Numbness and Tingling in Your Hands: What It May Mean

It is all too easy to put down a bit of numbness or tingling in the hands, particularly when it is intermittent. But if the sensation persists to the point of waking you at night, or you find your grip is not what it should be, there is a good chance a nerve is being compressed or otherwise irritated.

One might feel pins and needles in the course of everyday activities like typing, driving or even holding a phone. For some, there is an accompanying burning pain or weakness that can radiate up the forearm or into the elbow and wrist. Paying attention to such things will give you some idea of where the trouble lies.

Since similar symptoms have different origins, it is better to have an exam than to make assumptions. A clinician can determine where the nerve signals are off and put you on a course of treatment suited to the underlying cause. Being aware of the usual culprits is a good way to know when professional care is warranted.

Common Reasons Your Hands May Feel Numb or Tingly

What You Should Know

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Carpal Tunnel Syndrome

When one experiences numbness or a tingling sensation in the hand, carpal tunnel syndrome is a frequent culprit. The cause is compression of the median nerve in its passage through the carpal tunnel, that constricted area of the wrist.

This condition often affects the thumb, index finger, middle finger, and part of the ring finger. In the early stages the problem may be intermittent, but as time goes on the symptoms will tend to make themselves felt with greater regularity.

• Numbness or tingling in the thumb, index, and middle fingers
• Symptoms that are worse at night or when you first wake up
• Discomfort during driving, typing, or holding a phone or book
• Hand weakness or trouble gripping objects
• Occasional dropping of items unexpectedly

Because carpal tunnel syndrome may slowly worsen, it is a good idea to seek care if symptoms are becoming more frequent or if weakness begins. Early steps may help reduce irritation.

Cubital Tunnel Syndrome

The ulnar nerve is the one that gives you a jolt of electricity when you put your elbow on something and hit your “funny bone.” It is this same nerve, running down the inside of the elbow, that is involved in cubital tunnel syndrome.

Irritation or compression of the ulnar can result in a tingling or numbness in the small and ring fingers. One will typically find the symptoms are more pronounced after the elbow has been held in a bent position for any length of time, be it from working at a desk or while sleeping.

• Tingling in the ring and small fingers
• Symptoms that show up when sleeping with the elbow bent
• Numbness during phone use or desk work
• Hand weakness, especially with pinch or grip tasks
• Clumsiness with fine motor tasks

Could the Problem Be Coming From Your Neck?

The source of nerve trouble in the hand is not always to be found in the hand or wrist itself. At times, an irritated nerve root in the cervical spine, that is to say the neck, will send its way down the arm and into the hand.

Such a condition is known as cervical radiculopathy. One might experience neck pain or some discomfort in the shoulder, in addition to the usual numbness or tingling, with pain even radiating down the arm. All of these are telling signs for a proper evaluation.

Other Symptoms to Watch For

Numbness and tingling can be an early warning sign, but they are not always the only symptoms. As nerve irritation continues, other problems may appear and can help show how much the nerve is being affected.

• Burning or aching pain
• Weakness in the hand or fingers
• Difficulty gripping, pinching, or buttoning clothing
• Dropping objects more often
• Symptoms that wake you from sleep

If you are noticing weakness or losing hand control, it is especially important not to wait too long for an evaluation. That can help reduce the chance of lasting problems.

How We Evaluate Hand Numbness

We will begin the exam by going over your symptoms and an inspection of the neck, shoulders, elbows, wrists and hands. The way the numbness has been presenting itself, its duration and what seems to set it off are all useful in determining where to go from there.

The clinician is likely to test reflexes as well as skin sensation and strength. Should it be necessary to see just how badly a particular nerve is being affected and make a positive identification, further testing might be put forward.

Safety: When to Get Emergency Help

Should you experience a sudden onset of weakness or numbness in an arm or hand, particularly on one side, emergency medical attention is warranted. Do not delay in getting help if such symptoms are accompanied by any of the following: facial drooping, difficulty with speech, dizziness, confusion, a loss of balance, chest pain, shortness of breath or a bad headache.

Fast treatment is necessary as these may be signs of a stroke or some other pressing condition. When in doubt, the prudent course of action is to contact emergency services or make for the closest emergency department.

