What doctor to see for numbness and tingling

1. Headaches

Headaches are something we all experience. We can feel them stretching into our sinuses, across the top of our head, down through the muscles of the head, neck, and shoulders or along the base of the skull and brain. They can be caused by many conditions from a sinus infection to a throbbing toothache from a visit to the dentist. Symptoms of more serious headaches, including migraines, may be vomiting, a headache that becomes more severe or is continuous, a headache that comes on suddenly or pain that is worsened by strain, a headache that starts early in the morning, changes in vision, or even seizures. If your headache symptoms are severe enough, your primary care doctor may refer you to a neurologist.

2. Chronic pain

Chronic pain is pain that lasts for months or even years. This pain can be the result of illness or injury, but when it lasts longer than the usual recovery time, it can become a symptom of a different problem. When this pain is not something your primary care physician can help you manage, you may choose to see a neurologist, especially if you have other symptoms along with the pain like weakness, numbness, or problems with bladder or bowel control.

3. Dizziness

Dizziness can come in different varieties. Neurologists treat dizziness that is a symptom of vertigo or disequilibrium. Vertigo makes you feel as if you or the things around you are spinning; disequilibrium is difficulty keeping your balance. Your primary care doctor can help you decide if your dizziness is severe enough to see a neurologist.

4. Numbness or tingling

Numbness or tingling can happen for many different reasons, some as simple as sitting in a way that cuts off your blood circulation or having not eaten. However, if this numbness continues, comes on suddenly, or only happens on one side of the body, it may be time to see a neurologist. Numbness or tingling symptoms like those described can also be signs of a stroke, in which case you need to get help very quickly. While your primary care doctor can help you evaluate these symptoms, if you think you are having a stroke, get immediate medical help.

5. Weakness

Feelings of weakness that you should see a doctor for are different than tiredness or muscle aches after a long hike or lifting too many weights. You should consult your provider if you experience muscle weakness that impacts your daily activities or a rapid decline in muscle strength, especially in your arms and legs. It could be caused by a more serious condition or disease of your nervous system, such as stroke.

6. Movement problems

Problems moving, like difficulty walking, being clumsy, unintentional jerks or movements, tremors, or others, can be symptoms of a problem in your nervous system. You may want to see a neurologist if these movement problems interrupt your daily life, though something like a tremor can be a side effect of medication or anxiety. However, if your tremors also affect your daily activities, you may want to see a neurologist.

7. Seizures

Seizures can be almost unnoticeable or very extreme. Symptoms of seizures can range from staring to loss of consciousness, jerking movements of the arms and legs, breathing problems, confusion, or loss of consciousness. While some seizures could be caused by low blood sugar or withdrawals from addictive substances, you should consult your provider for seizures that seem sudden or without any obvious cause. Your primary care doctor can help you determine how serious your seizure is and if you should see a neurologist.

8. Vision problems

Difficulty seeing can be caused by aging or by the nervous system. If the difficulty is sudden and happens in both eyes, you may want to have your vision evaluated. Either an eye doctor or your primary care doctor can advise you on whether you should see a neurologist about your vision problem.

9. Memory problems or confusion

Problems speaking, extreme problems with memory, changes in personality, or confusion are all symptoms that could be caused by disorders or problems in the brain, spine, and nerves. Some of the symptoms may be due to learning disabilities or they may be caused by a disease like Alzheimer’s. Your primary care doctor can help you examine your symptoms and decide if you need to see a neurologist.

10. Sleep problems

While we know many obvious causes of sleep problems, going to bed too late, having a condition like sleep apnea or anxiety, nightmares, or others, some sleep problems are neurological disorders. An example of this is narcolepsy, which is a chronic, genetic disorder with no known cause that affects the body’s central nervous system.

Many of these symptoms could be part of a disorder that is not neurological. Your primary care doctor is your greatest resource in helping you decide if you should see a neurologist. However, if your symptoms are severe enough or you are still not confident in your primary care doctor’s recommendations, you may need to make an appointment with a neurologist.

What causes numbness and tingling?

Share on PinterestNumbness and tingling may occur after resting the head on a crooked arm.

Numbness (lost, reduced, or altered sensation) and tingling (an odd prickling sensation) are types of temporary paresthesia.

These sensations commonly occur after sitting or standing in a particular position or even wearing tight clothing for too long. This puts pressure on nerves and blood vessels, reducing sensation.

Symptoms usually go away soon after the nerve pressure is reduced or relieved.

