Doctors Discuss Causes of Hand Numbness or Tingling
It’s an odd feeling and worrisome feeling when your hands and fingers “tingle” or you notice numbness in one of the joints of your fingers or in your thumb. In most cases these symptoms are caused by conditions that aren’t serious and that are easily treated. However, in some cases the tingling or numbness can be an indication of something more serious.
However, tingling or numbness can be the result of a number of conditions, it is best to get it evaluated by a board certified specialist, like Macomb County hand and elbow doctor, Dr. Rehman. In the meantime, our Macomb County doctors have listed some of the most common causes of hand tingling or numbness.
However, your tingling or numbness is accompanied by swelling, or if you have sharp, “shooting” or radiating pain up your arm, it is important to see a board certified hand doctor as soon as possible, as this could signal a medical condition requiring urgent attention.
Carpal Tunnel Syndrome
The carpal tunnel is a narrow passageway located on the palm side of the wrist. One of the main nerves to the hand, the median nerve, runs through this tunnel, as do the nine tendons that bend the fingers. In cases of carpal tunnel syndrome, compression of this nerve can cause numbness, tingling and eventual weakening of the hand itself.
Symptoms typically affect the thumb, index finger, middle finger and part of the ring finger, and they are often worse at night or when holding a phone, steering wheel or book. Many patients wake up needing to shake out their hands, and over time they may notice a weaker grip or a tendency to drop objects. In advanced cases, the muscles at the base of the thumb can begin to thin.
Sometimes this compression is associated with repetitive, forceful or vibrating hand activities, but there may be a genetic predisposition to carpal tunnel syndrome as well. For some people, the carpal tunnel is naturally narrower and more at risk for irritation of the nerve running through it, and conditions such as pregnancy, diabetes, thyroid disease and rheumatoid arthritis also increase the risk. Mild cases often improve with night splinting and corticosteroid injections, while carpal tunnel release surgery may be recommended by Dr. Rehman when symptoms persist or nerve testing shows significant compression.
Trigger Finger or Trigger Thumb
Trigger finger, and trigger thumb when it affects the thumb, is a condition in which a flexor tendon cannot glide smoothly through its protective sheath. It gets its name because the affected finger or thumb catches when bent and then “snaps back” into place like a trigger releasing. If the condition is severe, the finger or thumb may become locked in a bent position.
Trigger finger or thumb affects women more often than men, and it is often associated with diabetes and rheumatoid arthritis. People whose work or hobbies require repeated gripping actions are at higher risk of developing trigger finger or trigger thumb. Inflammation and thickening of the tendon sheath, particularly at the entrance to the sheath in the palm, is the culprit, and a tender nodule can often be felt at the base of the affected finger.
Trigger finger mainly causes pain, stiffness, clicking and locking, and it does not usually cause numbness or tingling on its own. However, trigger finger frequently occurs alongside carpal tunnel syndrome, so patients with both conditions may experience tingling as well as catching. Treatment often begins with splinting and a corticosteroid injection, and a minor trigger finger release procedure performed by Dr. Rehman provides lasting relief when symptoms return.
Tendonitis
Tendons are the thick cords in the body that attach the muscles to the bones. Tendonitis occurs when the tendons in the wrist or near the hand become irritated, inflamed or swollen. This can be the result of a repetitive motion injury, or it could be due to an acute injury, such as those that occur in sports.
Tendonitis most often causes pain, aching or a burning sensation along the tendon, along with swelling and pain with movement. Tingling can occur when inflamed tendons swell within a tight space, such as the carpal tunnel, and press on a nearby nerve. De Quervain’s tenosynovitis, which affects the tendons on the thumb side of the wrist, is a common form of tendonitis and is sometimes called “texting thumb” or “mommy thumb.”
Tendons also become less elastic as we age, and tendon damage can occur more easily in individuals over 50. Most cases of tendonitis improve with rest, splinting, ice, anti-inflammatory medication and hand therapy, and a corticosteroid injection can help when symptoms persist. Dr. Rehman can confirm the diagnosis with an examination and, when needed, ultrasound imaging to guide the most effective treatment.