Note: Not All Hand Numbness Comes From Nerve Compression

Hand numbness can have medical causes beyond pressure on a nerve. Possible causes include diabetes-related neuropathy, vitamin B12 deficiency, thyroid disease, medication side effects, alcohol-related neuropathy, inflammatory or autoimmune neuropathies, and circulation-related problems. A checkup can help sort out the right reason.

When It’s Time to See a Specialist

Consider scheduling an evaluation if symptoms keep coming back, interrupt sleep, or start affecting daily activities. Ongoing numbness and tingling should not be ignored, especially if they come with weakness or trouble using your hand.

• Your symptoms keep returning
• You wake up with numb or painful hands
• You have weakness or trouble gripping objects
• Your symptoms move up the arm or start in the neck
• Daily tasks like typing, driving, dressing, or cooking are becoming harder

The right diagnosis can help you avoid making nerve irritation worse and can point you toward treatment that matches the true cause.

Don’t Ignore Persistent Hand Numbness

When one experiences recurring pain, weakness, or a sensation of numbness and tingling, it is often an indication of a nerve problem that warrants some attention. An early assessment is the best way to safeguard function and make a return to daily life more comfortable, no matter if the trouble appears to be in the neck, elbow or wrist.

Should the symptoms in your hands fail to abate or begin to get in the way of things, we would suggest an appointment with Princeton Orthopaedic Associates for a proper examination.

This blog post is meant to be informative and should not act as a self-diagnosis tool. If you’d like to see one of our doctors, please contact us here.

Ice or Heat for Pain Relief: How to Know Which One to Use

There is a tendency for people to put an ice pack or heating pad on when they are in pain or sore, not always sure which is the better remedy. While both have their uses, they go about it in different ways. As a rule of thumb, ice is preferable for fresh injuries where there is swelling, whereas heat will do more for tightness in the muscles or general stiffness.

Applied properly, either can be an aid to comfort and mobility as well as for managing swelling and pain. One should also be mindful of using them in a safe manner. Should the symptoms prove to be severe, fail to get any better or come back time and again, it would be prudent to seek medical counsel.

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Quick Differences Between Ice and Heat

How Ice Helps an Injured Area

Applying cold therapy is a way to put the brakes on blood flow in the affected region, which can be of some assistance in settling any swelling or irritation in the wake of an abrupt injury. The ice will also serve to dull the pain by numbing sore tissue for a time. While it is not going to remedy the underlying problem on its own, it does allow for more comfortable movement and rest.

One will typically turn to ice in the immediate aftermath of an impact, sprain or strain. This is particularly true if there is throbbing pain, warmth, bruising or visible swelling. A hard bump that has begun to mark the skin, a fresh knee sprain or even a rolled ankle would be typical cases for its use.

How Heat Helps Sore or Stiff Tissue

Applying heat can ease tight muscles and may improve circulation to the part that is sore. The result, for many people, is a stiff joint that can feel more at ease and yield to movement with less difficulty. When the pain is of an achy, tight nature as opposed to being sharp and swollen, many will find warmth to be of particular use.

It is a good remedy for persistent muscle soreness or stiffness in the back and neck where there is no obvious swelling. One might also turn to heat prior to some light activity or a bit of gentle stretching; it can help movement feel less stiff.

When Ice Is Usually the Better Choice

• Right after a sprain or strain
• When a joint or muscle is swollen
• For bruises or impact injuries
• After activity if the area looks more inflamed
• When pain feels sharp, hot, or throbbing

When Heat Is Usually the Better Choice

• For muscle tightness or spasms
• For stiffness in the neck, back, shoulder, or other joints
• Before stretching or gentle exercise
• For ongoing aches that are not swollen
• When movement feels limited because tissue feels tight

Can You Alternate Ice and Heat?

There is a time and place for both cold and warmth, particularly as one’s symptoms go from swelling to stiffness. Take an injury for instance: ice may be the way to go in the beginning, but once the swelling has subsided and you are left with tightness, heat will likely prove more soothing. Just be sure to observe proper timing and discontinue if there is any aggravation of symptoms.

Should you be uncertain of where you stand, let the signs tell you. A good rule of thumb is that ice is indicated when there is swelling and heat, whereas a lack of swelling accompanied by stiffness suggests heat would be better. If any doubt remains, err on the side of caution and seek some advice.