Multiple sclerosis

Numbness and tingling are two of the most common and early symptoms of MS.

MS often causes mild to severe numbness and tingling on the skin or certain parts of the body, including the:

  • arms and hands
  • legs and feet
  • face
  • body, often across the body in a band (sometimes described as an MS hug)

The numbness and tingling symptoms of MS are rarely disabling or permanent. But severe numbness can make it difficult for a person to use the numb body part, which may interfere with everyday activities.

For example, numb hands can make holding things, typing, or self-care hard or impossible. If someone has numb feet or legs, walking and driving can be dangerous. People with numbness and tingling in their face may also mistakenly bite their tongue or inner mouth.

Severe numbness can make it hard to tell when things are very hot or cold, increasing the risk of burns and frostbite.

Other conditions

Other conditions affecting the central nervous system that can cause numbness and tingling include:

  • Stroke. Sudden numbness in the arm, leg, or face, especially on one side of the body, is an early symptom of stroke.
  • Mini-strokes. Transient ischemic attacks, or mini-strokes, can cause one side of the face to go numb and droop.
  • Encephalitis. In severe cases, inflammation in the brain and spinal cord can cause a loss of sensation in parts of the body or partial paralysis in the arms or legs.
  • Transverse myelitis. Inflammation in the spinal cord can cause a band-like sensation across the torso, as well as weakness in the legs and sometimes arms.
  • Tumors. Tumors can put pressure on parts of the spinal cord and brain, resulting in numbness and tingling. Tumors in the cerebral cortex (outer region of the brain) tend to cause numbness on one side of the body. Tumors in and close to the cranial nerves tend to cause facial numbness and weakness. Tumors impacting the spinal cord can cause numbness, usually in both arms and legs.
  • Back and neck damage. Back and neck injuries can cause nerve damage or compression, resulting in numbness and tingling.
  • Magnesium deficiency. Magnesium helps regulate many systems in the body, including proper nerve function. Severe magnesium deficiencies, or hypomagnesemia, can cause numbness and tingling.

Some other conditions that target specific parts of the body can cause numbness and tingling. Body parts include:

Feet and legs

People with diabetes may experience diabetic neuropathy, a type of nerve damage. It can occur over time as the metabolic effects of diabetes in the bloodstream damage nerves.

One-third to one-half of people with diabetes have peripheral neuropathy, a form that typically causes numbness and pain in the feet and legs, or less commonly, in the hands and arm.

Hands and feet

Share on PinterestA number of medications may cause peripheral neuropathy.

Vitamin B12 deficiency, or pernicious anemia, can cause nerve damage due to low red blood cell levels and reduced oxygen circulation. This can cause peripheral neuropathy.

Alcoholic liver damage can cause peripheral neuropathy, affecting the hands and feet.

A range of medications can also cause peripheral neuropathy, such as:

  • blood pressure or heart medications
  • chemotherapy and cancer medications
  • medications for HIV and AIDS
  • anti-alcohol medications
  • anticonvulsants
  • skin medications
  • infection fighting medications

Fingers

Calcium is vital to proper nerve function and blood flow. Hypocalcemia, or calcium deficiency, can cause numbness and tingling in the fingers.

Carpal tunnel syndrome can also cause numbness, tingling, and pain in the hands and fingers. It occurs when the median nerve, a major nerve in the arm, becomes compressed in the space where it travels through the wrist.

Hands

Panic attacks, or sudden overwhelming periods of fear and anxiety without real danger, can cause a range of symptoms, including numbness or tingling in the hands.

Face

Toothaches and infections can compress facial nerves, causing numbness in the face and mouth.

Is it serious?

This depends on the underlying cause.

Persistent numbness of the feet can lead to falls which can be serious in the elderly.

Persistent numbness of the hands can affect your grip and make you prone to burns and injury.

What causes numbness and pins and needles?

Numbness and pins and needles occur when you lose normal sensation in an area of the body. This happens because pressure cuts off the blood supply to nerves that carry messages about sensation to the brain. This can affect any part of the body – eg, hands, feet, face.

This list does not include all the possible causes of numbness/pins and needles but lists some of the more common causes, including:

Pressure

Wearing tight shoes or sitting on your foot can give you a numb foot or leg or cause pins and needles. This kind of numbness has an obvious cause, gets better when the pressure is removed and doesn’t cause any further problems.

