What causes hand tingling, and can a chiropractor help?

Hand tingling and numbness are common symptoms that can range from a mild, temporary annoyance to a sign of a more serious underlying health issue. This sensation, often described as pins and needles, can significantly interfere with your work, sleep, and quality of life. Understanding where this feeling originates is the first crucial step towards finding effective relief.

In this article, Dr. Simon Nash (Chiropractor) discusses the common causes of tingling in the hands, from local compressions to issues stemming from the neck, and the comprehensive approach chiropractic care takes to diagnose and treat these conditions.

Please note: The information provided in this article is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for a diagnosis and personalised treatment plan.

Table of Contents

1. Understanding Hand Tingling and Numbness
2. Common Causes of Hand Tingling
3. The Diagnostic Process
4. Chiropractic Treatment for Hand Tingling
5. Understanding the Healing Timeline
6. Frequently Asked Questions (FAQs)
7. Book a Consult with Our Chiro Brisbane
8. References
9. Video Transcript

Understanding Hand Tingling and Numbness

The sensation of tingling or numbness in the hands is a type of paresthesia, a term used to describe an abnormal sensation, often a burning, prickling, or pins-and-needles feeling. This symptom is a clear indicator that the nerves supplying your hands are irritated, compressed, or damaged somewhere along their pathway—which runs all the way from the brain, through the neck, shoulder, elbow, and wrist.

As Dr. Nash explains, the problem isn’t always at the site of the symptom:

“A lot of hand tingling can be produced up the top near the neck where a lot of those nerves exit.”

This highlights the complexity of the issue, as a tingling hand might be a symptom of a problem in the cervical spine (neck), the thoracic outlet (shoulder/chest area), or the wrist. Correctly identifying the source is essential for successful treatment.

Common Causes of Hand Tingling

Dr. Nash outlines several key functional and structural irritations that can lead to tingling and numbness in the hands.

1. Issues in the Cervical Spine (Neck)

The nerves that control sensation and movement in your arms and hands exit the spinal cord in your neck. If there is dysfunction around the cervical spine, such as a disc bulge or arthritis, the nerve roots can become compressed or irritated, leading to pain, tingling, or numbness that radiates down the arm and into the hand—a condition often referred to as cervical radiculopathy.

“The patient’s history is an important point as well. So they may only feel it at nighttime. They might feel it when they’re sitting at their desk. They might feel it when they cough and sneeze. So that always gives us a clue of where it’s coming from and how we’re going to treat it”, says Dr. Nash.

This nerve root impingement is a frequent cause of persistent arm and hand symptoms. In fact, peer-reviewed literature suggests that foraminal encroachment, often due to degenerative changes and reduced disc height, is the most common cause of cervical radiculopathy, which directly impacts the nerves controlling the arm and hand (Chu, 2017).

2. Thoracic Outlet Syndrome (TOS)

The thoracic outlet is the narrow space between the collarbone (clavicle) and the first rib, through which the major nerves and blood vessels (the brachial plexus, subclavian artery, and vein) travel to the arm.

“We could have a thing called thoracic outlet syndrome, where you get a compression of the nerves and the blood vessels sometimes up around the outlet of the thorax or the neck, which supplies all the nerves that run down the hands.”

When structures in this area such as the scalene muscles or an extra cervical rib are tight or inflamed, they can compress the neurovascular bundle, leading to tingling, numbness, and sometimes pain or weakness in the arm and hand.

3. Carpal Tunnel Syndrome (CTS)

Carpal Tunnel Syndrome is perhaps the most well-known cause of hand tingling. It occurs at the wrist, where the median nerve is compressed as it passes through the carpal tunnel—a narrow passageway formed by bones and a strong ligament. This often causes tingling and numbness in the thumb, index finger, middle finger, and part of the ring finger.

“We’ve all heard of carpal tunnel, that’s one cause of tingling in the hands.”

4. Postural and Biomechanical Dysfunction

Sometimes, the cause is much simpler. Poor posture or sustained awkward positions can temporarily irritate the nerves.

“We can have postural dysfunction. So we’ve all been on a tablet or a device for too long, maybe laying in bed on our pillow with our hands up and that can cause tingling in the hands. So it’s not always caused from something of a condition.”

Dr. Nash emphasises that simple, repetitive biomechanical stressors can be the culprit, even without a major underlying condition like a disc bulge. Addressing these daily habits is a key part of long-term relief.

The Diagnostic Process

Given the variety of potential causes, a thorough physical and neurological examination is paramount to pinpointing the origin of the symptoms.

“When we’re assessing someone with tingling in the hands, we want to make sure of the origin of it. So we will run through a physical exam. Firstly, we’ll ask the patient when they feel it, where they feel it.”

