What are the early signs of carpal tunnel syndrome. How is carpal tunnel syndrome diagnosed. What treatments are available for carpal tunnel syndrome. Who is at higher risk of developing carpal tunnel syndrome. Can carpal tunnel syndrome be prevented. What lifestyle changes can help manage carpal tunnel syndrome. When should you see a doctor for carpal tunnel symptoms.

Understanding Carpal Tunnel Syndrome: An Overview

Carpal tunnel syndrome (CTS) is a prevalent neurological disorder affecting the hand and wrist. It occurs when the median nerve, which runs from the forearm to the palm, becomes compressed or squeezed at the wrist. This compression can lead to a range of symptoms, including numbness, weakness, and pain in the hand and wrist.

The carpal tunnel is a narrow passageway in the wrist formed by bones and ligaments. It houses the median nerve and tendons that control finger movement. When these tissues become irritated or swollen, they can narrow the tunnel, putting pressure on the median nerve and causing the characteristic symptoms of CTS.

The Role of the Median Nerve

The median nerve plays a crucial role in hand function. It provides sensation to the thumb, index, middle, and part of the ring finger. Additionally, it controls some of the small muscles at the base of the thumb. When this nerve is compressed, it can lead to the various symptoms associated with carpal tunnel syndrome.

Recognizing the Symptoms of Carpal Tunnel Syndrome

Carpal tunnel syndrome typically develops gradually, with symptoms often appearing first in one or both hands during the night. The dominant hand is usually affected first and experiences the most severe symptoms. Recognizing these early signs is crucial for timely intervention and treatment.

Early Symptoms of CTS

• Frequent numbness or tingling in the fingers, especially the thumb, index, and middle fingers
• A sensation of swollen or useless fingers
• Mild pain or tingling in the fingers

Advanced Symptoms

As the condition progresses, individuals may experience:

• Tingling sensations during daytime activities like talking on the phone or reading
• Mild to severe pain, often worsening at night
• Decreased range of motion in the hand
• Difficulty grasping small objects or performing manual tasks
• Muscle atrophy at the base of the thumb in chronic cases
• Inability to differentiate between hot and cold temperatures by touch in severe cases

Do these symptoms always indicate carpal tunnel syndrome? While these signs are characteristic of CTS, it’s important to note that they can also be associated with other conditions. A proper medical diagnosis is essential to confirm CTS and rule out other potential causes.

Risk Factors and Causes of Carpal Tunnel Syndrome

Carpal tunnel syndrome often results from a combination of factors that increase pressure on the median nerve and tendons within the carpal tunnel. Understanding these risk factors can help in prevention and early intervention.

Common Risk Factors

• Gender: Women are three times more likely to develop CTS than men
• Age: CTS is more common in adults, with risk increasing with age
• Hormonal changes: Pregnancy and menopause can increase the risk
• Medical conditions: Diabetes, thyroid disorders, and rheumatoid arthritis can contribute to CTS
• Occupational factors: Jobs involving repetitive hand movements or use of vibrating tools
• Wrist anatomy: A naturally narrow carpal tunnel can increase susceptibility
• Lifestyle factors: Obesity and smoking may increase the risk

Is carpal tunnel syndrome solely caused by repetitive motions at work? While repetitive hand movements can contribute to CTS, it’s important to understand that the condition can develop due to various factors, including genetics, medical conditions, and lifestyle choices. Many individuals with CTS have never worked in jobs traditionally associated with the condition.

Diagnosing Carpal Tunnel Syndrome: Methods and Procedures

Early diagnosis of carpal tunnel syndrome is crucial to prevent permanent nerve damage. Healthcare providers use a combination of physical examinations, medical history review, and diagnostic tests to confirm CTS and rule out other conditions.

Physical Examination

During a physical exam, your doctor will:

• Examine your hands, arms, shoulders, and neck
• Check for tenderness, swelling, warmth, and discoloration in the wrist
• Test finger sensation and muscle strength at the base of the hand
• Look for signs of muscle atrophy

Diagnostic Tests

Several tests can help confirm a diagnosis of CTS:

1. Tinel Test: The doctor taps on the median nerve at the wrist. A tingling sensation or shock-like feeling indicates a positive result.
2. Phalen Test: The patient holds their forearms upright with fingers pointing down and presses the backs of their hands together. Tingling or increased numbness within 60 seconds suggests CTS.
3. Electromyography (EMG): This test measures the electrical activity of muscles and can detect muscle damage.
4. Nerve Conduction Study: This test measures how quickly electrical impulses move through the nerves.
5. Imaging Tests: X-rays, ultrasound, or MRI scans may be used to rule out other conditions or identify abnormalities in the wrist structure.

