Acupuncture for Carpal Tunnel in San Francisco
Numb, tingling fingers that wake you at night, or a wrist that aches after a day at the keyboard? We treat carpal tunnel syndrome and wrist pain with acupuncture, dry needling, cold laser and hands-on work, and we'll tell you plainly if you need a hand surgeon instead.
Sound familiar?
- Numbness or tingling in the thumb, index, middle and part of the ring finger
- Waking at night with a dead or buzzing hand that you need to shake out
- Symptoms when you hold a phone, steering wheel or book for a while
What our patients say
5.0 on Google from 92 reviews
I had a golfers elbow and my coach referred me to Andrew. He has been an amazing acupuncturist and worked on my right elbow, shoulder and arm for a couple of weeks. I have felt so much better just after the first session and going back really helps the blood flow so much better and my right arm, elbow and shoulder feels less tense and more relaxed. Definitely recommend this place, especially for athletes!
Andrew is fantastic! He is knowledgeable and provides specialized treatment for my chronic nerve pain. I highly recommend him.
In our career it is very important to stay physically healthy, because our dance career is very short. We rehearse, work out every single day, and very often, because of the physical pressure from practicing so hard, we get injuries and surgery. My story is about my back, foot and wrist. I joined San Francisco Ballet a year ago. The first day of work, during ballet class, I hurt my back. I have had problems before with my wrist, and sadly, later on with the tough season, my foot got hurt. Luckily, I was recommended to Andrew Castellanos. I started with a few visits a month, and quickly saw results, so I made sure I finished my treatments. Thanks to Andrew, I was able to finish my successful season here. Now I have to spread the word…
Andrew is a cornerstone of my care team. He successfully unwinds my ills before they can become chronic problems.
Andrew is amazing! Very caring and concerned about your health and well being. He genuinely is a very kind person.
Andrew is terrific. I saw him post shoulder surgery and it was very beneficial in getting pain free and full range of motion.
Andrew treated me over a period of about two years for hip and shoulder problems, and he was tremendously helpful. I was impressed with his knowledge and skill, not to mention wonderful “bedside manner” and especially his enthusiasm for staying current in his field.
I loved coming to Andrew. He was a lifesaver in helping me through some back issues when I was pregnant with my first child. A lovely, warm place and Andrew is amazing!!!!
Andrew is a fantastic alternative and addition to physical therapy. He quickly understands your condition and treats it effectively.
Andrew introduced me to a form of healing which, after years of competitive long distance running and many injuries, I am more than thankful to have discovered! My latest injury, a small tear in my left hamstring, sidelined me for a number of months. After trying rest, physical therapy and anti-inflammatories with little results, I finally met Andrew. His approach from the very beginning was completely methodical, precise and extremely professional. Right away the pain eased, and I felt my body finally respond to treatment. Andrew was instrumental in healing my hamstring, and I trust that his acupuncture/massage techniques will keep me healthy and, importantly, keep me running for many decades and miles.
I came to Andrew after nearly six excruciating months of not being able to run. I had a seemingly minor Achilles tendon injury that simply refused to heal, defying every modality I tried. I hoped Andrew, a specialist in sports injuries, could break the deadlock. The simple answer is that in three visits, I was running again, hardly able to believe my good fortune. The more complicated answer runs deeper. Andrew’s work doesn’t just address physical injury; he works on spiritual and emotional injury and stress too. I didn’t realize that my physical injury was bound up with emotional trauma, but he did, and he figured out how to disentangle them so the healing process could start. The process can be painful; emotional injuries that have lodged in your body have to work their way out through muscle and bone, like a physical illness. But it’s also both profound and unexpected. As another of Andrew’s clients said, he is a true healer.
I’ve always wanted to be able to demonstrate clearly to professional dancers when giving them corrections or setting ballets. However, without the level of daily physical preparation that my body was used to when I danced, my body now has moments of rebellion that, however careful I am, need the assistance of experts to ensure I can do my job fully. Andrew’s combination of acupuncture and soft tissue work always made a significant difference to my mobility, helping me undertake my role in the studio at a level of physicality such that I’m not confined to the minimum level of demonstration. With his level of experience with dancers it was always easy to discuss problematic muscles and joints, and reassuring that he ‘got’ what was going on and what was required to improve the situation efficiently and effectively.