A chiropractor will use a combination of patient history, orthopaedic, and neuro testing, including:

• Tinel’s tap: Tapping over the median nerve at the wrist to check for carpal tunnel syndrome.
• Thoracic outlet tests: Specific movements and positions to see if they reproduce symptoms, indicating possible compression in the thoracic outlet.
• Cervical spine assessment: Examining the neck’s range of motion and joint function to rule out radiculopathy.

In some cases, the chiropractor may refer the patient for further investigation:

“Obviously, we could refer out if necessary for imaging such as MRI or just plain film radiography to have a look at their neck if we think it’s coming from there. We can do things such as nerve conduction studies. So, we might send them to a neurologist.”

This collaborative approach ensures an accurate diagnosis, which is the foundation of an effective treatment plan.

Chiropractic Treatment for Hand Tingling

Once the source of the nerve irritation is identified, treatment at Our Chiro Brisbane focuses on a combination of techniques to restore function, reduce inflammation, and relieve pressure on the affected nerves.

A multimodal approach may include:

• Spinal mobilisation and adjustment: Gently restoring movement and function to the cervical and thoracic spine to relieve nerve root compression.
  A case report demonstrated the successful alleviation of cervical radiculopathy symptoms, including hand numbness, through chiropractic adjustment targeting a malposition of the cervical spine (Chu, 2017).
• Soft tissue techniques: Focusing on the muscles that may be contributing to the compression, particularly the tight scalene muscles in the neck (a common factor in TOS) and muscles around the elbow and wrist. Chiropractic care often incorporates manual therapy to restore mobility to the joint and soft tissue boundaries of the thoracic outlet (Trager, R. J. 2021)
• Advanced technologies: Utilising therapies like dry needling for trigger points, Kinesio taping for support and function, shockwave therapy, and cold laser therapy to reduce pain and inflammation.

“We would be looking at doing mobilisations around the thoracic spine if that’s where it was coming from, around the cervical spine and restoring function through there. Doing mobilisations through the wrist, doing some muscle work in and around the elbow.”

Long-Term Management and Prevention

A crucial part of treatment is empowering the patient with tools to prevent recurrence. This includes:

• Stretches and rehabilitation exercises: Tailored exercises to strengthen core muscles, improve posture, and enhance flexibility, particularly around the neck and shoulder girdle.
• Postural advice: Guidance on ergonomic adjustments for work and daily activities to prevent nerve irritation from simple biomechanical dysfunction.

Understanding the Healing Timeline

The good news is that for most non-surgical cases, conservative care is very effective. However, the time it takes to resolve the symptoms can vary depending on the underlying cause and how long the irritation has been present.

“Typically again with orthopedic tissue healing and muscle function, we’d be looking between four weeks to eight weeks to actually have a reduction in pain and symptoms. Typically, we’d actually see pain reduce a lot faster than that time frame.”

Dr. Nash notes that while pain reduction is often quick, full tissue function and nerve health take a bit longer to restore. The goal is always to treat the root cause, not just the symptom, for lasting results.

Frequently Asked Questions (FAQs)

Q1: What’s the main difference between Carpal Tunnel and an issue in the neck? A: Carpal Tunnel Syndrome typically causes numbness/tingling in the thumb, index, middle, and half of the ring finger due to compression at the wrist. A neck issue (cervical radiculopathy) can cause tingling that runs down the arm and into the hand, often affecting different fingers or the entire hand depending on which nerve root is involved. A thorough examination is needed to differentiate.

Q2: Can my posture really cause my hand tingling? A: Yes. Poor, sustained postures, like slouching at a desk or sleeping with your arm awkwardly positioned, can put pressure on the nerves in your neck or thoracic outlet, leading to symptoms. Addressing these biomechanical dysfunctions is a key part of treatment.

Q3: How quickly can I expect relief from chiropractic care? A: Relief from pain often begins quickly, sometimes within the first few visits. However, full recovery to restore tissue function and nerve health can take anywhere from four to eight weeks, depending on the cause and severity of your condition.

Q4: Will I need X-rays or an MRI? A: Not always. Your chiropractor will determine if imaging is necessary based on your clinical history and physical examination findings, especially if a structural issue like a disc bulge in the neck is suspected, or to rule out other conditions.

Q5: Is spinal manipulation always used for hand tingling? A: No. Treatment is customised. If the tingling is caused by muscle tightness (like in a mild case of Thoracic Outlet Syndrome) or a local wrist issue, treatment might focus on gentle mobilisation, soft tissue work, laser therapy, and exercises. Spinal adjustments are used when necessary to restore function to the spinal segments affecting the nerves.