How accurate are these diagnostic tests for carpal tunnel syndrome? While these tests are valuable tools, no single test is definitive for diagnosing CTS. A combination of clinical symptoms, physical examination findings, and test results is typically used to make an accurate diagnosis.

Treatment Options for Carpal Tunnel Syndrome

Treatment for carpal tunnel syndrome aims to relieve symptoms and prevent further nerve damage. The approach depends on the severity of the condition and may include non-surgical and surgical options.

Non-Surgical Treatments

• Wrist splinting: Wearing a splint at night can keep the wrist in a neutral position, reducing pressure on the median nerve.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications can help reduce pain and inflammation.
• Corticosteroid injections: These can provide temporary relief by reducing inflammation around the median nerve.
• Physical therapy: Specific exercises and stretches can help improve wrist strength and flexibility.
• Lifestyle modifications: Changes in work habits, ergonomic adjustments, and activity modifications can help manage symptoms.

Surgical Treatment

If non-surgical treatments don’t provide relief or if symptoms are severe, surgery may be recommended. The most common surgical procedure for CTS is carpal tunnel release, which involves cutting the ligament that forms the roof of the carpal tunnel to relieve pressure on the median nerve.

What is the success rate of carpal tunnel release surgery? Carpal tunnel release surgery is generally very effective, with a success rate of over 90% in relieving nighttime pain and numbness. However, recovery time and the extent of symptom improvement can vary among individuals.

Preventing and Managing Carpal Tunnel Syndrome

While not all cases of carpal tunnel syndrome can be prevented, certain strategies can help reduce the risk and manage symptoms effectively.

Prevention Strategies

• Maintain good posture and wrist position during activities
• Take regular breaks from repetitive tasks
• Perform hand and wrist stretching exercises
• Use ergonomic tools and equipment
• Manage underlying health conditions like diabetes and arthritis
• Maintain a healthy weight
• Avoid smoking

Self-Care Techniques

For those already experiencing symptoms, several self-care measures can help:

• Apply cold packs to reduce swelling
• Perform gentle hand exercises to improve circulation
• Avoid activities that exacerbate symptoms
• Use over-the-counter pain relievers as directed
• Wear a wrist splint during activities that trigger symptoms

Can lifestyle changes alone resolve carpal tunnel syndrome? While lifestyle modifications can significantly help manage symptoms and slow progression, they may not be sufficient to resolve moderate to severe cases of CTS. It’s important to work with a healthcare provider to develop a comprehensive treatment plan.

Living with Carpal Tunnel Syndrome: Long-Term Outlook and Considerations

Understanding the long-term implications of carpal tunnel syndrome is crucial for individuals affected by this condition. With proper management and treatment, many people with CTS can experience significant improvement in their symptoms and quality of life.

Long-Term Prognosis

The outlook for individuals with carpal tunnel syndrome varies depending on several factors:

• Severity of the condition at the time of diagnosis
• Promptness of treatment
• Adherence to treatment plans and lifestyle modifications
• Individual health factors and underlying conditions

In many cases, early intervention and appropriate treatment can lead to complete resolution of symptoms. However, some individuals may experience persistent or recurring symptoms, especially if there is longstanding nerve damage.

Ongoing Management

For those living with chronic CTS, ongoing management strategies may include:

• Regular follow-ups with healthcare providers
• Continued use of splints or braces as needed
• Adapting work and leisure activities to minimize strain on the wrists
• Maintaining a healthy lifestyle to manage related health conditions
• Participating in occupational therapy or physical therapy programs

How often should individuals with CTS have follow-up evaluations? The frequency of follow-up appointments can vary based on the severity of the condition and the treatment plan. Initially, more frequent check-ups may be necessary, but as symptoms stabilize, visits may become less frequent. It’s important to consult with your healthcare provider to determine an appropriate follow-up schedule.

Impact on Daily Life and Work

Carpal tunnel syndrome can significantly impact various aspects of daily life and work:

• Work productivity and performance
• Ability to perform household tasks
• Participation in hobbies and recreational activities
• Sleep quality
• Overall quality of life

Many individuals with CTS may need to make adjustments to their work environment or duties. This could involve using ergonomic equipment, taking more frequent breaks, or in some cases, considering job modifications or career changes.

Psychological Considerations

Living with a chronic condition like CTS can also have psychological impacts. Some individuals may experience:

• Frustration or anxiety about symptom management
• Concerns about job security or career progression
• Depression related to limitations in daily activities
• Stress about the potential need for surgery

It’s important for individuals with CTS to address these psychological aspects as part of their overall management plan. Support groups, counseling, or therapy can be beneficial in coping with the emotional challenges of living with a chronic condition.