Does this sound like you?
Carpal tunnel syndrome happens when the median nerve is squeezed as it passes through the wrist. These are the classic signs.
If several sound familiar, an assessment will help us work out whether the wrist is the problem or the nerve is irritated higher up.
- Numbness or tingling in the thumb, index, middle and part of the ring finger
- Waking at night with a dead or buzzing hand that you need to shake out
- Symptoms when you hold a phone, steering wheel or book for a while
- Aching in the wrist or palm that can spread up the forearm
- A clumsy hand, trouble with buttons, or dropping things
- A little finger that feels completely normal
What carpal tunnel syndrome is
The carpal tunnel is a narrow passage in the wrist, about an inch wide, with small bones on three sides and a tough ligament across the top. The median nerve shares it with nine tendons that bend your fingers. If anything swells or crowds that space, the nerve gets squeezed.
The median nerve carries feeling from the thumb side of the hand, which is why the little finger is usually spared. Symptoms are often worst at night, because many of us sleep with our wrists bent, and they tend to creep up gradually over months.
Most cases come from a mix of factors rather than one cause. Some people simply have a smaller tunnel, and repeated gripping or bending the wrist, swelling from pregnancy, diabetes and arthritis all add to the pressure, according to the American Academy of Orthopaedic Surgeons.
Common contributors
- Long hours of typing, mousing or phone use with bent wrists
- Hard gripping: climbing, cycling, lifting, tools
- Pregnancy, from fluid and swelling
- Diabetes, thyroid conditions or rheumatoid arthritis
- An old wrist fracture or sprain
- A family history of carpal tunnel
Carpal tunnel or your neck?
Tingling in the hand doesn't always start at the wrist. A nerve root irritated in the neck can feel similar, and some people have both. Checking the neck is part of every carpal tunnel assessment we do.
| Compared on | Carpal tunnel syndrome | Nerve irritation from the neck |
|---|---|---|
| Where it starts | The median nerve at the wrist | A nerve root in the neck, often from a disc or arthritis |
| Where you feel it | Thumb, index, middle and half the ring finger | A strip down the arm, sometimes into the hand, often with neck or shoulder blade pain |
| What sets it off | Bent wrists, gripping, sleep, typing | Turning or tilting the head, looking down for long periods |
| Night symptoms | Very common, eased by shaking the hand | Can happen, often tied to neck position in bed |
| Where we focus | The wrist, forearm muscles and your setup | The neck, upper back and shoulder, then the arm |
Wrist pain without numbness
If your wrist aches but your fingers feel normal, it's more likely a tendon, joint or muscle problem than carpal tunnel. We see this often in climbers, lifters, cyclists and heavy keyboard users, and treat it through the forearm and wrist in much the same way as an overloaded elbow tendon.
Who gets carpal tunnel
It's common in desk-heavy San Francisco, but it isn't only a computer problem. Women are at higher risk than men, and pregnancy is a common trigger.
People we see most
Pregnant? Fluid and swelling make carpal tunnel common in pregnancy. See our pregnancy acupuncture care, led by Suzanne, who has advanced training in pregnancy and postpartum care.
Related problems we treat
- Neck pain and arm tingling
- Shoulder and upper back tension
- Long-term and nerve pain
- Tingling and numbness from neuropathy
- Thoracic outlet syndrome
- Repetitive strain injuries
How we treat carpal tunnel
We try to take pressure off the nerve, release the forearm muscles that crowd the wrist and clear any tension further up the arm. Most visits combine several of these.
- Sports acupuncturePoints at the wrist and forearm, often with points further up the arm, to ease pain, numbness and tingling.
- Dry needlingInto tight forearm, shoulder and neck muscles that add tension along the nerve's path.