Q6: What is a “Double Crush” phenomenon? A: The Double Crush hypothesis suggests that a nerve that is already compressed at one site (e.g., in the neck) is more vulnerable to injury or compression at a distant site (e.g., in the wrist, leading to Carpal Tunnel Syndrome). This makes it crucial to assess the entire nerve pathway, not just the area where the symptoms are felt.

Q7: Can I still work out with hand tingling? A: It depends on the cause. You may need to temporarily modify or avoid activities that involve repetitive overhead motions or heavy gripping. Your chiropractor will provide specific advice and therapeutic exercises that you should be doing to help with your recovery.

Book a Consult with Our Chiro Brisbane

We understand that persistent tingling and numbness in your hands can be incredibly frustrating. It can interrupt your sleep, make simple daily tasks like cooking or typing a challenge, and leave you feeling worried about the cause.

At Our Chiro Brisbane, we are here to offer a thorough assessment to accurately identify the source of your symptoms, whether it’s an issue in your neck, shoulder, or wrist. We’ll then craft a personalised, evidence-based treatment plan to get you back to using your hands comfortably and confidently.

Don’t let pins and needles interfere with your life any longer. We use a range of gentle techniques, from spinal adjustments to soft tissue therapy and rehabilitation, aiming for long-term relief and prevention.

Take the first step towards a resolution. You can book an appointment for a comprehensive Initial Consultation or check out our range of Chiropractic Services to see how we can help with conditions affecting your nerves and joints.

References

Trager, R. J. (2021). Chiropractic and Nontraditional Treatment of NTOS. Thoracic Outlet Syndrome, 229–240. https://doi.org/10.1007/978-3-030-55073-8_23

Chu, E. C.-P., Lim, T., & Mak, K.-C. (2018). Cervical Radiculopathy Alleviating by Manipulative Correction of Cervical Hypolordosis. Journal of Medical Cases, 9(5), 139–141. https://doi.org/10.14740/jmc.v9i5.3051

Video Transcript

What causes hand tingling and how can chiropractic how can we help? So hand tingling can be caused by a few functional or structural irritations. So we’ve all heard of carpal tunnel um that’s one cause of tingling in the hands. We could have a thing called thoracic outlet syndrome. um where you get a compression of the nerves and the blood vessels sometimes up around the outlet of the thorax or the neck um which supplies all the nerves that run down the hands um we can also have um dysfunction around the cervical spine um and that can cause tingling in the hands. So a lot of hand tingling can be produced up the top near the neck where a lot of those nerves exit. Um but also it can be local such as carpal tunnel and other simple things. So we can have postural um dysfunction. So we’ve all been on a tablet or a device for too long maybe laying in bed on our pillow with our hands up and that can cause tingling in the hands. So it’s not always caused from something of a condition. So like carpal tunnel or it’s not always caused by a problem such as thoracic outlet syndrome or even a disc problem up in the neck. Um it can be caused by simple biomechanical dysfunction. So when we’re assessing someone with tingling in the hands, we want to make sure of the origin of it. So we will run through a physical exam. Firstly we’ll ask the patient when they feel it, where they feel it. um we might do some um orthopedic testing and some neuro testing in the in the um in the wrist or up in the shoulders. So we might test the thoracic outlet syndrome. Uh we might do tinnels tap on the carpal tunnel to see if that reproduces any symptoms. Um we’ll also do u movement and orthopedic assessment around the elbow and the wrist as well as the shoulder and the cervical spine just to determine where that tingling in the hand is coming from. And obviously the patient’s history is an important um point as well. So they may only feel it at nighttime. They might feel it when they’re sitting at their desk. They might feel it when they cough and sneeze. So that always gives us a clue of where it’s coming from and how we’re going to treat it. Obviously, we could refer out if we if necessary for imaging such as MRI or just plain film um radiography um to have a look at their neck if we think it’s coming from there. Um, we can do things such as nerve conduction studies. So, we might send them to a neurologist. Um, if we can’t determine where it’s coming from or we think it’s more of an impingement that needs a neurological intervention. So, in that case, we’d refer out for um a neurologist to actually have an assessment of that. So once we’ve assessed where it’s from and if we um if we’ve had to refer the patient on, got those results back from a nerve conduction test, we’ll then work out how we’re going to treat it. Um so again, typically we’d be looking at doing mobilisations around the thoracic spine if that’s where it was coming from around the cervical spine and restoring function through there. Uh doing mobilisations through the wrist, doing some muscle work in and around the elbow. Um to restore that function, we would look at using techniques such as needling, uh kinesio taping, cold laser, shockwave therapy. We’d be giving the patient stretches um and rehabilitation exercises to do at home. Uh typically again with orthopedic tissue healing and muscle function, we’d be looking between four weeks to eight weeks to actually have a reduction in pain and symptoms. Typically, we’d actually see pain reduce a lot faster than that time frame.