Advancements in Carpal Tunnel Syndrome Research and Treatment

The field of carpal tunnel syndrome research is continually evolving, with new insights and treatment approaches emerging. Staying informed about these advancements can provide hope and new options for those affected by CTS.

Emerging Diagnostic Tools

Researchers are exploring new ways to diagnose CTS more accurately and efficiently:

• Advanced imaging techniques: High-resolution ultrasound and specialized MRI protocols are being developed to provide more detailed views of the carpal tunnel anatomy.
• Biomarker research: Scientists are investigating potential biomarkers that could indicate the presence or severity of CTS through blood tests.
• Artificial intelligence: Machine learning algorithms are being developed to assist in the interpretation of diagnostic tests, potentially improving accuracy and consistency in CTS diagnosis.

Innovative Treatment Approaches

New treatment modalities for CTS are under investigation:

• Minimally invasive surgical techniques: Endoscopic and ultrasound-guided procedures are being refined to reduce recovery time and improve outcomes.
• Regenerative medicine: Stem cell therapy and platelet-rich plasma injections are being studied for their potential to promote nerve healing and reduce inflammation.
• Neurostimulation: Techniques like transcutaneous electrical nerve stimulation (TENS) are being explored for their ability to manage pain and improve nerve function.
• Nanoparticle drug delivery: Researchers are investigating targeted drug delivery systems using nanoparticles to improve the efficacy of anti-inflammatory medications.

What is the most promising area of research for carpal tunnel syndrome treatment? While all areas show potential, minimally invasive surgical techniques and regenerative medicine approaches are generating significant interest due to their potential to improve outcomes and reduce recovery times. However, more research is needed to fully establish their effectiveness and long-term benefits.

Preventive Strategies

Research is also focusing on better understanding risk factors and developing more effective preventive strategies:

• Genetic studies: Identifying genetic markers associated with CTS could help in early identification of at-risk individuals.
• Occupational health research: Ongoing studies are refining our understanding of workplace risk factors and developing more effective ergonomic interventions.
• Wearable technology: Smart devices that monitor hand and wrist movements and provide real-time feedback are being developed to help prevent overuse and strain.

Future Outlook

As research progresses, the future of CTS management looks promising. Potential developments include:

• Personalized treatment plans based on genetic and biomarker profiles
• More effective non-surgical interventions that could reduce the need for surgery
• Improved surgical techniques with faster recovery times and better long-term outcomes
• Advanced prevention strategies that could significantly reduce the incidence of CTS in high-risk populations

How can individuals stay informed about new developments in CTS research and treatment? Staying in touch with healthcare providers, following reputable medical news sources, and considering participation in clinical trials are good ways to stay updated on the latest advancements in carpal tunnel syndrome management.

Carpal Tunnel Syndrome | National Institute of Neurological Disorders and Stroke

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is a common neurological disorder that occurs when the median nerve, which runs from your forearm into the palm of the hand, becomes pressed or squeezed at the wrist. You may feel numbness, weakness, pain in your hand and wrist, and your fingers may become swollen and useless. You might wake up and feel you need to “shake out” your hand or wrist.

The median nerve and the tendons that bend the fingers pass through the carpal tunnel—a narrow, rigid passageway of ligament and bones at the base of the hand. The median nerve provides feeling to the thumb, index, and middle finger, and part of the ring finger (but not the little finger). It also controls some small muscles at the base of the thumb.

Sometimes, thickening from the lining of irritated tendons or other swelling narrows the tunnel and compresses the median nerve. CTS is the most common and widely known of the entrapment neuropathies, in which one of the body’s peripheral nerves is pressed on or squeezed.

You can sometimes treat carpal tunnel syndrome at home, but it may take months to heal. Your doctor can recommend treatments. CTS rarely recurs following treatment and home care.

Symptoms

Symptoms usually start gradually, with frequent numbness or tingling in the fingers, especially the thumb and the index and middle fingers. Symptoms often first appear in one or both hands during the night. The dominant hand is usually affected first and procures the most severe symptoms. Early symptoms include:

• Numbness, particularly at night  
• A feeling the fingers are useless or swollen
• A tingling sensation or pain in the fingers.

As symptoms worsen, people might feel:

• Tingling during the day, especially with certain activities such as talking on the phone, reading a book or newspaper, or driving

• Mild to severe pain, sometimes worse at night 
• Some loss of movement in the hand

• Hand weakness may make it difficult to grasp small objects or perform other manual tasks.