How to Use Ice Safely

• Wrap an ice pack or bag of ice in a towel before applying
• Do not place ice directly on skin
• Use for about 15 to 20 minutes at a time, then take a break
• Check the skin during and after treatment
• Stop if skin becomes painful, blotchy, white, blistered, unusually red, feels burned, or if the area stays numb after treatment
• Do not use ice over broken skin or areas with poor circulation unless a clinician tells you to

How to Use Heat Safely

• Use a warm heating pad, warm towel, or another gentle heat source
• Heat should feel warm, not hot or scalding
• Use for about 15 to 20 minutes at a time while checking the skin
• Stop if skin becomes painful, blotchy, white, blistered, unusually red, feels burned, or if the area remains numb after treatment
• Avoid heat on new injuries, active swelling, redness, warmth, infection, or bleeding
• Avoid falling asleep with a heating pad on

When Heat or Ice Should Be Used With Extra Caution

Those with reduced sensation, diabetes, neuropathy or other nerve issues stemming from the condition should consult a clinician prior to applying ice or heat. The same goes for anyone with poor circulation, peripheral vascular disease, Raynaud’s, or simply an inability to gauge temperature properly. One can easily do damage to the skin with cold or heat and not be the wiser for it, so some additional precautions are in order.

Avoid heat on any part of the body that is red, hot, swollen or otherwise inflamed, especially after a new injury. Heat is out of the question if there is a fever, infection or bleeding. As for open wounds or any skin that is not in good shape, ice should not be put on it without the go ahead from a clinician.

When to Get Checked by an Orthopedic Specialist

While ice and heat are useful for easing pain, putting swelling in check and allowing for more comfortable movement, they are no substitute for a proper evaluation if something more serious is at play. Should the pain be considerable, fail to improve, or change for the worse, particularly following an injury, it is best to have it examined.

There are certain warning signs that call for a trip to urgent care or other timely medical intervention: deformity, a suspected fracture, or an inability to put weight on the limb. The same goes for severe or escalating pain, new weakness of any kind, numbness, tingling, a fever or any indication of infection.

Possible blood clot symptoms also need urgent attention. Watch for calf swelling, warmth, redness and pain, especially if it happens in one leg or does not improve. Do not make the mistake of using ice or heat in place of getting the care you need when such symptoms present themselves.

This blog post is meant to be informative and should not act as a self-diagnosis tool. If you’d like to see one of our doctors, please contact us here.

Hip Pain While Sitting: Common Causes and Ways to Find Relief

There is a certain frustration to having hip pain when one is seated; it can put a damper on work, meals, driving and any time off. The root of the problem is frequently an irritation of the muscles, tendons, joints or nerves in the vicinity, and the way the symptoms present themselves will often tell you something about what is at play.

It could be an ache along the side of the hip, a pinching sensation in the groin, stiffness upon rising, or discomfort that radiates down into the thigh or buttock. While some find relief through a bit of home care and by adjusting their posture and activities, any pain that lingers or gets worse should be properly assessed in order to get the appropriate treatment underway.

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Key Points About Hip Pain During Sitting

What You Should Know

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Why Sitting Can Make Hip Pain Worse

Prolonged sitting keeps the hips in a bent position, which is apt to put added pressure on the hip joint and its environs. For soft tissues that are stiff or already in an inflamed state, this can be a source of strain.

Then there is the matter of inactivity. A lack of movement while you are seated will cause the muscles about the hip to become rigid over time. The result is that any discomfort makes itself known all the more when one gets up to walk or simply changes position.

Common Causes of Hip Pain While Sitting

Many conditions can cause hip discomfort in a seated position. Some affect the joint itself, while others involve soft tissue around the hip. Some problems start in the lower back and are felt near the hip.

Hip osteoarthritis

Osteoarthritis is the wear and tear of the joint cartilage. It often causes stiffness and aching in the groin or thigh. Pain may feel worse after sitting for a while or when you first get up.

Hip bursitis

There are small sacs called bursae, filled with fluid to keep friction at bay between tissues in motion. Should a bursa get irritated, it can be the source of pain on the outside of the hip, particularly when one is sitting or has to lie on that side. Then again, such discomfort in the outer hip might stem from the gluteal tendons; this type of irritation is commonly referred to as greater trochanteric pain syndrome.

Muscle or tendon irritation

Tight or overused muscles and tendons around the hip can become sore, particularly after exercise, repetitive activity, or prolonged poor posture. This can lead to a deep ache, tightness, or a pulling feeling while seated.

