Tingling in hands: Causes, diagnosis, treatment

If your hands are tingling there could be many different causes.
Your hand may have fallen asleep or you may have a pinched nerve indicative of Carpal tunnel.
Tingling hands could also signal an underlying condition like diabetic neuropathy or fibromyalgia.

Most people have experienced tingling hands at some point. 

This might present as the "pins and needles" feeling that people get when their arm falls asleep. In other cases, it might be accompanied by pain, burning, or weakness. 

In almost all cases, tingling hands are caused by something going wrong in the nervous system.

"This sensation is typically caused by a nerve being irritated," says Daniel Gittings, MD, orthopedic surgeon and hand and wrist specialist with Hoag Orthopedic Institute.

Here are eight things that might be causing your tingling hands.

1. Your limb fell asleep

Almost everyone has experienced having an arm or leg "fall asleep," when the limb feels heavy and tingly, like pins and needles are pricking it, when you go to move. 

The official name for this condition is temporary paresthesia. It occurs when there's pressure on a nerve, says Kelsey Satkowiak, MD, a neurologist with Spectrum Health. 

When the nerve is compressed it can't signal the brain properly. Then, when the compression is removed, signals can be sent erratically, giving you that familiar but uncomfortable pins and needles feeling. 

Treatment: Luckily, once you get moving, it relieves pressure on the nerve and the uncomfortable tingly sensation will resolve in a few seconds in most healthy individuals. If the pins and needles sensation lasts longer than that, or occurs frequently, talk to your doctor, Gittings says. 

2. Radiculopathy

Radiculopathy occurs when there's a pinched nerve, usually in the spinal cord, which can cause a range of symptoms, including tingling.

Over time the tingling can progress to numbness and weakness in the affected area. 

Where exactly you experience radiculopathy depends on what nerve is pinched. Cervical radiculopathy, for example, occurs when a nerve in the neck is pinched, resulting in tingling, pain and weakness in the shoulder, arms, and hands.  

Diagnosis and treatment: A pinched nerve is diagnosed using imaging machines like an x-ray or MRI. In some cases, pinched nerves will resolve on their own, but a doctor will typically recommend physical therapy or surgery for treatment, says Satkowiak. 

3. Carpal tunnel syndrome

Carpal tunnel syndrome is a very common cause of tingling in the hands. Usually, the tingling is accompanied by pain, numbness, and weakness, but typically only in one hand. It affects all the fingers except the pinky. 

Carpal tunnel is a specific type of pinched nerve, says Gittings. The condition happens when the median nerve, one of three major nerves in the arm, is pinched in an area of the wrist called the carpal tunnel. 

Symptoms of carpal tunnel can be worse in the mornings, Satkowiak says. They're also three-times more common in women, and can flare up in people who are pregnant or breastfeeding. 

Diagnosis and treatment: Carpal tunnel is typically diagnosed by an initial physical exam followed by electrodiagnostic testing, which measures the strength and speed of the electrical signal from the median nerves into the surrounding muscles in your wrist and fingers. If the signals are weak or slow, it confirms that the nerve is indeed pinched, providing a diagnosis of carpal tunnel. 

Treatments for carpal tunnel focus on relieving pressure on the median nerve, so that it sends normal neurological signals. Some methods include: 

Wearing a brace to avoid flexing the wrist too much, which can irritate the pinched nerve more. 
Ergonomic adjustments at work to avoid hyperflexion. This might include using an ergonomic keyboard, which is generally lower to the desk, or taking a break between repetitive motions. 
Steroid injections are considered one of the most effective treatments for carpal tunnel and have been shown to improve symptoms in as little as two to four weeks. 
Physical therapy can teach you certain exercises to relieve pressure on the nerve and improve discomfort.

If none of the above attempts work, or if your symptoms are severe, your doctor might recommend surgery, known as a carpal tunnel release. The surgery releases pressure on the nerve by cutting the ligament in the carpal tunnel that's pinching it.  

4. Infection

All sorts of viral infections can cause hand tingling, says Satkowiak. 