In chronic and/or untreated cases, the muscles at the base of the thumb may shrink and waste away. Some people with very severe CTS cannot determine between hot and cold by touch and may burn their fingertips without knowing it.

Who is more likely to get carpal tunnel syndrome?

Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Sometimes no single cause can be identified. Contributing factors may include:

• Trauma or injury to the wrist that cause swelling, such as sprain or fracture
• Imbalance of either the pituitary gland or the thyroid gland
• Rheumatoid arthritis or other arthritic diseases
• Mechanical problems in the wrist joint
• Repeated use of vibrating hand tools
• Fluid retention during pregnancy or menopause
• Development of a cyst or tumor in the canal
• Sex—women are three times more likely than men to develop CTS
• Having diabetes or other metabolic disorders that directly affect the body’s nerves and make them more susceptible to compression
• Repeated sleeping on a bent wrist
• Increasing age—CTS usually occurs only in adults.

The risk of developing CTS is not confined to people in a single industry or job but may be more reported in those performing assembly line work—such as manufacturing, sewing, finishing, cleaning, and meatpacking—than it is among data-entry personnel. Many people who have CTS report never have working at these types of jobs.

How is carpal tunnel syndrome diagnosed and treated?

Diagnosing CTS

Early diagnosis and treatment are important to avoid permanent damage to the median nerve.

• Physical exam. Your doctor will examine your hands, arms, shoulders, and neck to determine if your complaints are related to daily activities or to an underlying disorder and to rule out other conditions that mimic carpal tunnel syndrome. Your wrist will be checked for tenderness, swelling, warmth, and discoloration. Your fingers will be tested for sensation, along with muscles at the base of the hand for strength and signs of atrophy.
• Routine laboratory tests and X-rays can reveal fractures, arthritis, and nerve-damaging diseases such as diabetes.
• Specific wrist tests may produce the symptoms of CTS.
  • In the Tinel test, the doctor taps on or presses on the median nerve in your wrist. The test is positive when tingling in the fingers or a resultant shock-like sensation occurs.
  • The Phalen, or wrist-flexion, test involves having you hold your forearms upright by pointing the fingers down and pressing the backs of the hands together. If you have CTS, you should feel tingling or increasing numbness in your fingers within 1 minute. Your doctor may also ask you to try to make a movement that brings on symptoms.
• Electrodiagnostic tests may help confirm the diagnosis of CTSs.
  • A nerve conduction study measures how quickly impulses are transmitted along a nerve. Electrodes are placed on your hand and wrist and a small electric shock is  applied and the speed with which nerves transmit impulses is measured
  • In electromyography, a fine needle is inserted into a muscle and electrical activity is viewed on a screen to determine the severity of damage to the median nerve.
• Diagnostic imaging also can help diagnose CTS or show problems.
  • Ultrasound imaging can show an abnormal size of the median nerve.
  • Magnetic resonance imaging (MRI) can show the anatomy of the wrist but to date has not been especially useful in diagnosing carpal tunnel syndrome.

Treating CTS

Treatments for carpal tunnel syndrome should begin as early as possible, under a doctor’s direction.  Underlying causes such as diabetes or arthritis should be treated first.

Non-surgical treatments

• Splinting.   Initial treatment is usually a splint worn at night.
• Avoiding daytime activities that may provoke symptoms.  If you have slight discomfort you may wish to take frequent breaks from tasks, to rest the hand.  If the wrist is red, warm and swollen, applying cool packs can help.
• Over-the-counter drugs.  In special circumstances, various medications can ease the pain and swelling associated with carpal tunnel syndrome. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and other nonprescription pain relievers, may provide some short-term relief from discomfort but haven’t been shown to treat CTS.
• Prescription medicines.  Corticosteroids (such as prednisone) or the drug lidocaine can be injected directly into your wrist or taken by mouth (in the case of prednisone) to relieve pressure on the median nerve if you have mild or intermittent symptoms. (Check first with your doctor if you have diabetes or may be predisposed to it, as prolonged use of corticosteroids can make it difficult to regulate insulin levels. )
• Exercise. Ask your doctor about hand exercises that might help with pain.
• Alternative therapies. Yoga has been shown to reduce pain and improve grip strength among those with CTS. Other alternative therapies, such as acupuncture and chiropractic care, have benefited some people with CTS but their effectiveness remains unproved.
• Vocational or occupational therapy. You may need to learn new ways to perform certain tasks or job skills that will not complicate or worsen your CTS.

