These are typical timelines, not promises.
Yes. I work alongside doctors, physical therapists and specialists. If something I find needs a closer look from one of them, I'll tell you.
I'm an out-of-network provider. You pay at the time of your visit, and my office submits the claim so any reimbursement comes to you. Free benefit checks are available before your first visit through the verification form, and HSA and FSA cards work. I don't take Medicare or Medicaid, though some Medicare Advantage plans reimburse out-of-network care. Full insurance details
Yes. I treat adults, teens and children, though I don't specialize in infants or toddlers.
Yes. Book a free discovery call to ask your questions and see whether we're a good fit.
Dry needling is a form of acupuncture. Fine needles go into tight bands of muscle and trigger points to lower muscle tension and change how the area is signaling.
You may feel a brief twitch or a deep ache as the needle reaches tight muscle. It passes quickly, and any soreness afterward usually fades within a day or two.
It's generally safe with a properly trained practitioner. Needles are sterile and single-use, and I check your health history first, including blood thinners. In New York, dry needling can only be performed by licensed acupuncturists, MDs and DOs. Physical therapists and chiropractors aren't permitted to perform it.
Eat something light beforehand and wear loose clothing that lets me reach the area being treated.
Usually not. Ultrasound helps in a few specific cases, but it hasn't been shown to improve results for common trigger points. A careful hands-on exam is what guides the needle. More on ultrasound-guided dry needling
Dry needling aimed at the pelvic floor and the hip and abdominal muscles around it, for pain, tension and urinary symptoms driven by those muscles and their nerves. More on pelvic floor dry needling
Sometimes, depending on the muscles involved, and you'll be draped throughout. Treatment always follows your consent and comfort. I don't do internal exams or internal treatment.
No, though it helps if you've already seen a doctor or pelvic floor physical therapist. Bring any notes or imaging you have.
Completely. I've heard it all, and there's no judgment here, just a straightforward conversation so we can treat what's going on.
Yes, I treat adults of every gender and identity. After gender-affirming surgery involving the pelvis, bring your surgical notes and we'll decide together what fits.
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Evidence-based acupuncture and dry needling on the Upper West Side. From chronic pain and headaches to pelvic floor dysfunction, Dr. Jordan Barber pairs the highest level of training with care that actually listens.
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