"These are treated differently and affect different parts of the body depending on the type of infection," she says. 

If your tingling is caused by infection, you'll likely experience other symptoms like fever, chills, cough or nausea. 

Diagnosis and treatment: Shingles is usually diagnosed by its symptoms, which often starts as tingling or burning on the skin, possibly including the hands, says Gittings. A red rash that appears within 5 days of your tingling hands is also a tell-tale sign.

Shingles can be treated with antiviral medications, but 10% to 18% of people who get shingles will experience ongoing pain, burning or tingling known as postherpetic neuralgia. This condition has no treatment, but can be managed with pain medications like ibuprofen or acetaminophen and in more severe cases Tylenol with codeine or oxytocin. 

5. Fibromyalgia

Fibromyalgia is a condition that causes pain throughout the body, and can also trigger tingling in the hands. 

It's due to issues with sensory processing in the central nervous system, so it often comes with other symptoms including pain, tiredness and cognitive impairments. Unfortunately, there's no definitive test for fibromyalgia. 

Diagnosis and treatment: "Fibromyalgia is a difficult diagnosis to make and typically made after excluding other overlapping disorders," says Gittings. 

There's no cure for fibromyalgia, but symptoms can be managed with medications, alternative therapies and lifestyle changes. Exercise is particularly important for people with fibromyalgia. 

6. Diabetic neuropathy

Diabetic neuropathy can cause tingling in the fingers, often accompanied by numbness that doesn't go away. 

About half of people with diabetes have some form of neuropathy, or nerve damage. Neuropathy is most common in people with diabetes who have poorly-controlled blood sugars. 

Peripheral neuropathy is particularly common in diabetics. Although it can affect the arms and hands, it most often occurs in the legs and feet. 

Treatment: There's no treatment for peripheral neuropathy, but controlling your blood sugar levels can keep it from getting worse. 

7. Neurological conditions

"Dysfunctions with the central nervous system, including the brain, can lead to tingling sensations," says Gittings. For example, multiple sclerosis can cause tingling in the hands. 

Another example, though uncommon, is Parsonage-Turner Syndrome. It's a neurological condition that comes on suddenly after a viral infection, and can cause tingling, along with pain in the neck, shoulders, and wrists. 

Diagnosis and treatment: Parsonage Turner syndrome may resolve on its own, or be treated with anti-inflammatory and pain medications. 

Since these neurological conditions are serious and chronic, it's important to see a doctor for diagnosis. 

8. Nerve damage

Any sort of nerve damage, including impacts, injuries or burns, can cause tingling in the hands. 

Nerve damage can include: 

Chronic paresthesia — abnormalities in the communications between nerves 
Peripheral neuropathy — damage to the neural system that communicates between the central nervous system and the rest of the body.

Diagnosis and treatment: If you experience tingling hands due to nerve damage, your doctor will try to get to the root of the issues. Depending on the cause, your doctor may suggest treatments like PT or surgery that might help address the nerve damage. 

When to see a doctor

Tingling in your hands can be easy to brush aside because it's often mild or comes and goes. However, the tingling might indicate that you need medical treatment. 

"Most causes of tingling in the hands or fingers have a slow onset and come and go over the course of months to years," says Gittings. "Permanent nerve damage may occur if not appropriately diagnosed and treated."

It's always best to see a doctor for a definitive diagnosis. Your primary care physician is a great place to start, says Satkowiak.

If hand tingling comes on suddenly or is accompanied by additional numbness anywhere on the body, call 911 immediately as this can be a sign of stroke. 

Insider's takeaway

There are many possible causes of tingling hands. Most of them are related to the nervous system, and can include anything from compression of a nerve to diabetes. 

Almost everyone experiences their hands "falling asleep" at some point, but if you have tingling hands that occur regularly, you should get evaluated for a potential underlying health condition that requires medical treatment.  

"People should see a doctor about tingling hands if the symptoms are persistent or worsen over time," Gittings said. 

Kelly Burch

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