Surgery

• Carpal tunnel release is one of the most common surgical procedures in the United States. It may be recommended when non-surgical treatments are ineffective or if the disorder has become severe. Carpal tunnel surgery involves cutting a ligament to relieve the pressure on the nerve. Surgery is usually done under local or regional anesthesia (involving some sedation) and does not require an overnight hospital stay. Many people require surgery on both hands.
• Open release surgery is the traditional procedure used to correct carpal tunnel syndrome. It consists of making an incision up to 2 inches in your wrist and then cutting the carpal ligament to enlarge the carpal tunnel. The procedure is generally done under local anesthesia on an outpatient basis, unless there are unusual medical conditions.
• Endoscopic surgery may allow somewhat faster functional recovery and less postoperative discomfort than traditional open release surgery but it may also have a higher risk of complications and the need for additional surgery. The surgeon makes one or two incisions (about ½ inch each) in your wrist and palm, inserts a camera attached to a tube, observes the nerve, ligament, and tendons on a monitor, and cuts the carpal ligament (the tissue that holds joints together) with a small knife that is inserted through the tube. Following the surgery, the ligaments usually grow back together and allow more space than before. Your symptoms may be relieved immediately after surgery, but full recovery can take months. You may have infections, nerve damage, stiffness, and pain at the scar. Almost always there is a decrease in grip strength, which improves over time. You may need to modify work activity for several weeks following surgery or need to adjust job duties or even change jobs after recovery from surgery.   

Recurrence of carpal tunnel syndrome following treatment is rare. Less than half of individuals report their hand(s) feeling completely normal following surgery. Some residual numbness or weakness is common.

How can self-care or lifestyle changes support a treatment plan for carpal tunnel syndrome?

At night, keep your wrist straight while resting or asleep to prevent pressing on the nerve and carpal tunnel.

Tasks at home or work, along with workstations, tools, and tool handles, can be redesigned to help your wrist maintain a natural position during work.  Wearing fingerless gloves can help keep hands warm and flexible.  At the workplace, workers can do on-the-job conditioning, perform stretching exercises, take frequent rest breaks, and use correct posture and wrist position.   Jobs can be rotated among workers.  Employers can develop ergonomic programs to adapt workplace conditions and job demands to the capabilities of workers. 

What are the latest updates on carpal tunnel syndrome?

The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge of the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.  The NINDS is a component of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world. NINDS is the leading NIH funding Institute on nerve disorders, including carpal tunnel syndrome.

Scientists supported by NINDS are studying the factors that lead to long-lasting neuropathies (diseases or malfunction of nerves), and how the affected nerves are related to symptoms of pain, numbness, and functional loss. Researchers also are examining biomechanical stresses that contribute to the nerve damage responsible for symptoms of carpal tunnel syndrome in order to better understand, treat, and prevent CTS and other costly and disabling occupational illnesses.

Scientists funded through NIH’s National Center for Complementary and Integrative Health are investigating the effects of acupuncture on pain, loss of median nerve function, and changes in the brain associated with CTS. In addition, a randomized clinical trial designed to evaluate the effectiveness of osteopathic manipulative treatment in conjunction with standard medical care is underway. Evaluations of these therapies and other therapies will help to tailor individual treatment programs.

Another NIH component, the National Institute of Arthritis and Musculoskeletal and Skin Disorders (NIAMS), supports research on tissue damage associated with repetitive motion disorders, including CTS. Scientists have developed animal models that are helping to understand and characterize connective tissue in hopes of reducing harmful tissue buildup and identifying new treatments.

More information about carpal tunnel syndrome research supported by NINDS and other NIH Institutes and Centers can be found using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.  RePORTER also includes links to publications and resources from these projects.

For research articles and summaries on carpal tunnel syndrome, search PubMed, which contains citations from medical journals and other sites.

file-medical

Learn About Clinical Trials

Clinical trials are studies that allow us to learn more about disorders and improve care. They can help connect patients with new and upcoming treatment options.

How can I or my loved one help improve care for someone with carpal tunnel syndrome?

Consider participating in a clinical trial so clinicians and scientists can learn more about carpal tunnel syndrome. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for people with CTS at Clinicaltrials.gov.
 

Where can I find more information about carpal tunnel syndrome?