Cubital Tunnel Syndrome
Cubital tunnel syndrome occurs when the ulnar nerve is compressed or stretched as it passes along the inside of the elbow, the area commonly called the “funny bone.” After carpal tunnel syndrome, cubital tunnel syndrome is the second most common nerve compression condition of the upper extremity. It typically causes numbness and tingling in the ring and small fingers, along with aching on the inner side of the elbow.
Symptoms are often worse when the elbow stays bent for long periods, such as while holding a phone, driving or sleeping with the arms folded. As the condition progresses, patients may notice weakness of grip, clumsiness with fine tasks such as buttoning a shirt, and, in advanced cases, visible thinning of the small muscles of the hand. Because prolonged nerve compression can cause lasting weakness, early diagnosis is important.
Diagnosis is based on a physical examination and is often confirmed with nerve conduction studies or ultrasound. Mild cases usually improve with activity changes, elbow padding and a night splint that keeps the elbow straighter during sleep. When symptoms persist or muscle weakness develops, Dr. Rehman may recommend cubital tunnel release surgery to relieve pressure on the ulnar nerve, sometimes combined with repositioning the nerve.
Cervical Radiculopathy (Pinched Nerve)
Cervical radiculopathy, commonly called a pinched nerve in the neck, occurs when a nerve root is compressed as it exits the cervical spine. The most common causes are a herniated disc and age-related degenerative changes such as bone spurs and disc narrowing. Because the nerves that supply the arm and hand begin in the neck, compression at this level can produce symptoms far down the arm.
Cervical radiculopathy typically causes pain that radiates from the neck or shoulder blade into the arm, along with numbness, tingling or weakness in a specific pattern. Symptoms in the thumb and index finger, the middle finger, or the ring and small fingers can point to which nerve root is affected. The pain often worsens with certain neck movements, such as turning the head or looking up.
Because cervical radiculopathy can mimic carpal tunnel syndrome and cubital tunnel syndrome, and a patient can have compression at the neck and the wrist or elbow at the same time, careful examination and nerve testing are essential. Most cases improve with physical therapy, anti-inflammatory medication and activity modification. When the source of symptoms is in the neck, Dr. Rehman coordinates care with a spine specialist. Progressive weakness, difficulty walking or loss of balance, or changes in bladder or bowel control require urgent medical attention.
Thoracic Outlet Syndrome
Thoracic outlet syndrome refers to a group of conditions in which the nerves or blood vessels passing between the collarbone and the first rib become compressed. This narrow space, called the thoracic outlet, carries the brachial plexus, the network of nerves that supplies the arm and hand, along with the major artery and vein of the arm. The large majority of cases are neurogenic, meaning the nerves are primarily affected.
Neurogenic thoracic outlet syndrome often causes tingling and numbness in the arm and fingers, most commonly the ring and small fingers, along with aching in the neck, shoulder and arm. Symptoms typically worsen with overhead activities such as reaching, lifting or styling hair. Contributing factors include poor posture, repetitive overhead work or sports, neck injuries such as whiplash and, less commonly, an extra rib present from birth, called a cervical rib.
Thoracic outlet syndrome is diagnosed through a detailed history, physical examination and tests that rule out other causes, such as nerve studies and imaging. Most patients with the neurogenic form improve with physical therapy focused on posture, stretching and strengthening. Surgery is reserved for cases that do not respond or that involve blood vessel compression. Sudden swelling, bluish discoloration, coldness or heaviness of the arm may signal a blood clot and requires immediate emergency care.
Diagnosis & Treatment for Hand Tingling | Macomb County
If you are experiencing numbness or tingling in your hands and fingers, contact a Macomb County board certified hand surgeon Doctor Rehman for a complete evaluation. Many causes of hand tingling and numbness can be treated with minimally invasive procedures such as rest, applying cold packs, anti-inflammatory medication and sometimes corticosteroid injections. If the minimally invasive procedures don’t provide relief, surgery may be considered.
The hand and wrist are delicate structures, upon which you rely for every daily activity. So it is important to have a specialist who is trained and experienced in the hand and wrist to insure a good outcome and a full recovery.
Dr. Rehman has a team of hand therapists who will design a program of hand and wrist exercises and occupational therapy to return your affected hand, finger or thumb to full function and strength. Dr. Rehman is a Macomb County hand surgeon who specializes in conditions and injuries to the hand, fingers, wrist and arm.
