Numbness and tingling of the fingers affects many Americans. There are multiple causes but carpal tunnel syndrome and cubital tunnel syndrome are two of the most common reasons. Carpal tunnel syndrome is associated with numbness in the thumb, index and middle fingers whereas cubital tunnel syndrome typically affects the small finger. Carpal tunnel syndrome is caused by compression of the median nerve at the wrist and cubital tunnel syndrome is associated with compression of the ulnar nerve at the elbow. The symptoms are usually felt at night and may affect sleep. Additionally, day time symptoms associated activities of daily living such as driving or using one's cellphone often bring a great deal of distress.
There are other locations where nerve compression can affect the upper extremities, such as the cervical spine in the neck. Occasionally, an individual can have two sites of compression. This is called a double crush phenomenon. In order to properly diagnose the reason for hand numbness, tingling and pain, a hand surgeon will gather pertinent medical history, perform a detailed physical exam, and possibly obtain electrodiagnostic studies. There are a variety of non-operative treatments such as bracing, use of anti-inflammatory medications (ibuprofen, naproxen), activity modification, and occupational therapy. Surgical intervention is often necessary for those with symptoms that are not improved with non-operative interventions alone. Surgery can be performed either endoscopically with a use of a special camera or the more traditional open technique.
Results after surgical intervention are typically very positive. Many patients who had trouble with sleep before often say that they get a great night's sleep after the surgery. Surgical site pain can persist several months but is typically managed well with supportive therapies such as massage of the incision. Patients are able to start using their hands shortly after surgery and can return to work usually a few days after surgery.
For more information, please visit www.handcare.org and click on the conditions and injuries tab.