The following resources may help individuals, families, friends, and caregivers of people living with CTS:

Foundation for Peripheral Neuropathy
Phone: 877-883-9942

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Phone: 301-496-8190 or 877-226-4267

Information about CTS is also available: 

Centers for Disease Control and Prevention (CDC)
Phone: 800-311-3435 or 404-639-3311

National Library of Medicine
Phone: 301-496-6308 or 888-346-3656

Occupational Safety & Health Administration (OSHA)
Phone: 800-321-6742

Learn about related topics

• Repetitive Motion Disorders 

10 Causes, Diagnosis, and Treatment

Written by Rick Ansorge

• Causes of Tingling in the Hands and Feet
• Diagnosis of Tingling Hands and Feet
• Treatments for Tingling Hands and Feet

Tingling hands, feet, or both is an extremely common and bothersome symptom. Such tingling can sometimes be benign and temporary. For example, it could result from pressure on nerves when your arm is crooked under your head as you fall asleep. Or it could be from pressure on nerves when you cross your legs too long. In either case, the “pins and needles” effect — which is usually painless — is soon relieved by removing the pressure that caused it.

But in many cases, tingling in the hands, feet, or both can be severe, episodic, or chronic. It also can come with other symptoms, such as pain, itching, numbness, and muscle wasting. In such cases, tingling may be a sign of nerve damage, which can result from causes as varied as traumatic injuries or repetitive stress injuries, bacterial or viral infections, toxic exposures, and systemic diseases such as diabetes.

Such nerve damage is known as peripheral neuropathy because it affects nerves distant from the brain and spinal cord, often in the hands and feet. There are more than 100 types of peripheral neuropathy. Over time, the condition can worsen, making you less mobile and even disabled. More than 20 million Americans, most of them older adults, are estimated to have peripheral neuropathy.

It’s important to get medical help right away for any tingling in your hands, feet, or both that’s lasted a while. The earlier the cause of your tingling is found and brought under control, the less likely you are to get what could be lifelong problems.

Diabetes is one of the most common causes of peripheral neuropathy, accounting for about 30% of cases. In diabetic neuropathy, tingling and other symptoms often first develop in both feet and go up the legs, followed by tingling and other symptoms that affect both hands and go up the arms. About two-thirds of people with diabetes have mild to severe forms of nerve damage. In many cases, these symptoms are the first signs of diabetes.

In another 30% of peripheral neuropathy cases, the cause is unknown, or “idiopathic.”

The remaining 40% of cases have a variety of causes such as:

Nerve entrapment syndromes. These include carpal tunnel syndrome, ulnar nerve palsy, peroneal nerve palsy, and radial nerve palsy.

Systemic diseases. These include kidney disorders, liver disease, vascular damage and blood diseases, amyloidosis, connective tissue disorders and chronic inflammation, hormonal imbalances (including hypothyroidism), and cancers and benign tumors that impinge on nerves.

Vitamin deficiencies. You need vitamins E, B1, B6, B12, and niacin for healthy nerves. A B12 deficiency, for example, can lead to pernicious anemia, an important cause of peripheral neuropathy. But too much B6 also can cause tingling in the hands and feet.

Alcoholism. People who have alcoholism are more likely to lack thiamine or other important vitamins because of poor dietary habits, a common cause of peripheral neuropathy. It’s also possible that alcoholism itself can cause nerve damage, a condition that some researchers call alcoholic neuropathy.

Toxins. These include heavy metals such as lead, arsenic, mercury, and thallium, and some industrial and environmental chemicals. They also include certain medications — especially chemotherapy drugs used for lung cancer — but also some antiviral and antibiotic drugs.

Infections. These include Lyme disease, shingles (varicella zoster), cytomegalovirus, Epstein-Barr, herpes simplex, and HIV and AIDS.

Autoimmune diseases. These include chronic inflammatory demyelinating polyneuropathy, Guillain-Barre syndrome, lupus, and rheumatoid arthritis.

Inherited disorders. These include a group that may have sensory and motor symptoms; the most common type is known as Charcot-Marie-Tooth disease.

Injury. Often related to trauma, nerves can be compressed, crushed, or damaged in other ways, resulting in nerve pain. Examples include nerve compression caused by a herniated disk or dislocated bone.

Multiple sclerosis. The disease causes your body’s immune system to attack the fatty myelin sheath around nerve fibers in your brain and spine. Tingling in the hands and feet is a common symptom.

If you seek care for your tingling hands or feet, your health care provider will do a physical exam and take an extensive medical history addressing your symptoms, work environment, social habits (including alcohol use), toxic exposure, risk of HIV or other infectious diseases, and family history of neurological disease.

They also may perform other tests, such as:

• Blood tests. These can include tests to detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, and signs of abnormal immune system activity.
• An examination of cerebrospinal fluid. This can identify antibodies associated with peripheral neuropathy.
• An electromyogram (EMG), a test of the electrical activity of muscle
• Nerve conduction velocity (NCV)

Other tests may include:

• Computed tomography (CT)
• Magnetic resonance imaging (MRI)
• Nerve biopsy
• Skin biopsy to look at nerve fiber endings

Successful treatment depends on an accurate diagnosis and treatment of the cause of the tingling. As long as the peripheral nerve cells have not been killed, they can regenerate.

