Do you notice numbness and tingling in your fingers with prolonged activities? Maybe you have numbness and tingling symptoms at night-time? These symptoms are often concerning and may even be associated with weakness of the hand and/or pain.

When numbness and tingling are located in the thumb, index, long, and radial portion of the ring fingers, symptoms may be secondary to carpal tunnel syndrome. When numbness or tingling is located in the ulnar aspect of the ring finger and/or small finger, symptoms may be secondary to cubital tunnel. Carpal Tunnel. Cubital tunnel.

In carpal tunnel, the median nerve is compressed by the transverse carpal ligament at the wrist. In cubital tunnel, the ulnar nerve is compressed at the medial aspect of the elbow by multiple different structures. Initial office evaluation involves testing the areas of potential compression for responses to provocative maneuvers.

Physicians may also order electrodiagnostic testing to further evaluate symptoms. This type of testing includes nerve conduction studies and electromyography. Results from these tests describe the speed with which your nerves send signals and characterize how your muscle fibers respond to electrical stimulation.

Non-operative treatment options for carpal tunnel syndrome include wrist splinting in a neutral wrist position, activity modification, over-the-counter medication, and cortisone injection. Surgical treatment for carpal tunnel syndrome involves the release of the transverse carpal tunnel ligament. Removing pressure from the median nerve may help relieve symptoms.

Non-operative treatment options for cubital tunnel include avoidance of prolonged elbow flexion, avoidance of pressure to the medial elbow, night-time bracing of the elbow to prevent flexed elbow posture, utilization of an elbow pad, activity modification, and over the counter medications. Surgical treatment involves the release of areas of constriction of the ulnar nerve at the medial elbow.

Numbness of the hand may be caused by carpal tunnel or cubital tunnel. These symptoms may interfere with a multitude of daily activities including typing or writing. If you have any concerns, you should contact your physician for evaluation. There are also many other causes of numbness, tingling, pain, and weakness that your physician will consider.

The decision regarding nonoperative versus operative treatment is complex and should be discussed with your treating physician. 

Outcomes after surgical treatments vary and risks and benefits should be discussed in detail with your treating physician. Nonoperative treatment also carries risks and benefits which should be discussed with your treating physician.

Disclaimer: Evaluation and treatment of neurologic conditions involve complex decision-making. There are many different conditions that may cause numbness, tingling, pain, and/or weakness. These considerations should be reviewed with your treating physician. This information is not intended to covey, substitute or supplant any medical advice. In order to establish a treating relationship, please schedule and complete your visits with a licensed physician.

Copyright 2/6/2022 Tanay Amin, MD

Do not copy, distribute, or publish this article. Please contact Precision Hand and Orthopedic Surgery PLLC with regards to any inquiries or corrections.