Are your hands tingling?
Have you ever seen a robotic hand? They can be impressive, but even the best robotic hands can’t match the dexterity, adaptability and sensitivity of the human hand — a true biomechanical marvel.
Unfortunately, sometimes our hands’ functions can be limited by injury or a nerve problem. You’ve likely heard of, or even had, carpal tunnel troubles. Another problem we can have with our hands is what we call ulnar nerve dysfunction. Fortunately, if you have issues with your arms or hands, you can recover if you get timely, professional treatment.
The carpal tunnel is actually a little tunnel or passage of ligament and bones at the base of your hands near the wrists. Nerves and tendons pass through this tunnel.
Irritated tendons or other swelling can press on the nerves in the tunnel. This can cause tingling or numbness in the hand or wrist. Over time, the discomfort can increase, and you may have difficulty or pain when trying to grasp objects. The syndrome can also result in sharp pain that shoots through the wrist and up the arm.
The exact cause of carpal tunnel syndrome may be hard to pinpoint, but repetitive hand work, a wrist injury or a disease such as rheumatoid arthritis can cause it. Some people simply have smaller carpal tunnels.
The dominant hand is usually affected first and can become the most painful.
The signs usually start gradually. You may notice:
- Burning, tingling or itchy numbness in the palm and fingers. It may be more noticeable in your index and middle fingers.
- Fingers become hard to use. It may become hard to make a fist.
- Fingers feel swollen even though there’s no physical swelling.
You may notice symptoms first appear during the night. Sleeping with flexed wrists can cause this.
Left untreated, muscles at the base of the thumb begin to waste away. Some with carpal tunnel syndrome may notice they’re no longer able to tell the difference between hot and cold by touch.
Carpal tunnel prevention
At work, you can do on-the-job conditioning, perform stretching exercises, take frequent rest breaks, wear splints to keep wrists straight and use correct posture and wrist position. Wearing fingerless gloves can help keep your hands warm and flexible.
Watch for ways to keep your wrist in a natural position during work.
If you notice the signs of carpal tunnel syndrome, see your health care professional as soon as you can. It isn’t an emergency, but delaying treatment can reduce chances for a full recovery.
If the underlying cause of the problem is diabetes or arthritis, your health care professional likely will treat those conditions first and might suggest medications to help.
Stretching and strengthening exercises can help if symptoms have subsided. The exercises may be supervised by a physical therapist or an occupational therapist.
And carpal tunnel release is a common surgery usually recommended if symptoms last for six months. The procedure involves cutting the band of tissue around the wrist to reduce pressure on the median nerve. This outpatient surgery is done under local anesthesia.
Ulnar nerve dysfunction
What we call ulnar neuropathy happens when there’s damage to your ulnar nerve, which crosses the elbow just under the skin and travels down your arm. The damage often destroys the nerve covering (myelin sheath) or part of the nerve (axon) and slows or prevents nerve signaling.
Damage to the ulnar nerve can be caused by:
- Long-term pressure on the elbow.
- An elbow fracture or dislocation.
- Long-term pressure on the base of the palm.
Temporary pain and tingling of this nerve can occur if the elbow is hit, producing the experience of hitting your “funny bone” at the elbow.
With this condition, you may notice:
- Abnormal sensations in the little finger and part of the ring finger, usually on the palm side
- Loss of coordination of the fingers
- Numbness, decreased sensation
- Tingling, burning sensation
- Weakness and clumsiness of the hand
- Pain or numbness that may awaken the sufferer from sleep.
Ulnar nerve dysfunction prevention
- Avoid prolonged pressure on your elbow or palm
- Limit activities that can make the condition worse, such as tennis or golf
- Do not lean on your elbow while driving or sitting
- Keep your arm straight while at rest
- Wear a splint while you sleep to prevent the elbow from bending
- Try to prevent falls or direct impact to the inside of the elbow (near the funny bone).
Knowing the cause will allow appropriate treatment. Sometimes, no treatment is needed. Otherwise:
- Over-the-counter or prescription pain relievers may control discomfort
- Corticosteroids injected into the injury area may reduce swelling and pressure on the nerve
- A supporting splint at the wrist or elbow may help prevent further injury and relieve the symptoms
- Surgery may be needed to relieve pressure.
As with carpal tunnel syndrome, early diagnosis increases the chances of successful treatment. If you have concerns about carpal tunnel syndrome, ulnar neuropathy or another problem with your arms or hands, promptly see your health care professional.
About the Author
Ofer M. Zikel, MD, is a neurosurgeon at Aurora Medical Center in Summit, WI.