Do you have pins and needles in your fingers? Have you been told it’s carpal tunnel but you’re not 100% sure!
Pins and needles in your fingertips is not always carpal tunnel
Fingertip pins and needles is relatively common with a reported 14% of the population getting it. Although this may be a consolation that you’re not alone, it still doesn’t make the pins and needles any better.
This is one of the presentations that we see far too often. People turn up with pins and needles in their hands and the automatic diagnosis of carpal tunnel syndrome.
The reality is that there are two major nerve pathways that supply the hand. The first is the median nerve that runs down the middle of the forearm and passes under a ligament, through the so-called carpal tunnel, into the hand supplying the skin of the thumb and first two fingers.
The ulnar nerve is the second nerve that supplies the hand. This nerve runs up the inside of your forearm before supplying the skin of the ring and little finger and some of the small muscles of the hand. There is a little bony outcrop in the palm of the hand which the ulnar nerve passes around before it supplies the fingers, called the tunnel of Guyon, that is susceptible to compression and injury.
The differentiation between these nerve entrapments is critical to getting the appropriate intervention and outcome. Often for sufferers the diagnosis is carpal tunnel and the solution is too often carpal tunnel surgery. The big catch is if you have ulnar nerve entrapment, carpal tunnel surgery will make it worse
The beauty is that you can readily differentiate between median nerve and ulnar nerve entrapment. They may present very similarly, with pain at the wrist and a generalised “I have pins and needles in my fingers”, but there are some obvious differences.
In regard to numbness and pins and needles, median nerve entrapment will affect the thumb and first two fingers, while ulnar nerve entrapment will affect the ring finger and little finger.
Reoccurring pins and needles is never something to be taken lightly. Diagnosing the correct mechanism of irritation is critical in determining the appropriate method of treatment and hence the best outcome.
Do you want to quickly check whether the pins and needles you get in your fingers might be something other than carpal tunnel syndrome?
Here are a couple of things you can quickly check:
- Location of the pins and needle – carpal tunnel will affect the thumb and first two fingers, while ulnar nerve entrapment will affect the ring finger and little finger.
- Tap your wrist – if you tap your wrist in the middle and get pins and needles then it is highly likely to be related to the median nerve. If you tap on the base of the inside of your palm and get pins and needles in the ring and little finger then it is most likely ulnar nerve entrapment.
- Forearm pain – Do you get pain in your forearm. Pain in the forearm is almost always related to ulnar nerve entrapments
- Do you have pins and needles in all fingers – if your symptoms occur in all the fingers then the problem most likely is further up at the elbow, shoulder or neck.
If you get pins and needles in your fingers and want to chat to someone about it, post me on our Facebook page and I’ll help you work out what’s going on.