As part of my history taking with a new patient, I will ask about any other symptoms or concerns they may have. A common complaint seems to be wrist pain which may or may not be accompanied by tingling in the fingers or sometimes it is tingling alone. As always, is my job to get to the root cause of what is happening. Is this Wrist Pain vs. Carpal Tunnel Syndrome vs. Cervical Radiculopathy? To this end, it helps to be able to distinguish the causes of the complaints based on nuances of the symptoms.
It is significant to see which fingers are affected by tingling, numbness or pain. The Median nerve comes out of the wrist and controls the thumb, index and middle fingers. So if only those fingers are affected that strongly points to the issue coming from the wrist. It is a case of classic Carpal Tunnel Syndrome. This is best addressed by adjusting the carpals, the wrist bones, so as to take pressure off the Median nerve. Treatment is actually similar if it is a simple matter of wrist pain with no tingling. By restoring the carpals to their proper positioning the irritation to that area can be relieved. In both cases some home stretches and exercises are in order to address the soft tissue around the wrist and give the area more stability.
Tingling in the hands can also come from the neck. This gets a bit more complex. Depending on which nerve or nerves coming from the neck and going down into the hand are pinched will determine what part of the hand has numbness, tingling or pain. Fortunately a few orthopedic tests can be used to distinguish where the nerve is being affected. If gently pressing down on the patients head causes an increase in symptoms that points to the nerve being pressed at the neck. On the other hand, if tapping on the patient’s wrist elicits symptoms into the fingers, that points to wrist involvement.
Bear in mind, the patient is allowed to have more than one problem. I have seen patients with tingling in the fingers that had nerve interference in both the neck and the wrist. Fortunately a comprehensive history and exam can uncover both causes so the patient can make a complete recovery.