Tingling In The Hands : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 08/09/2022

Tingling in the hands appears with various neurological problems: carpal tunnel syndrome, radial nerve neuropathy, spinal compression caused by a herniated disc. Less commonly, stabbing sensations develop as part of neuroses, vitamin deficiency B12, caffeine or alcohol intoxication. To diagnose the causes of tingling, ENMG, angiography and Doppler flowmetry, radiography of the hand and MRI of the spinal column are performed. To relieve symptoms, drugs (antiplatelet agents, anti-inflammatory and sedative drugs), physiotherapy methods, and surgical interventions are used.

Why does tingling occur in the hands

Physiological factors

In a healthy person, tingling and numbness of the hand occurs with a long stay in an uncomfortable position. The symptoms are caused by circulatory disorders in the limb. As a rule, the symptom manifests itself if the patient sleeps with his hand under his head or under a pillow. A person wakes up and “does not feel” the hand, and when trying to actively move, unpleasant feelings of tingling and immobility arise. The disorder disappears on its own after 5-1 minutes.

The symptom may develop after physical exertion (lifting dumbbells, carrying heavy bags). Fatigue of the muscles in the hands causes a slight tingling, heaviness, which disappear after a long rest. In people of physical labor, such signs are determined almost daily: the hands get tired in the evening, which is manifested by severe tingling, weakness in the limbs.

Raynaud's syndrome

At the beginning of the disease, tingling is noted periodically, provoked by low temperature, excitement, smoking. The stitching pains are most pronounced in the tips of the fingers, which suddenly become white and numb. Gradually, discomfort disappears, pallor is replaced by cyanosis or hyperemia. Attacks end with a feeling of heat and burning in the arms, mainly in the hands.

With the progression of the pathology, paroxysms of stabbing pains with paresthesias disturb more often. The tingling lasts more than 1 hour, begins without visible provoking factors. Discomfort often persists even in the interictal period. The skin of the hands is constantly cold, acquires a bluish tint. In the absence of medical care, the long-term Raynaud's syndrome ends with trophic ulcers and gangrene.

carpal tunnel syndrome

When the median nerve is compressed in the wrist area, the patient feels pain and tingling on the palmar surface of 1-4 fingers. Symptoms are most typical for office workers, pianists, packers - people whose hands are subjected to constant monotonous loads (flexion-extension). First, a person experiences periodic backache and tingling, which are provoked by an increased load on the hands.

The progression of the tunnel syndrome leads to constant stabbing pains, disturbing even during rest. The patient complains of difficulty in turning and grasping with the hand, as if "everything falls out of hand." Symptoms are accompanied by coldness or a feeling of heat in the hands, discoloration of the skin, the appearance of marbling. A tingling sensation localized on the back of the hand indicates a lesion of the radial nerve.

Tingling in the hands


Intervertebral hernia

The defeat at the level of the upper thoracic vertebrae is manifested by tingling and paresthesias throughout the skin of the hands. Discomfort symptoms are observed periodically, intensify after being in an uncomfortable position, physical activity on the shoulder girdle. Sometimes weakness develops in the hands, it becomes difficult for a patient with an intervertebral hernia to do their usual housework.


Tingling in the hands is possible with psycho-emotional disorders, such as hysterical neurosis, panic attack, specific phobias. Some patients complain of crawling, coldness and trembling fingers. The tingling lasts throughout the attack, after which it disappears without a trace. Sometimes, due to stabbing sensations, a person begins to comb the skin, rub his hands together, or make other stereotypical movements.


Tingling of the skin of the hands occurs with a lack of vitamin B12, which provokes the development of peripheral neuropathy. Patients feel moderate stabbing pains, which are combined with tickling, a feeling of crawling. Unpleasant symptoms first appear in the fingers of the limb, gradually spread to the entire arm, pass to the trunk. Sometimes there are hot flashes or, conversely, a cold snap of the hands.

Rare Causes

  • Bad habits : caffeine addiction, alcohol abuse.
  • Toxin poisoning : arsenic, mercury, thallium.
  • Neurological disorders : acute disorders of cerebral circulation, multiple sclerosis.
  • Autoimmune pathologies : scleroderma, dermatomyositis, systemic lupus erythematosus.