Hip labral tear

The labrum is a ring of cartilage that helps stabilize the hip socket. A tear can cause groin pain, clicking, catching, or a sense that the hip is not moving smoothly. Sitting can increase discomfort for some people.

Sciatica or other nerve-related pain

If a nerve is irritated, pain may start in the buttock or low back and travel into the hip or leg. Sitting can worsen these symptoms, especially when numbness, tingling, or burning is also present.

Referred pain from the lower back

Hip pain does not always come from inside the hip. Problems in the lower spine can create pain that feels like it is centered in the hip, especially when sitting for long periods.

What You Can Do at Home to Ease Hip Pain

For mild symptoms with no history of a recent fall or other trauma, there are some straightforward measures one can take at home to ease the irritation. What is important is to lessen the strain without allowing the hip to become stiff. Should any of these approaches aggravate the pain, they ought to be discontinued.

• Change positions often instead of sitting for long stretches.
• Stand up and walk briefly every 30 to 60 minutes if you can.
• Use ice for short periods if the area feels inflamed or sore after activity.
• Try gentle stretching only if it does not increase pain. Stop if it worsens your symptoms.
• Check your chair height and support so your hips and knees feel comfortable.
• Avoid sitting on very hard surfaces if that clearly worsens symptoms.

When taking an over the counter medication, be sure to follow to what the label says as well as any instructions you may have gotten from a doctor. In the case of anti-inflammatory drugs, it is best to seek some direction from a professional first should you have kidney trouble, be on blood thinners or are pregnant. The same applies if there is a history of stomach ulcers or bleeding, or any other medical issues to consider.

Helpful Sitting and Movement Adjustments

Small changes in how you sit and move during the day can help. These strategies may be most helpful when pain is related to posture, soft tissue irritation, or joint stiffness. If you notice worsening pain, scale back and consider getting evaluated.

• Sit with your feet flat on the floor and avoid crossing your legs for long periods.
• Keep your lower back supported so you are not slumping forward.
• Use a cushion or supportive seat if hard chairs increase pain.
• Break up long drives with standing or walking stops when possible.
• Return to exercise gradually and avoid pushing through pain that is increasing.

When Hip Pain While Sitting Should Be Evaluated

Some hip pain improves with time and careful self-care. Yet one should not assume that pain in the hip from sitting is nothing at all. There are occasions when it is more than something simple. Any symptoms that do not go away, or those that are on the increase, as well as pain following an injury or indications of a nerve or systemic issue, should warrant an evaluation to get to the root of the problem and put in place the right treatment.

• Pain lasts more than a few days or keeps coming back.
• The pain is getting worse instead of improving.
• You are limping or changing how you walk.
• You notice catching, locking, or clicking in the hip.
• You have numbness, tingling, or pain that travels down the leg.
• The pain interferes with work, sleep, exercise, or daily activities.

How Orthopaedic Specialists Diagnose Hip Pain

An examination is almost always the first step in making a diagnosis. From there, we can determine the source of the pain and what kind of movements set it off, as well as assess hip function and any possible back involvement.

If the symptoms require it, you may be advised to have imaging done, be it an X-ray or another form of study. Such tests are useful for spotting structural issues, arthritis or other ailments that are beyond what home remedies can address.

Treatment Options for Ongoing Hip Pain

Treatment depends on the source of the pain. Many patients improve with non-surgical care aimed at reducing irritation, improving movement, and strengthening the muscles that support the hip.

• Activity modification to reduce pain triggers
• Physical therapy to improve flexibility, strength, and movement mechanics
• Anti-inflammatory medication when appropriate
• Image-guided injections for certain diagnoses
• Further orthopaedic evaluation for structural hip problems or advanced arthritis

If symptoms are not improving, getting the right diagnosis early may help reduce prolonged pain and unnecessary limit setting.

Don’t Ignore Hip Pain That Keeps Returning

You should not have to live with hip pain when you sit. The nature of the symptoms will point to what is required for some relief, be the source the joint itself, soft tissue in the vicinity or the low back. If the pain lingers, gets worse or affects your day to day life, please call your doctor or schedule an appointment with the POA Team.

This blog post is meant to be informative and should not act as a self-diagnosis tool. If you’d like to see one of our doctors, please contact us here.