- Cold laserLow-level laser over the wrist, a needle-free option some people prefer.
- Sports massageSoft tissue work through the forearm, palm and upper arm.
- CuppingAcross the upper back and shoulders when tension there is part of the picture.
Who performs dry needling in California?
In California, dry needling is performed by licensed acupuncturists. Physical therapists in California are not currently authorized to perform dry needling. Our whole team is licensed in acupuncture by the State of California.
What the research says
Some of the most interesting work looks at the nerve itself. In a 2017 trial of 80 people published in Brain, real acupuncture improved how well the median nerve conducted signals and how the brain mapped the fingers, and those changes were linked to lasting improvement three months later.
A 2023 review of 16 trials with 1,025 people found acupuncture may help when it's added to other care. A 2024 overview of nine reviews agreed that it may reduce pain and appears safe.
In practice, we see acupuncture as one part of a plan for mild to moderate carpal tunnel, alongside splinting and changes to how you use your hands. If you're new to it, here's what an acupuncture visit involves.
The short version
- Studies suggest it may ease pain and support nerve function
- Most likely to help mild to moderate cases
- Works best with splinting and setup changes
- Not a substitute for surgery when the nerve is damaged
Your first visit and your plan
Plan on about an hour for your first visit. How many sessions you'll need varies, and we'll give you an honest estimate after your assessment.
Assess
We map where the numbness falls, test grip and thumb strength, and check your neck, shoulder and forearm to see where the nerve is being irritated.
Treat
You'll sit or lie with your arm resting on a towel. Needles go into the wrist and forearm, with points up the arm or at the neck when they're involved.
Afterwards
Some people notice less tingling within a day or two. The forearm may feel a little tender after dry needling, which settles quickly.
Build it back
We help with your desk setup, show you gentle nerve gliding exercises and talk about a night splint, which the NHS suggests trying for up to six weeks.
When you need a hand surgeon
Carpal tunnel that's left too long can damage the nerve for good. The AAOS recommends surgery when nonsurgical care stops working, and for long-standing cases with constant numbness or wasting of the thumb muscles. Carpal tunnel release is a common, usually very successful operation.
If any of the signs listed here apply, please see your doctor or a hand surgeon rather than starting with us. We're glad to help with pain and recovery alongside them, including after surgery.
Sudden numbness or weakness in the face, arm or leg, or trouble speaking, can be a stroke. Call 911 right away.
See a doctor or hand surgeon if you have
- Numbness that never goes away, day or night
- A flattened, hollow pad at the base of the thumb
- A weak pinch, or dropping things often
- Numbness and swelling after a wrist fall or fracture
- No real change after several weeks of conservative care
Who'll treat you
Our three California-licensed acupuncturists all trained in Traditional Chinese Medicine and see nerve and repetitive strain problems every week. Andrew Castellanos has 25+ years of experience, and Ali Hakimi uses targeted acupuncture for nerve-related conditions. We check your neck, shoulder and forearm as well as the wrist.
Andrew Castellanos
L.Ac, CST · Clinic owner
Wrist, forearm and neck work for numb fingers and grip pain.
- Cold laser and dry needling in the same plan
- Soft tissue mobilization and myofascial release for the forearm
- Neuromuscular re-education for repetitive strain
Ali Hakimi
L.Ac
Targeted acupuncture for tingling, numbness and nerve irritation.
- Targeted acupuncture and moxibustion for neurological conditions
- Neuropathy and nerve pain are a main focus
Suzanne Lange
DACM, L.Ac, CMT
Hands-on care for wrist pain, including during pregnancy.
- Advanced study in pregnancy and postpartum care
- Trained in myofascial and trigger point therapy
- Certified massage therapist with 20+ years of practice
Pricing and booking
Carpal tunnel treatment happens in a standard session, using the mix of acupuncture, dry needling, laser and massage that suits your hand and arm. There's no separate package to buy.
We don't bill insurance, but we provide a superbill you can submit for possible out-of-network reimbursement, and we accept HSA and FSA cards and all credit cards. We're on Webster Street, a short walk or bus ride for anyone searching for acupuncture in the Marina District.