A neurologist is engaged in finding out the cause of tingling in the hands. During the initial examination, the patient is offered to perform simple tests (clench the hand into a fist, rotate the thumbs), during which it is easy to detect motor problems and innervation disorders. If neuropathy of the radial or median nerve is suspected, Tinnel's symptom is checked. During further examination, the following instrumental methods are used:

  • Electroneuromyography. A comprehensive study of the neuromuscular transmission is necessary to identify problems with peripheral nerves and to know the location of the lesion. ENMG helps to determine the severity and prevalence of the process. The technique is effective for the differential diagnosis of neuromuscular and vascular pathologies.
  • Radiography. X-ray visualization of the bones of the shoulder, forearm, and hand makes it easier to identify the site of nerve injury. On the pictures, you can see bone deformities, degenerative-dystrophic changes or narrowing of the bone canals, which could cause tingling and paresthesia in the hands.
  • Angiography. The study of the peripheral vascular bed with the use of contrast is necessary for the verification of Raynaud's syndrome. The doctor draws attention to the uneven lumen of the vessels, the absence of collateral branches and a decrease in the number of capillaries. Additionally, capillaroscopy of the nail bed is shown.
  • MRI of the spine. This is the most accurate method that allows neurologists to diagnose herniated discs. MRI shows not only the presence of a hernial protrusion, but also its size, the degree of compression of the spinal cord. The study is informative for the exclusion of tumors, hematomas and other volumetric neoplasms.
  • Additional Methods . To clarify the degree of spinal compression in intervertebral hernias, computed tomography with myelography is used. Peripheral microcirculation is assessed using Doppler flowmetry. Gastroscopy and gastric intubation, blood tests help to identify the causes of B12 deficiency.




Help before diagnosis

To prevent episodes of tingling in the hands, the patient is advised not to overload the brushes, to take breaks in monotonous work. For those who are forced to work at a computer all day long, there are special palm rests and computer armrests that relieve some of the load. It is necessary to avoid sudden overheating or hypothermia of the hands, so as not to provoke vasospasm.

Conservative therapy

The tingling is generally mild to moderate, so symptomatic treatment with analgesics is usually not necessary. With sharp stabbing pains, it may be necessary to take systemic painkillers or the introduction of local anesthetics (therapeutic blockades). Complex therapy is selected taking into account the etiology of the disease. The following groups of drugs are used:

  • calcium antagonists . Recommended for dilating the lumen of blood vessels, which plays a decisive role in the treatment of Raynaud's disease. If they are ineffective, treatment is increased with ACE inhibitors and selective serotonin receptor blockers.
  • Antiplatelet agents . They improve blood flow in peripheral arteries and capillaries, reduce the effects of vasospasm and ischemia of the hands. Medicines help reduce the frequency of seizures in those suffering from Raynaud's syndrome, and prevent complications of the disease.
  • Anti-inflammatory drugs . Exacerbations of neuropathies require the use of non-steroidal anti-inflammatory drugs, which eliminate pain and swelling, and eliminate discomfort. In severe cases, therapy is supplemented with systemic corticosteroids.
  • Sedatives . With neurotic disorders, herbal and synthetic sedatives are effective, which stabilize the patient's emotional background. Occasionally, tranquilizers, antidepressants are used.
  • Vitamins . With vitamin deficiency B12, cyanocobalamin is administered parenterally, which quickly eliminates tingling in the hands and paresthesia. With neuropathies and intervertebral hernia, other B vitamins (thiamine, pyridoxine) have a good effect.

In the treatment of neuropathies, the targeted administration of drugs into the affected area is effective, which is carried out by means of electrophoresis, phonophoresis. After clinical improvement and disappearance of stabbing pains, mud therapy, electromyostimulation, myofascial massage of the hand are prescribed. Physiotherapy methods are necessary to restore nerve function and increase muscle strength.


Operative interventions are resorted to with the ineffectiveness of conservative measures, if the patient develops severe carpal syndrome, neuropathy of the radial nerve. With a pronounced spinal compression against the background of osteochondrosis, it is recommended to remove the herniated disc by microdiscectomy, puncture vaporization, and laser reconstruction.