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

Why These Symptoms Happen

The nerves are responsible for relaying signals from the brain and spinal cord to the rest of the body. Should a nerve be compressed, inflamed or otherwise irritated, those signals will be altered. The result can be weakness, a burning pain, or a sense of numbness and tingling.

Symptoms themselves are often telling. One might look at which fingers are affected, what time of day the issue presents itself, or if there is accompanying pain in the elbow, wrist or neck to determine where the nerve is being impacted.

Frequently the problem is one of compression; as the nerve passes through some of the body’s more confined spaces, pressure builds on it. Yet that is not the only explanation, making a proper evaluation necessary.

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.

Treatment Options

Treatment depends on the cause of your symptoms, how long they have been present, and whether nerve weakness is involved. Many people improve with non-surgical care, especially when treatment starts sooner.

• Activity changes to reduce pressure on the nerve
• Bracing or splinting, especially at night for certain conditions
• Anti-inflammatory medication for pain or swelling when it is appropriate for you
• Physical therapy or occupational therapy to improve movement and function
• Surgery for ongoing compression or progressive weakness in selected cases

While anti-inflammatory drugs can be of service in reducing pain and inflammation, they are not a cure for the underlying nerve compression. Nor should they be seen as a substitute for an accurate diagnosis. For some, carpal tunnel symptoms will abate with such medication, but it is unlikely to be sufficient on its own.

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.

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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.