Causes of tingling in the hands and feet

Diabetes is one of the most common causes of peripheral neuropathy in England. Between 10% and 20%
of people recently diagnosed with diabetes will have a peripheral neuropathy, called peripheral
polyneuropathy. In diabeticpolyneuropathy, tingling and other symptoms often first develop in both feet
and ascend the legs, followed by tingling and other symptoms that affect both hands and ascend the
arms. People with diabetes have mild to severe forms of nerve damage. In many cases, these symptoms
are the first signs of diabetes.
In a number of peripheral neuropathy cases, the cause is unknown or "idiopathic." However, there are a
variety of conditions that cause the condition 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 andbenign tumours that impinge on nerves.
Vitamin deficiencies. Vitamins E, B1, B6, B12 and niacin are essential for healthy nerve function. A B12
deficiency, for example, can lead to pernicious anaemia, an important cause of peripheral neuropathy.
However, too much B6 can also cause tingling in the hands and feet.
Alcoholism. Alcoholics are more likely to have a thiamine or other importantvitamin deficiencies 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.

Causes of tingling in the hands and feet continued...

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 medicines used for lung cancer -- but also some antiviral and antibiotic medicines.
Infections. These include Lyme disease, shingles (varicella-zoster),cytomegalovirus, Epstein-
Barr, herpes simplex and HIV/AIDS.
Autoimmune diseases. These include Guillain-Barre syndrome, lupus andrheumatoid arthritis.
Inherited disorders. These include a group of disorders collectively known as Charcot-Marie-
Tooth disease.
Injury. Often related to trauma, nerves can be compressed, crushed or damaged, resulting in nerve pain.
Examples include nerve compression caused by a herniated disc or dislocated bone.

Diagnosis of tingling hands and feet

If you seek care for your tingling hands or feet, your doctor will 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, and perform a physical
examination.
He or she also may perform:

 Blood tests. These can include tests to detect diabetes, vitamindeficiencies, liver or kidney dysfunction,
other metabolic disorders and signs of abnormal immune system activity.
 You may be referred to see a hospital specialist who may perform tests that may include:

 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 fibre endings

Treatments for tingling hands and feet

Successful treatment depends on an accurate diagnosis and treatment of the underlying cause of the
tingling. As long as the peripheral nerve cells have not been killed, they have the ability to regenerate.
Although no treatments are available for inherited types of peripheral neuropathy, many of the acquired
types can be improved with treatment. For example, goodblood sugar control in diabetes can slow the
progression of diabetic neuropathy; vitamin supplementation can correct peripheral neuropathy in people
with vitamin deficiencies.
General lifestyle recommendations include maintaining an optimal weight, avoiding exposure to toxins,
following a medically-supervised exercise programme, eating a balanced diet and avoiding or limiting
alcohol consumption. Recommendations also include stopping 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 reduced with medications
that include painkillers and other medicines originally developed for treating seizures and depression.
Further reading:

 Understanding peripheral neuropathy: The basics

 Daily skincare routine for people with diabetes
 Spinal cord injury and pain
 Carpal tunnel syndrome
 What is neuropathy
 Peripheral neuropathy and diabetes
 Chronic pain management
 See all Peripheral neuropathy topics

Hand n shoulder physical therapy

It’s a question we get a lot at Total Performance Physical Therapy, and unfortunately the truth is, like
most cases, there’s not one definite answer.
There are many different causes for your hand to develop paraesthesias, or commonly described as
“pins and needles” or uncomfortable tingling. Your skin is filled with tiny nerve endings that relay signals
to the brain regarding sensation. When these nerves are interrupted during signaling to the brain,
which can be caused by compression, pulling, inflammation, or having reduced blood supply to the
nerve, the skin feels a sensation of prickling and tingling.

The most important thing to note is that tingling can most often be a fore warning of worse things to
come, like loss of muscle in the hands and arm. Often people report a tingling sensation and then, after
ignoring it for a while, report difficulty holding a glass or using the hand.

First I’ll explain the most common reasons people develop pins and needles in their hands and then how
physical therapy can help the common condition.

MORE COVERAGE

Injuries to the hand that can be easily missed

Nerve Compression: It means just that; your nerves are being compressed. Trapped nerves at the neck,
shoulder, around the elbow, the forearm, and even wrist, can affect the hand. This pain can be either
short or long in duration depending on the problem causing the pain. Some common reasons for short
lived pins and needles can be as simple as leaning on your forearms, wrists, or hands at your desk or
carrying a heavy bag around your shoulder, arm, and wrist. However, in more severe cases the nerves
can be compressed due to overuse injuries caused by inflammation and swelling in the arm, wrist, and
hand or by abnormalities in bone/muscle structure. Here are the more common causes of nerve
compression:

Carpel Tunnel: This syndrome involves the median nerve in your arm, which supplies sensation to the
thumb, index, middle, and half of your ring finger. When the muscles of the front of your wrist get over
worked or are used too much they become inflamed and swollen. The median nerve then gets trapped
in a thick ring-like sheath surrounding your wrist and causes added pressure to this tunnel and puts an
abnormal pressure on all the structures inside of it. As a result, the nerve is compressed and you feel a
sensation of tingles in the areas of the front of your hand near the thumb, index, and middle finger.

