Wrist pain and hand numbness is not synonymous with carpal tunnel syndrome although sometimes it is diagnosed as if it were. Carpal tunnel syndrome is usually treated with a carpal tunnel release surgery but there are many good reasons to begin with conservative care. The carpal tunnel is not the only place where impingement can occur that results in pain in the wrist and numbness in the hands. Double crush syndrome is when the nerve that travels through the wrist is impinged at multiple locations such as the elbow, shoulder and neck. A carpal tunnel release surgery yields disappointing results when these smaller “pinches in the hose” are the true culprit behind the symptoms. The typical treatment plan for a double crush presentation is conservative. It involves releasing soft tissue restrictions with theraputic massage and joint mobilization.