- Duration
- Acute Triage (Hours 0-72) | Integrated Rehabilitation (Weeks 2-6)
- Frequency
- Care combines precision carpal/radial joint mobilization with immediate targeted median nerve gliding and tendon retraining.
- Equipment
- Digital Pinch Dynamometer, Phalen Compression Target, First Extensor Compartment Glide Board, Flexor Tendon Slings.
- 1.1. Differential Neurological vs. Tendon TriageWe differentiate median nerve compression (digital numbness, nocturnal hand shaking) from De Quervain's tenosynovitis (sharp radial styloid pain on thumb extension).
- 2.2. Joint & Retinaculum Unloading ('Opening the Window')Dr. Paul Sta. Juana, DC performs gentle carpal tunnel and radial styloid mobilization to decompress trapped nerve pathways and relieve tendon sheath friction.
- 3.3. Immediate Targeted Physical TherapyWhile nerve pressure and tendon sheath tension are reduced, Liza Sta. Juana, PT guides nerve gliding exercises, pinch strength re-education, and ergonomic modification.
- 4.4. Functional Capacity & Task Tolerance TestingWe re-test typing endurance, jar twisting, lifting mechanics, and sleep continuity under direct 1-on-1 supervision.
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Numb Fingers or Sharp Wrist Pain Keeping You From Working?
Experience The Open Window Method: Joint Mobilization + Immediate Physical Therapy for Carpal Tunnel & De Quervain's under one roof in Alamo, TX.
Call (956) 591-8589 To ScheduleEducational Disclaimer: This publication is for health education purposes only and does not constitute formal medical advice or guaranteed outcomes. Individual results vary. Direct clinical examination is required to determine eligibility for care.
The Wrist That Interrupts the Smallest Jobs
Whether you are typing at a workstation in McAllen, lifting a child in Pharr, carrying groceries in Edinburg, or waking up in Alamo shaking your hand out to get feeling back into your fingers, hand and wrist problems quickly dismantle your daily routine.
The most common mistake patients make is treating every hand or wrist problem like simple muscle weakness or temporary fatigue. They buy an off-the-shelf drug store brace, wear it for a few weeks, and wonder why the symptoms return the moment they start typing, gripping, or lifting again.
To fix wrist pain permanently, you must first understand that numbness and sharp pain come from entirely different biological structures:
- Carpal Tunnel Syndrome (Nerve Compression): Produces numbness, tingling, or burning in the thumb, index, middle, and ring fingers—frequently waking you up at night or causing you to drop objects.
- De Quervain’s Tenosynovitis (Tendon Friction): Produces sharp, localized pain on the thumb side of the wrist (radial styloid) during lifting, twisting jar lids, or reaching for a child.
"Your Wrist Pain Needs a Clearer Explanation"
Treating nerve compression with basic wrist stretches or treating tendon inflammation with generic joint popping leads to failed outcomes. Each condition demands specific clinical reasoning.
"If your hand goes numb or your thumb-side wrist feels sharp, do not treat every wrist problem the same. We see this with people who wake up shaking their hand out, feel numbness while typing, lose grip strength, or get sharp wrist pain when lifting a child, opening a bottle, or carrying bags. Do not keep relying only on a brace if symptoms return every time you type, grip, lift, or sleep. Numbness and tingling often point toward nerve irritation. Sharp pain near the thumb side of the wrist points toward tendon irritation. Find the source. Build the plan."
The Open Window Method: Why Doing PT Immediately After Chiropractic Is Best
At South Texas Accident & Injury (located at 505 W Business Hwy 83 Ste 7 in Alamo, TX), we treat hand and wrist conditions using The Open Window Method—combining chiropractic joint mobilization with immediate physical therapy:
CHIROPRACTIC UNLOADING → OPENS MOVEMENT WINDOW → IMMEDIATE PHYSICAL THERAPY RE-EDUCATION
Step 1: Chiropractic Mobilization ("Opening the Window")
Dr. Paul Sta. Juana, DC performs gentle, vector-specific mobilization of the carpal bones, radius, and ulna. This restores proper wrist joint alignment, removes pressure from the flexor retinaculum, and decompresses the median nerve or trapped thumb tendons.
Step 2: Immediate Neuromuscular Physical Therapy ("Locking In Recovery")
While the wrist joints are aligned and nerve/tendon friction is reduced, you step directly into our physical therapy area under Liza Sta. Juana, PT. We guide you through median nerve gliding exercises, first extensor compartment tendon retraining, and pinch/grip strength re-education to ensure your hand maintains function under real-world loads.
Find the Source. Build the Plan.
When hand numbness or sharp wrist pain is ignored, nerve damage or chronic tendon scarring can occur. We combine gentle chiropractic carpal mobilization with targeted physical therapy to restore true hand function.
Symptom Masking
- ✕ Wearing a brace without addressing carpal alignment
- ✕ Ignoring nocturnal hand shaking or grip drops
- ✕ Allowing tendon sheath scarring to lock up thumb movement
The Open Window Method
- ✓ Carpa/radial mobilization opens nerve & tendon window
- ✓ Immediate 1-on-1 nerve gliding & pinch strength PT
- ✓ Co-managed DC + PT care under $0 out-of-pocket LOP liens
Serving Hand & Wrist Patients Across the Rio Grande Valley
Located centrally at 505 W Business Hwy 83 Ste 7 in Alamo, TX 78516, our facility provides quick access off I-2 / US-83 for residents across the RGV:
Alamo • McAllen • Pharr • San Juan • Edinburg • Mission • Weslaco • Donna
Frequently Asked Questions
How do I know if my wrist pain is Carpal Tunnel Syndrome or De Quervain’s Tenosynovitis?
Carpal Tunnel Syndrome involves median nerve compression, producing numbness, tingling, or burning in the thumb, index, middle, and ring fingers—often waking you up at night. De Quervain’s Tenosynovitis involves tendon sheath friction on the thumb side of the wrist, producing sharp pain when extending your thumb, making a fist, or twisting jar lids.
Why is physical therapy performed immediately after chiropractic wrist mobilization?
Timing is everything. Chiropractic carpal mobilization aligns the carpal bones and radius, removing physical compression from the median nerve or tendon sheath and creating an "open window." Performing physical therapy immediately afterward retrains your tendons to glide smoothly and locks in nerve decompression.
Do you accept car accident (LOP) attorney liens for wrist injuries?
Yes. If your wrist or hand injury occurred during a car accident (such as hyper-flexion or impact against the steering wheel), we accept cases under a Letter of Protection (LOP) with $0 out-of-pocket cost to you, working alongside your attorney while providing defense-grade medical records.




