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Client-reported paresthesia in the lateral hand with wrist extensor weakness raises suspicion for radial nerve involvement or a C6–C7 segmental issue rather than median nerve compression, which typically affects the palmar lateral three-and-a-half digits and is provoked by wrist flexion/Phalen’s test. In the assessment domain for massage practice, screening neurological function precedes technique selection to ensure safety and appropriate referral if needed. Assessing dermatomes (light touch/pin along C6–C7 distribution) and myotomes (resisted wrist extension for C6–C7/radial nerve) provides functional data on possible radiculopathy or peripheral nerve entrapment (e.g., radial tunnel/posterior interosseous). Thoracic rotation measurement is unrelated to the primary complaint and would not clarify nerve integrity. Palpating the FDP may identify local tenderness but does not explain wrist extension weakness, and trigger-point referral patterns do not cause objective myotomal weakness. If neurological deficits are confirmed (e.g., diminished sensation, decreased strength, reflex changes), the therapist should consider referral to a healthcare provider while adapting massage plans (lighter pressure, avoid aggressive end-range or compressive techniques) to remain within scope and protect client safety.

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