Treating Nerve Pain in the Hand

Tingling. Numbness. Pain. Weakness. These are classic signs of nerve conditions that affect the hand and arm. If you notice these symptoms, consider them a red flag, says Manas Nigam, M.D., a plastic surgeon at The Center for Plastic Surgery at Sentara Fort Norfolk. “If you address it early, you can keep a small problem from becoming a big problem,” he says.

Dr. Nigam has specialized training in hand surgery. He is experienced in treating nerve disorders that affect the hand, including carpal tunnel syndrome and cubital tunnel syndrome. Dr. Nigam shares his advice for treating hand nerve pain.

What Is Carpal Tunnel Syndrome?

The carpal tunnel is a space in the wrist through which the median nerve passes from the arm to the hand. A bundle of tendons also passes through that narrow space. “There’s a lot of traffic around one nerve,” Dr. Nigam says.

Carpal tunnel syndrome occurs when the tendons become inflamed or irritated, compressing (squeezing) the median nerve. Symptoms of carpal tunnel syndrome include:
– Numbness or tingling in the thumb, index and middle fingers, especially at night
– Pain or weakness in the hand
– Difficulty grasping small objects

Carpal tunnel may be caused by:
– Wrist injury
– Health problems that affect nerves and joints, including diabetes, arthritis and conditions that cause hormonal changes
– Doing repetitive movements, such as knitting, golfing, assembly line work or using vibrating tools such as a jackhammer
– Sleeping in positions that cause the wrists to bend

What Is Cubital Tunnel Syndrome (Ulnar Nerve Entrapment)?

Hand problems can also be caused by compressed nerves in other parts of the body. The ulnar nerve runs from your neck down to your hand. At the elbow, that nerve passes through a space called the cubital tunnel. When the ulnar nerve gets squeezed at the elbow, it’s called cubital tunnel syndrome or ulnar nerve entrapment.

Cubital tunnel syndrome is less common than carpal tunnel syndrome, but it can cause similar symptoms. Those include:
– Numbness or tingling in the pinky and ring fingers (which can come and go when you bend your elbow)
– Pain on the inside of the elbow
– Weakened grip
– Difficulty coordinating fingers, such as when you’re typing

Cubital tunnel syndrome may be caused by:
– Keeping your elbow bent for long periods
– Leaning on your elbow for long periods
– Fluid buildup in the elbow
– Injury to the arm
– Baseball pitching

Treating Nerve Pain in the Hand: Carpal Tunnel Relief

The earlier you treat nerve compression, the better, Dr. Nigam says. When these conditions are diagnosed early, you can often heal them by wearing a wrist splint (brace) at night. “It can take some getting used to, but there are many types of splints available. We have padded splints and even custom splints, so we can find something that’s comfortable for you,” he adds.

If nerve compression goes untreated for a while, symptoms get worse. What started as on-and-off tingling can evolve to constant numbness, weakness and loss of muscle tone. The nerves of the hand and arm are also involved with movement. You might start to have trouble grasping small objects or pinching things between your finger and thumb.

Sometimes, you may need surgery to raise the “roof” of the carpal tunnel and make more space for the nerve to pass through. In severe cases, Dr. Nigam says, he needs to use advanced techniques like tendon replacement to restore normal function. “If you wait too long, there’s no guarantee you’ll get full sensation back,” he adds.

A Whole-Body View

During an evaluation for carpal tunnel, Dr. Nigam usually starts with a head-to-toe exam to determine whether the nerve symptoms originate in the wrist, elbow or even somewhere less expected, such as the neck. “The whole body is connected. It’s not always obvious what underlying issue is causing downstream effects in the hand,” he says.

If you’re experiencing symptoms of nerve compression, don’t ignore them. It may be tempting to wait to see if it gets better on its own. But early treatment can prevent lasting damage. “Be good to your hands, and they will be good to you,” Dr. Nigam says.

Dr. Nigam practices at Sentara Fort Norfolk. Call 757-252-1700 to schedule an appointment.