Although there are no treatments for inherited types of peripheral neuropathy, many of the acquired types can be improved with treatment. For example, good blood sugar control in diabetes can help keep diabetic neuropathy from getting worse, and vitamin supplements can correct peripheral neuropathy in people with vitamin deficiencies.

General lifestyle recommendations include keeping weight in check, avoiding exposure to toxins, following a doctor-supervised exercise program, eating a balanced diet, and avoiding or limiting alcohol. Recommendations also include quitting smoking, which constricts blood supply to blood vessels supplying nutrients to peripheral nerves.

In some cases, tingling and other symptoms of peripheral neuropathy may be eased with prescriptions developed for treating seizures and depression.

Top Picks

Scientists have found out what tingling in the fingers indicates

https://ria. ru/20210917/vitamin-1750435091.html RIA Novosti, 09/17/2021

Scientists have found out what tingling in the fingers indicates2021-09-17T01:11

2021-09-17T01:11

2021-09-17T11:43

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MOSCOW, September 17 – RIA Novosti. Tingling and numbness of the fingers and toes may indicate a deficiency in the human body of a vital vitamin, writes the British Express edition, citing the results of research by scientists from the University of Michigan Public Health. We are talking about vitamin B12. Its lack can cause nerve damage, which in turn causes discomfort in the arms and legs. Numbness and tingling, experts say, should not be scary, however, if such symptoms are observed too often, you should consult a doctor, undergo an examination and begin treatment. .B12 is a water-soluble vitamin, also called cobalamin. He is not only responsible for the functioning of the nervous system, but is involved in the production of red blood cells and DNA. Deficiency of this nutrient can lead to nerve damage and cause tingling and numbness in the arms and legs, muscle weakness and loss of reflexes. Previously, it was known that a thick and reddened tongue could be a sign of vitamin B12 deficiency, a lack of which increases the risk of pernicious anemia.

https://ria.ru/20210310/anemiya-1600542847.html

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MOSCOW, September 17 – RIA Novosti. Tingling and numbness of the fingers and toes may indicate a deficiency in the human body of a vital vitamin, writes the British edition of Express, citing the results of research by scientists from the University of Michigan Public Health.

This is vitamin B ₁₂ . Its deficiency can cause nerve damage, which in turn causes discomfort in the arms and legs.

Numbness and tingling, experts say, should not be frightening, however, if such symptoms are observed too often, you should consult a doctor, undergo an examination and begin treatment.

B ₁₂ is a water soluble vitamin also called cobalamin. He is not only responsible for the functioning of the nervous system, but is involved in the production of red blood cells and DNA. Deficiency of this nutrient can lead to nerve damage and cause tingling and numbness in the arms and legs, muscle weakness and loss of reflexes.

A syndrome that causes a feeling of extreme fatigue is revealed

March 10, 2021, 00:55

It was previously known that a thick and reddened tongue can be a sign of vitamin B deficiency ₁₂ , the lack of which increases the risk of pernicious anemia.

SM-Clinic cardiologist spoke about the causes of hand swelling in adults

Edema of the hands occurs quite often, and can be a manifestation of physiological changes or one of the symptoms of pathology. When should edema alert and where to address the problem?

ALENA PARETSKAYA

Pathophysiologist, immunologist, member

St. Petersburg Society of Pathophysiologists


ANDREY GRACHEV

Leading cardiologist of the holding

SM-Clinic, Doctor of Medical Sciences, Academician of the Russian Academy of Medical Sciences

Swelling of the hand is a cause for concern if it occurs frequently or almost daily, is accompanied by additional symptoms, is aggravated or is not eliminated by simple methods.

What you need to know about hand swelling

• Why does the hand swell
• How to relieve swelling
• Questions and answers

Why the hand swells in adults

Swelling of the arm or both at once may be physiological or be a sign of pathology. It may be localized or spread to surrounding tissues. With swelling, the limb increases in volume, discomfort, soreness, and inconvenience when performing precise finger movements may be felt. It is difficult to remove the rings from the fingers or the watch from the wrist.

Swelling in the right or left arm occurs when the blood or lymphatic vessels are compressed by items of clothing during sleep. Swelling of the fingers and hands, which is especially noticeable if you remove rings or watches, occurs after alcohol or excess salty foods, fluids at night.