Trapped nerve

Numbness or pins and needles can also be due to a trapped nerve. A slipped disc or back problem can put pressure on a nerve that travels from your back, down your leg and into your toes. A trapped nerve in the neck can also cause numbness or pins and needles anywhere from your neck, down your arms and into your fingers. Carpal tunnel syndrome is a trapped nerve at the wrist, giving you pins and needles and pain in the hand and loss of grip. Other examples are thoracic outlet syndrome and spinal stenosis.

Diabetes

Diabetes can damage small blood vessels that supply nerves in fingers and toes. This can cause pins and needles, pain or numbness in the hands and feet (peripheral neuropathy). Being unable to feel anything in your hands and feet can be dangerous, as you may stumble, drop things or not realise when you are touching something hot.

Injury

Damage to nerve endings in fingers or toes can be the result of an injury. People who use vibrating tools a lot may also develop nerve damage and may experience pins and needles.

Medicines

Some medicines can cause nerve damage. It is usually reversible when the medicine is stopped. The medicines include some chemotherapy medicines used to treat breast cancer and lymphoma, antiretrovirals used to treat HIV/AIDS, and the antibiotic metronidazole.

Diseases that damage nerves

Many conditions can damage the nervous system and cause areas of numbness or pins and needles. These include stroke, multiple sclerosis and brain tumours. These conditions are serious but relatively rare and will all cause other symptoms in addition to the numbness/pins and needles.

Alcohol

Alcohol abuse can damage nerves.

Vitamin deficiency

Vitamin B12 deficiency is common among very elderly people, vegans and people with a condition called pernicious anaemia. The lack of vitamin B12 causes anaemia and nerve damage.

Treatments

Treatment will depend on the likely cause of your numbness/pins and needles. You may be asked to keep a diary of the circumstances in which they happened. Most cases will be managed by your GP but you may be referred to a hospital for further investigation and treatment.

What investigations might I need?

The doctor will want to know more about the length of the periods of numbness/pins and needles. Is there any obvious cause? Have you started new medication? Do you drink a lot of alcohol? Do you have diabetes? These details will help the doctor to make a diagnosis. Your doctor will examine you. They will check your heart, including your blood pressure and pulses in your wrists and feet. Your nervous system will be checked and you may be asked whether you can feel a pinprick or other sensations in your limbs. You may be asked to have a blood test to check for diabetes, anaemia and vitamin B12 levels. Further tests of your heart and nervous system may be necessary.

How can I avoid numbness/pins and needles?

You will need to find the underlying cause and try to address it if possible.

Pressure on nerves, due to back and neck problems, is very common.

Diabetes is the most common cause of persistent numbness/pins and needles.

Who might be affected by numbness/pins and needles?

You can get numbness/pins and needles by putting pressure on a part of your body, like wearing tight shoes or sitting on your foot. People with back pain, those who have diabetes or people who use vibrating tools are more prone to develop the problem.

Is This Normal: The Pins-and-Needles Feeling

Falling asleep in an awkward position can cause an uncomfortable but harmless pins-and-needles feeling.

Our bodies do all kinds of weird things. How do you know when to ignore something and when to get to the doctor ASAP? We break down what’s normal and what’s not in this occasional series.

Most of us have experienced the pins-and-needles feeling. Maybe you slept on your arm, or you squeezed into an awkward position in a tiny airplane seat and your foot fell asleep. The next thing you know, the limb is tingling, almost like it’s pulsing from inside, and you can’t really do anything with it.

What Causes the Pins-and-Needles Feeling?

Any tingling or numbness indicates a problem with your nerves. “The nerves are like electrical wires that connect every part of your body to the brain,” explains Andrew Chang, MD, a primary care doctor at Medical Associates of Louisa. If you compress the nerves, like when you fall asleep on your arm, the nerves can’t send the signals to your brain as effectively.

Usually, we can easily figure out the cause:

  • Falling asleep in an awkward position, with pressure on your foot or arm
  • Sitting or standing in one position for a long time
  • Tight clothing

Most instances of pins and needles last for brief periods of time and cause no lasting harm. But once in awhile, the sensation signals something more serious.

Weird symptoms?

Make an appointment with a UVA primary care doctor.

When the Tingling Needs Medical Attention

If you can easily identify the cause of your pins and needles or numbness, and it only lasts for a few seconds, there’s no need to worry. But see your doctor if:

  • The feeling persists or keeps recurring.
  • You’re experiencing it with symptoms such as dizziness, balance issues and weakness.
  • It’s not just happening in one part of the body.
  • You can’t figure out the cause.

What Could the Pins-and-Needles Feeling Mean?

