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Tingling and Numbness


Tingling and Numbness?


Tingling and Numbness is where the hand or some of your fingers become numb. There are various causes sually it follows a nerve getting pinched in the wrist or the inner side of the elbow or the neck.

  • Carpal tunnel syndrome
  • Pronator syndrome
  • Cubical tunnel syndrome (Ulnar)
  • Thoracic outlet syndrome

Carpul Tunnel Syndrome


It is a situation where the nerve is pinched at the level of the wrist. Often seen in females, one or both the hands get affected and it disturbs the sleep.

Tingling is in thumb, index and middle fingers or at times in all the fingers. If the symptoms have been present for several years, the patient may drop objects and find it difficult to hold simple light weight objects like a cell phone or a cup of tea in the hand.

Investigations


The diagnosis is made by clinical examination and further substantiated by a few tests.

  • Ultrasonography is a noninvasive test where the nerve diameter is assessed. The nerve may be swollen and at times pinched. The test is done by radiologists who specialize in musculoskeletal sonography.
  • Electromyography is another test where the quality of nerve function is tested.
  • MRI may additionally be necessary, though rarely, if there is any suspicion of a lump seated in the depth of the wrist which causes additional pressure on the nerve.

Treatment


If the disease has been existing for a very short period, the symptoms may be relieved with a wrist support called a cock-up splint. If this does not help, the next stage is a single injection of an anti-inflammatory medicine together with another medicine to numb the part, near the wrist which may relieve the symptoms.

The persistence of symptoms in spite of these measures require a short surgery of the palm, where the causative structure (flexor retinaculum) is released. The surgery can be done with the help of an endoscope or open surgery. Open surgery is safe, effective and is considered a gold standard.

Presence of Diabetes mellitus, thyroid disease, hypertension, vitamin B12 deficiency and intake of any medication causing tingling as a side effect should be rule out.

Ulnar Nerve Compression


After carpal tunnel syndrome, this is is the second most common cause of tingling in the hand. The patient gets tingling in ring and small finger usually when doing activities with the elbow bent,like computer operation or driving a vehicle.Avoiding activities where the elbow is bent helps.
If the symptoms are relentless , this may require surgery .While there are several options available.The common factor is to identify and release all the causative factors of nerve compression.

Releasing the nerve from its location and anterior transposition over the length will eliminate the tension over the nerve. This helps alleviate the symptoms

Case Study 1


Tingling in the finger is a common symptom. When the tingling is in the small finger, often it is due to compression of the ulnar nerve at the elbow. Initially the symptoms are confined to tingling alone .In due course, there may be onset of finger weakness and inability to extend the ring and small fingers.

Activity modification may at times help. If symptoms persist, this may require surgery. There are various types of procedures available for alleviating the symptoms. One of them is ulnar nerve decompression with or without anterior transposition.

 Dr Pankaj Jindal Hand Surgery  Dr Pankaj Jindal Hand Surgery

Case Study 2


Non union lateral condyle humerus
The child had an injury earlier leading to non-union of lateral condyle of the distal humerus. The progressive deformity of the elbow lead to ulnar nerve stretching. The ulnar nerve was surgically freed and transposed anteriorly.

The child had an injury earlier leading to non-union of lateral condyle of the distal humerus. The progressive deformity of the elbow lead to ulnar nerve stretching. The ulnar nerve was surgically freed and transposed anteriorly.

 Dr Pankaj Jindal Hand Surgery  Dr Pankaj Jindal Hand Surgery  Dr Pankaj Jindal Hand Surgery

India's Top Rated Hand Surgeon

Dr. Pankaj Jindal, Master of Surgery in Orthopaedics. Fellowship in Hand Surgery, Microsurgery & Research in France & USA.

Dr. Pankaj Jindal

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