Tingling in the Arms and Hands
That Pins-and-Needles Feeling!
A common complaint in this modern computer age is tingling in one’s fingers, hands or forearms. It is not uncommon for people to experience this feeling, particularly as the aging process begins to affect the body and circulation becomes impaired. Is tingling something to be taken seriously? Absolutely! Tingling is more than a minor inconvenience. It is a messenger, like all pain, sent to tell you that there is an underlying health issue that needs to be addressed. Tingling and numbness in your extremities should always be taken seriously. The first thing that you should do when you notice consistent tingling in any area of your body is to consult with your family physician to rule out any serious underlying causes. Some diseases such as diabetes, multiple sclerosis or Guillain-Barre syndrome can cause tingling in the extremities. Tingling in the arm, accompanied with other symptoms can indicate a heart attack or a CVA (stroke), so this is one more reason to take tingling in the upper extremities seriously. Once the more serious causes are (hopefully) ruled out, your health professional will look at other causes of tingling. Nutritional causes can include malnutrition or malabsorption of calcium or vitamin B12, or excess of vitamin B6 in your diet. Stress can also be a cause. Panic attacks or generalized anxiety can excite the sympathetic nervous system and cause constriction of arteries leading to tingling sensations in the fingers and toes, or can exacerbate existing conditions such as Raynaud’s phenomenon. One other condition to rule out is Thoracic Outlet Syndrome which affect venous blood flow from the arms back to the heart (though sometimes nerves are also involved). In most cease this condition is treatable with massage and a regime of remedial exercises at home. With most people, tingling is at least partly related to ergonomic or lifestyle factors. To educate yourself in this area check out my articles on Repetitive Strain Injury and Workstation Ergonomics.
Once the cause is determined, effective treatment can begin, but you must first involve your family physician before beginning a course of treatment. The actual medical term for this pins-and-needles feeling is paresthesia. Paresthesia can manifest as tingling, burning, prickling, or even an itchy feeling in the area affected. The most common cause is nerve irritation caused by mechanical pressure on a nerve, or by soft tissue entrapment of a nerve. Continued nerve irritation can eventually lead to nerve damage and numbness (one more reason to take it seriously). As you can see in figure 1, the nerve network heading down to our hands is quite extensive. Nerve compression can happen right where the nerve exits the spine (in the neck), or anywhere else along the way to the hand, including the carpal tunnel in the wrist. Tight muscles, as well as restrictions or swelling in our soft tissue can restrict nerves or blood vessels causing nerve compression, creating a tingling sensation. Massage can have dramatic effects on soft tissue restrictions. If the initial cause is a degenerative or herniated disk in the neck, massage or manual therapy can still help with symptoms, but cannot get at the root cause of the pain. However, if the restriction is not due to nerve root problems, massage or manual therapy is an extremely effective therapy. It should also be noted that tingling sensations could also happen because the circulatory system (as opposed to the nervous system) is experiencing a restriction somewhere on its pathway down to the forearm or hand. The circulatory system parallels the nerve network from the clavicle (collarbone) down to the hand. Treatment of a circulatory restriction usually begins by releasing tight muscles around the neck but will also typically include work on all muscles of the upper arm and forearm.
After a treatment session we will prescribe some home exercises. These will be tailored to your unique situation, but will typically involve gentle stretches, then a general strengthening of your cardiovascular system. The healthier your heart and cardiovascular system is, the better your body-wide circulation will be. As well, massage, exercise and stretching typically helps to reduce soft tissue adhesions and restrictions, improving most impingement syndromes. Finally, we will likely offer some lifestyle/ergonomic changes that you can make, since these factors typically contribute to impingement syndromes as well.