If you’ve ever had a numbness or tingling in your hands and fingers, you know how uncomfortable it can feel. But before you start fearing the worst, read on.
We checked with John Bojescul, MD, an orthopedic surgeon at Doctors Hospital in Augusta, Georgia, about the most common causes and how they are treated.
What are the most common causes for numbness or tingling in the hands?
Dr. Bojescul: Several factors can lead to numb, tingly hands. Here are some of the most common causes:
1. Carpal tunnel syndrome (CTS): This is a condition in which the median nerve—a nerve that supplies sensation to the thumb, index finger, longer finger and half of the ring finger—is compressed in the carpal tunnel. The tunnel is a narrow passageway for nerves and tendons to pass through at the base of the hand. You may feel pain in the forearm and the wrist, as well as numbness, tingling and sometimes weakness in those fingers.
If you’re diagnosed with CTS, treatment may include wrist braces, cortisone injections, occupational therapy, or in more extreme cases, carpal tunnel release surgery.
2. Raynaud’s phenomenon: This is a vasospasm, or spasm of the blood vessels, in the fingers and toes, and usually occurs in response to stress or exposure to cold temperatures. Raynaud’s phenomenon (also called Raynaud’s syndrome) usually affects both sides of the body, and may or may not be a sign of an autoimmune diseases, such as lupus or rheumatoid arthritis. Your hands may appear pale and blue.
For primary Raynaud’s phenomenon, your doctor will probably recommend lifestyle changes first. Your physician may suggest staying warm and dry, exercising and quitting smoking. If these prove inadequate, patients may benefit from medications that relax the blood vessels.
3. Pinched, compressed or damaged nerve: A pinched nerve occurs at areas of potential restriction or compression. Common areas of compression occur in the cervical spine (neck), the shoulders, elbows and wrists. Your doctor may be able to determine where the compression is during a physical exam, and then do an electromyogram (EMG) and nerve conduction velocity test to see how severely the nerve is damaged. Your doctor may recommend rest, bracing, cortisone injections or in extreme cases, surgery.
4. Peripheral neuropathy. This condition may affect one nerve (mononeuropathy) or many nerves (polyneuropathy) and can be acute or chronic. It is often caused by diabetes, hypothyroidism, traumatic injuries, vitamin deficiencies or exposure to toxins. Certain medications used to treat high blood pressure, heart problems, cancer, autoimmune diseases, alcoholism and HIV/AIDS may contribute to the problem, along with some antibiotics.
The cause of the condition will determine the treatment plan. If diabetes is the primary problem, lowering blood sugar levels will be the first order of business. Neuropathy can be treated with nerve pain medication like pregabalin or gabapentin, and by avoiding any medication that makes symptoms worse.
5. Dupuytren’s contracture. This is a condition defined by the abnormal thickening of tissue in the hands that can eventually cause the fingers to bend into the palm. Generally, the lumps and bumps that form in the hands are painless, however some people living with the condition may experience pain or discomfort. As the condition progresses, many people also find it difficult to wash their hands, shake hands or perform everyday tasks, like opening jars.
Though genes seem to play a role, the exact cause of Dupuytren’s contracture is unknown, it most commonly affects men, people over 40 and those of northern European descent. The condition doesn’t always require treatment, but severe cases can be treated with non-surgical options, like injectables, or surgery.
How do I know if I need to see a doctor?
Dr. Bojescul: Most of the time, numbness and tingling will improve over time with the appropriate treatment and therapy. However, if the symptoms progress so much that there is a loss of function or motor weakness, you should see your doctor right away. You should also see a doctor if the problem persists more than 30 days. If caught early, most adverse outcomes can be avoided or minimized.
See more from Dr. Bojescul:
What is a ball and socket joint? What is the function of synovial fluid in joints? How can I prevent stiffness and pain in my joints as I get older?