Appointments
- 60-min initial acupuncture & assessment
- $225
- 45-min acupuncture follow-up
- $195
- 60-min acupuncture/massage combo
- $225
- 75-min acupuncture/massage combo
- $265
- 90-min acupuncture/massage combo
- $300
Carpal tunnel FAQ
Does acupuncture work for carpal tunnel?
Many people come to us for numbness, tingling and night pain, and research suggests acupuncture may help. A 2017 trial found real acupuncture improved how well the median nerve conducted signals, and a 2023 review found it may help when added to other care. Results vary from person to person. We see it as one part of a plan for mild to moderate cases, and we'll estimate how many sessions you may need after your assessment.
Can acupuncture cure carpal tunnel or help me avoid surgery?
We can't promise either. For mild to moderate cases, conservative care that may include acupuncture, a night splint and changes to how you use your hands is a reasonable first step. If you have constant numbness or thumb muscle wasting, surgery protects the nerve, and we'll encourage you to see a hand surgeon.
How many sessions will I need?
It varies with how long you've had symptoms and how severe they are. We'll estimate after your first assessment, check progress over the first few visits and tell you if it isn't helping enough to continue.
Where do the needles go?
Usually around the wrist and forearm, and often further up the arm, shoulder or neck, depending on where we think the nerve is being irritated. We'll explain each point before we place it.
Is it safe, and does it hurt?
Reviews have found no serious side effects from acupuncture for carpal tunnel. Minor bruising or brief soreness at a needle site can happen. The needles are very thin, and most people feel little more than a light tap or a dull ache.
Should I wear a wrist splint?
For many people, yes. A splint that keeps the wrist straight at night is a standard first step, and the NHS suggests trying one for up to six weeks. It pairs well with treatment, and we can talk through options at your visit.
Can you treat carpal tunnel during pregnancy?
Yes. Carpal tunnel is common in pregnancy because of fluid and swelling. Tell us you're pregnant when you book so we can adjust positioning and point selection, and let your OB or midwife know too.
Do I need a nerve test before booking?
No referral or nerve conduction test is needed to start. If your symptoms are severe, constant or getting worse, we'll suggest seeing a physician for testing, since the results help decide whether surgery is needed.
Where can I find acupuncture for carpal tunnel in San Francisco?
We treat carpal tunnel and wrist pain at 2920 Webster Street in Cow Hollow, one block north of Union Street. Andrew Castellanos brings more than 25 years of experience, and Ali Hakimi uses targeted acupuncture for nerve-related conditions like this one. Treatment may include acupuncture, dry needling, cold laser and hands-on work.
Can I come in after work?
Andrew sees patients until 7pm on Mondays, Tuesdays and Thursdays, and Ali until 7pm on Mondays, Tuesdays and Wednesdays, so you can come once your workday in the Financial District or SoMa is done. If your wrist is at its worst after a long day at the keyboard, an evening visit is a good time to have it looked at, and you can book online.
References
- Maeda Y, et al. Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture. Brain. 2017.
- Dong Q, et al. Acupuncture for carpal tunnel syndrome: A systematic review and meta-analysis of randomized controlled trials. Frontiers in Neuroscience. 2023.
- Liu Y, et al. Effectiveness and safety of acupuncture for carpal tunnel syndrome: An overview of systematic reviews and meta-analyses. Integrative Medicine Research. 2024.
- American Academy of Orthopaedic Surgeons. Carpal Tunnel Syndrome. OrthoInfo.
- NHS. Carpal tunnel syndrome.
Ready to sleep through the night?
Book an assessment at our Cow Hollow clinic, or call us to talk it through first.
Visit us in Cow Hollow
2920 Webster Street, between Union and Filbert. A short walk from the Marina, Pacific Heights and the Presidio.
Address
Acupuncture for Athletics2920 Webster Street
San Francisco, CA 94123 Gate code: in your booking confirmation email
Hours
- Every day
- 7:30am – 9:00pm