My Hand Tingles – Could I Have a Pinched Nerve? And if So, What Can I Do About It?

Having a hand fall asleep and stay asleep with numbness and tingling is often caused by a pinched nerve.

The term “pinched nerve” describes a type of damage or injury to a nerve or set of nerves. The two most common problems that cause pain and numbness in the arm and hand are carpal tunnel syndrome and a pinched nerve in the neck.

Carpal tunnel syndrome is often associated with repetitive movements with the hand such as typing or factory line work. The most common symptoms are numbness in the first two fingers, pain at the wrist and loss of grip strength. The symptoms can also involve the whole hand and radiate up the arm, and they are usually worse with movement. Symptoms often wake a person up at night due to the position of the hand during sleep.

An unusual condition, entrapment of the ulnar nerve at the wrist, is usually the result of a space-occupying lesion such as a ganglion cyst, a lipoma, or ulnar artery aneurism. Repetitive trauma, such as operating a jackhammer, sometimes causes this condition. Nerve compression is more common in people with arthritis, alcoholism, diabetes, and/or thyroid problems.

Pain is not usually a symptom of ulnar nerve entrapment at the wrist. Most patients report weakness and increasing numbness, symptoms that may be the result of direct pressure on the outside edge of the hand.

Depending on the location of the problem, ulnar nerve entrapment at the wrist produces sensory and/or motor changes to the hand. The most common of these is a tingling sensation over the ring and little fingers, as well as the loss of sensation at the tip of the little finger. There may be signs of muscle atrophy, or weakness of the muscles uses to spread the fingers apart.

A pinched nerve in the neck is caused by the nerve being compressed as it exits the spine. The problem is usually a herniated disc or a bone spur. The pain often shoots down the arm when the neck moves; it can also cause numbness and weakness.

Peripheral neuropathy is a general term for disorders of the peripheral nervous system. The peripheral nervous system is the network of nerves outside the central nervous system (the brain and spinal cord) connected to the spinal cord. Peripheral neuropathy is a common condition that can cause numbness and tingling. It can be caused by diseases of the nerves or by other illnesses. Diabetes is one of the most common causes of peripheral neuropathy. Other causes may include:

o Excessive alcohol consumption

o Nutritional deficiencies

o Infection or inflammation

o Overexposure to toxic chemicals, such as mercury or lead

o Tumors

o Rheumatoid arthritis

Nerve compression problems behind the elbow are called cubital tunnel syndrome. The ulnar nerve passes through the cubital tunnel which is a bony passageway. When you “hit your funny bone” and have tingling in the small and ring fingers, you are hitting the ulnar nerve at the cubital tunnel.

Treatment for a pinched nerve usually involves resting the affected area. Pain medication may be prescribed. Occasionally corticosteroid injections are used along with splinting and physical therapy. Sometimes changes in occupational routine will be recommended. In some cases, surgery is recommended. Carpal tunnel syndrome may be managed with either closed endoscopic nerve release or open release. Cubital tunnel is managed with open release. Physical therapy and splints or collars may also be used.

Treatment for peripheral neuropathy often focuses on treating the condition that caused it–for example, controlling diabetes or repairing a ruptured disk. Physical therapy may also be recommended.