Thoracic outlet syndrome: Many of the nerves and blood vessels in the shoulder all the way down into
the hand come from what’s called the “brachial plexus,” which is a bunch of nerves that come from the
neck and branch off into the arm, forearm, wrist, and hand. However, these nerves have to pass through
the thoracic outlet, or a small space composed of a lining of bone and muscles by your neck. When this
space becomes smaller, which can be due to tight musculature of the neck, poor posture, and poor body
alignment, nerves and blood vessels can become compressed. This can cause a reaction down the nerve
all the way into the hand, causing numbness and pins and needles.

Think about how most people sit at a computer, after awhile their shoulders slump forward, this exact
posture winds up creating thoracic outlet syndrome compressing the nerves and causing tingling. If it
gets bad enough, it can cause loss of muscle, like losing the ability to grip things.

Cervical Root Radiculopathy: There are many causes of cervical root radiculopathy, including herniated
discs or bulging discs, spinal root compression, and spinal instability. All of these diagnoses can cause
the roots of the cervical spine, which turn into the nerves in your arms and hands as they work their way
down, to become inflamed. So if the nerves in your neck are irritated, it can in turn affect signaling of
the nerve all the way down into the hand. This type of pain usually, but not always, has arm tingling
associated with it.

Swelling: The term swelling is used when there is an abundance of fluid in a localized or generalized
area. In terms of pins and needles in the hand, swelling is commonly caused by, but not limited to,
trauma from an object coming into direct contact with the body. If the hand, wrist or arm undergoes a
trauma, the body’s natural response is to fix the tissues and structures that were damaged by sending
blood and other fluids to the site of trauma in order to help with the healing process. The abundance of
fluid in the area causes severe pressure put on all items surrounding the area, including nerves. The
nerve conduction can be decreased due to the pressure produced by the swelling. Women who are
pregnant often experience tingles in the hand due to the fluid increase and retention that the body
undergoes during pregnancy.

Decreased Circulation: One of the most common causes for pins and needles in the hand is decreased
circulation. Everything in your body needs blood circulation to function properly, and believe it or not
nerves are a big one. The more distal you go, meaning the further you go down your arms and legs, the
smaller the arteries and veins, which help pump blood and bring them back to your heart. Over time,
arteries can start to pump less blood, whether they become stiffened due to plaque build-up or you
have a low resting blood pressure. Another reason for decreased circulation can be caused by poor
posture, much like the previous example of thoracic outlet syndrome.

So, how can physical therapy help you if your hands are tingling?
Depending on the type of injury, physical therapy can provide a range of treatments in order to decrease
the pins and needles felt in your hand. It is important to get help soon after noticing tingling in the
hands and forearms, because sometimes putting it off in this case it can actually be too late.

In nerve compression injuries, the main focus is to decrease the pressure caused by the matter
compressing it. For example, in carpal tunnel syndrome, physical therapy can work on tendon gliding of
the wrist muscles to help decrease the amount of compression on the median nerve. Because
compression syndromes can be caused by overuse injuries and postural issues, physical therapists will
assist in postural management and education in order to decrease the inflammation and use of muscles
that cause tendons to enlarge and cause compression on nerves. In cases of carpal tunnel, the physical
therapist will often educate patients on proper wrist placement during every day and work related
activities.

In thoracic outlet syndrome, postural education, strengthening, and stretching are important in order to
restore proper muscle length and tension relationship, which includes stretching of tight muscles and
strengthening of loose or weak muscles. If nerves are being compressed in the cervical spine, traction
(light pulling/stretching) of the vertebrae in the neck, is used by therapists in order to decrease the
pressure placed on the nerves being pinched.

If there is significant swelling, physical therapists can provide hands on manual therapy that helps with
circulation of fluids in order to decrease swelling in an area to provide relief for nerves and other
structures being compressed. They will also provide modalities in the form of ice to decrease the
amount of fluid drawn to the area of injury.

If decreased circulation is the cause, whether it is from a postural issue decreasing circulation or a blood
pressure issue, physical therapy can work on restoring a more normal posture and provide fitness
education and exercise programs in order to improve cardiovascular health and blood transport
throughout the body.

Read more at http://www.philly.com/philly/blogs/sportsdoc/Why-is-my-hand-

tingling.html#K5t7MERD1qLbRuRp.99
Third - http://www.medicinenet.com/numbness_fingers/symptoms.htm

Fourth-http://www.everydayhealth.com/columns/my-health-story/took-doctors-solve-mystery-tingling-
fingers/