What could be causing numbness and tingling in my hands?

Dr. David A. Cautilli, MD
Orthopedic Surgeon

If you have numbness or tingling in your hands, things that wake you up at night, or if you feel you’ve lost strength in your hands, you should be evaluated for carpal tunnel syndrome. Most people chalk it up to the aging process and don't necessarily get these things looked at. By the time they come to get treated their symptoms are fairly advanced but could have been prevented or made better earlier.

The most common cause cause for numbness and tingling in the hand is carpal tunnel syndrome which is compression of the median nerve in the carpal tunnel of the wrist. This typically will cause numbness in the thumb, index and middle finger. Other causes include ulnar nerve compression at the elbow or heel of the palm (Guyon's canal). Intermittent pins and needles sensations when circulation is affected either by compression of veins or arteries from hyperflexion at the elbow or extrinsic compression. Other causes can include a pinched nerve in the neck affecting C7, C8 or T1 nerve roots.

Numbness and tingling are hallmark signs that the nerves supplying that particular area are not functioning properly. In the case of the wrist and hand, the altered sensation is usually due to increased pressure on the nerve, also known as a compression neuropathy. The most common type of compression neuropathy is carpal tunnel syndrome (CTS). CTS is increased pressure on the median nerve when it travels through carpal tunnel of the wrist. Most often the result is numbness and tingling in the thumb, index, and middle fingers. If the condition is severe enough it may lead to weakness and pain. Causes of CTS include pregnancy, arthritis, and overuse activities with the hands (i.e. typing).

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