Right hand

A small local edema, if the mobility of the limb is preserved, is possible with bruises. In the area of ​​​​edema, there may be soreness, redness, bruises or abrasions may appear. If it is a hematoma, the edema will be more pronounced, a seal is determined under the skin, in the center of which fluctuation (fluid movement) is felt. Swelling is typical for sprains in the area of ​​the carpal, elbow or shoulder joint, with torn ligaments or their rupture. Severe pain is characteristic, which increases with movement, if the ligaments are torn, it is almost impossible to move the hand.

Edema is possible with fractures of bones, dislocations of joints. Then there is pain, limb deformity, complete impossibility of movement.

Edema may appear with frostbite of the fingers, burns, infectious processes in the area of ​​the hand, forearm or shoulder.

Left hand

Swelling of the finger of the left hand (as well as the right one) is possible with panaritium – suppuration in the phalanx. If it is a deeper lesion, the edema passes to the hand. Carbuncles or boils on any part of the arm can also lead to swelling. In this case, cyanosis or a purple area with suppuration is visible in the center of the inflamed focus. Edema is possible with suppuration of wounds, erysipelas, purulent arthritis and osteomyelitis.

Joint damage in other forms of arthritis also leads to tissue swelling. With rheumatoid arthritis, the joints of both hands are symmetrically affected, with gout, the fingers swell, with psoriasis, the joints of the fingers and hand.

Edema is typical for joint damage – thrombosis. In addition to edema, a feeling of fullness, pain, thickening of tissues, discoloration of the skin, crawling, and a change in sensitivity are typical.

Morning

Lymphatic edema is possible after operations to remove the mammary gland, if the axillary lymph nodes were excised. Puffiness may increase or appear in the morning with malformations of the lymphatic capillaries, with post-burn scars, thrombophlebitis, lymphadenitis. Without treatment, swelling can become permanent.

Hand edema also occurs against the background of heart failure. In the morning they are minimal, intensify in the evening. In contrast, renal swelling of the hands is most pronounced in the morning and decreases or disappears during the day.

Pregnancy

Puffiness in the fingers or hands is due to hormonal changes, especially as the pregnancy progresses. In the first trimester, a slight swelling of the fingers is typical, which is almost not noticeable. By the third trimester, swelling can be pronounced, making it difficult to wear rings, watches, bracelets. Puffiness gradually disappears in the first days after childbirth.

However, pathological edema associated with hypertension, excess weight gain and the development of preeclampsia is also possible in pregnant women. Then the appearance of protein in the urine, a pronounced weight gain per week, severe swelling of the arms and legs, face, and body are typical.

How to relieve hand swelling in adults

At home or for first aid, you need to give your hand an elevated position.

If this is an injury, the hand should be immobilized with a bandage or splint, a cold compress should be applied to the affected area, and an anesthetic should be taken.

If these are diseases of the joints, it is necessary to use painkillers and anti-inflammatory drugs locally and orally. If the swelling develops quickly, with severe pain and dysfunction of the hand, you should immediately consult a doctor.

Doctors can use two options for treating edema – conservative and surgical. It depends on the cause, the severity of the condition, and possible complications. In case of injuries, emergency care, bandages, anti-inflammatory drugs, anesthesia are indicated.

In vascular edema, antispasmodic, angioprotective and phlebotonic drugs are used.

Physiotherapy, gymnastics, massage or manual therapy are also prescribed.

If the injury is serious or severe lesions of blood vessels, bones, joints are detected, the edema is not eliminated, surgical interventions are used.

Popular Questions and Answers

Edema can be a short-term phenomenon and does not threaten anything. But sometimes they are symptoms of dangerous conditions. Andrey Grachev, a cardiologist, helped us figure out the problem.

Why is hand swelling dangerous?

Swelling is often a sign of a serious infection, cancer, heart or kidney problems. And if the swelling is persistent, then the disease has worsened or is rapidly progressing. Edema can be complicated by tissue malnutrition, skin inflammation, stretch marks, and discoloration.

When should I see a doctor for swollen hands?

In any situation when you notice swelling of your hands – in the morning, in the evening or during the day, you need a doctor’s consultation and at least a minimal set of tests and examinations. Edema itself is a symptom of problems in the body, and you need to find out what caused it.

Is it possible to remove swelling of the hands with folk remedies?

There are a number of diuretic decoctions and infusions, but it is extremely dangerous to use them on your own, not knowing what the causes of edema are. This can lead to a worsening of the situation, an electrolyte imbalance, a sharp decrease in pressure, dehydration and malaise.

In addition, various traditional medicines can cause allergies, worsen the condition, negatively affect the effects of the drugs taken and have a number of contraindications for taking.