What is that Tingling in Your Hand Telling You?

Pins and needles, mild tingling or your hand feels like it “fell asleep” can happen occasionally to anyone. But when the tingling becomes more frequent or it does not resolve itself, it could be a signal that something more serious is going on and it is time to speak with a physician.

What Causes the Tingling?

Orthopaedic surgeon Dr. Jasmine Bauknight of Shore Physicians Group in Somers Point specializes in hand and upper extremity procedures and said tingling and numbness in the hand and wrist are not uncommon. “There are a number of reasons a person would have numbness in their hand and fingers,” said Dr. Bauknight. “It could be something as simple as sleeping in a position where it puts pressure on a nerve. The temporary reduction of blood to the nerve may cause that pins and needles feeling. Many people unknowingly sleep with their wrists or elbows bent and that puts additional tension on the nerve. The numbness in the hand or wrist could also be caused by many other reasons including pressure on the median nerve or carpal tunnel syndrome.”

Other than carpal tunnel syndrome, Dr. Bauknight said some of the other reasons a person may experience numbness or pins and needles in their hands and wrists could be due to cubital tunnel syndrome, cervical spondylosis, thoracic outlet syndrome, peripheral neuropathy, diabetes, as well as sleep posture.

Our Complex Hand

The human hand is amazing. It can pick up, pull, push, grip, grab, and high five and take hold of a hand. The hand is made up of the wrist, palm, and fingers and consists of 27 bones, 27 joints, 34 muscles, over 100 ligaments and tendons, and many blood vessels and nerves. The wrist is made up of eight small bones (the carpal bones) plus the two long bones in the forearm, the radius and ulna.

As Dr. Bauknight explained, the hand is very complicated, and broken bones, injured ligaments, and pinched nerves can happen anywhere. The kitchen is a prime spot for hand accidents, and cuts that occur in a split second can damage nerves, tendons and ligaments and may require multiple stitches and possibly even surgery.

Carpal Tunnel Syndrome

Numbness and tingling in the hand and arm may result from a compressed nerve in the wrist, according to Dr. Bauknight. “Carpal tunnel syndrome is actually a compression neuropathy, where the median nerve is basically getting squeezed under ligaments and tendons as they pass through the carpal tunnel. The nerve does not like to be compressed and may result in tingling, that numb pins and needle feeling. It may also cause weakness in the hand or diminished grip strength and even dropping things, depending upon the severity of the compression.” Dr. Bauknight added that wrist anatomy along with patterns of hand use may contribute to the severity of the individual’s carpal tunnel syndrome.

Carpal Tunnel Syndrome Treatment

Treatment for carpal tunnel syndrome may include rest, ice, wrist splints or braces, exercises, cortisone injections and surgery if necessary. Dr. Bauknight said, left untreated, carpal tunnel syndrome can lead to weakness, a lack of coordination in the fingers and thumb and may impact the individual’s ability to grip as well as their range of motion. Dr. Bauknight cautioned that people suffering with symptoms of carpal tunnel syndrome should not put off seeing their physicians because the symptoms can get worse. They may result in irreversible changes such as weakness and muscle-wasting and in some cases, Dr. Bauknight said the beefy part of the palm can flatten out.

If surgery is necessary, Dr. Bauknight indicated there are two different techniques: open carpal tunnel release or endoscopic. The open carpal tunnel release involves an incision in the wrist. The ligament is cut to allow the release. The endoscopic technique is a done with a small incision in the wrist and using a tiny camera-guided instrument, the surgeon releases the ligament. The more rapid recovery is via the endoscopic procedure but both have a good outcome for the patient. They will need to follow with therapy post-surgery.

Avocado Hand

Dr. Bauknight warned that something as simple as making a bowl of guacamole can turn into a trip to the emergency room and possibly require surgery from one quick cooking shortcut. Avocados are a big part of many meals but a sharp knife can easily go right through that leathery and slippery avocado skin and into the hand holding it, Dr. Bauknight said. She adds that cooks will too often try to quickly remove the pit by smacking it with a sharp knife in an attempt to yank it free from the fruit. “The hand is so complex and compact. A sharp knife can go right through the skin and cut nerves and tendons. Stitches to repair the damage is only part of the problem. I can make the repair but there will need to be weeks of physical and occupational therapy for them to regain their full range of motion.”

To make an appointment with Dr. Bauknight at the new 710 Centre Street Somers Point location to discuss your hand discomfort, call Shore Physicians Group’s Orthopaedic Division at 609-365-6280.