Several conditions can cause the pins-and-needles feeling.

Diabetes, for instance, causes nerve damage because your vessels and nerves become inflamed. When inflammation strikes blood vessels, the nerves don’t get enough blood, Chang explains.

Vitamin deficiencies, on the other hand, destroy the myelin that covers and protects the nerves. If severe, the damage can last, permanently.

Tingling and numbness in the wrists and hands could signal carpal tunnel syndrome, a common nerve disorder of the hand.

There are plenty of good reasons to avoid overindulging in alcohol, but here’s another one: If you’re drunk, you can experience radial neuropathy, also known as Saturday night palsy. This occurs when someone falls asleep with their arm hanging over the edge of the chair, couch or bed. A sober person soon realizes this is uncomfortable and adjusts, but a drunk person may sleep that way for a long time.

In serious cases, the blood supply cuts off, causing serious and permanent nerve damage. As a result, you’ll have trouble feeling and moving part of your arm. Fortunately, this is rare, Chang says.

Other conditions your doctor will check for:

  • Thyroid problems
  • Potassium or sodium imbalance
  • Infection around the nerves
  • Tumors
  • Infections such as HIV, syphilis or Lyme disease
  • Hepatitis

If your bloodwork and vitamin levels test normal for these, Chang says your doctor will refer you to a neurologist for nerve tests.

Photo: Jeremy Yap ((Unsplash)

It happens when you least expect it: one minute your hand is functioning as usual, and then next it’s partially numb, but also feels like you’re getting pricked by pins and needles. In other words, your hand fell asleep.

The medical term for this is paresthesia, and it happens when pressure is placed on a nerve that supplies a limb. According to Anthony Kouri, M.D., an orthopedic surgeon at the University of Toledo Medical Center, the most common reason our hand falls asleep is that we lie on it in a flexed position while we’re sleeping. This causes blood flow to be cut off from the nerve, which causes numbness or tingling.

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Why and where this happens

The numbness from this is generally in the thumb, index and middle fingers, Kouri tells Lifehacker. If you experience numbness in the pinky and/or ring fingers, that is typically from your elbow being hyper-flexed while we sleep, causing compression and decreased blood flow to the ulnar nerve.

Meanwhile, if your entire arm is numb, that means you either slept on your shoulder the wrong way, decreasing blood flow to multiple nerves in the arm, or slept with your neck in a strange position, affecting the nerves coming directly from the spine, Kouri explains. At this point, your hand and/or arm can feel tingly—that “pins and needles” sensation—or just numb. Either way, you’re probably looking for a way to get rid of it.

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How to get rid of the pins and needles

Whether this happens while we’re asleep or just sitting on the couch watching TV, our first reaction is often to shake the hand and/or arm to attempt to regain feeling in it, or get the pins and needles to go away. According to Kouri, doing this does help to improve blood flow to the nerve, but simply releasing the pressure from our sleeping or couch-sitting position will typically allow sensation to return.

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You may also want to try clenching and then unclenching your fist, physician Nikola Djordjevic M.D. tells Lifehacker. “This method is able to get the blood flow to your hands and ease the nerves, thus relieving you from feeling pins and needles,” he says.

Is there a way to speed up the process?

While we’d love to report that there’s a quick hack that will make your hand feel normal again in a few seconds, unfortunately, one doesn’t exit. Kouri says that there is no existing data definitively ruling that one technique is faster than the other, but notes that anecdotally, it seems that sensation does return more quickly with shaking or clenching.

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How to prevent pins and needles

If you notice that your hand is frequently asleep when you wake up in the morning, Kouri says there are a few things you can do to prevent this. First, check to see which fingers are affected. If it is primarily your thumb, index and middle finger, you may want to try wearing over-the-counter neutral wrist braces at night. Conversely, if you notice that your pinky and ring finger are primarily affected, you can try wearing an elbow brace at night, or simply roll a towel and place it inside your elbow while you sleep. This will often prevent numbness when you wake up.

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How to know if it’s a sign of something else

If you notice that your hands, arms, feet or legs are going numb on a regular basis and the techniques above don’t work, it could be the sign of another condition like carpal tunnel syndrome or multiple sclerosis. At this point, it’s a good idea to see a medical professional about it. But in most cases, feeling pins and needles in your hand just means it’s a temporarily pinched nerve and you should be back to normal soon.

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This story was originally published on 8/10/11 and was updated on 6/27/19 to provide more thorough and current information.

It Took 12 Doctors to Solve the Mystery of My Tingling Fingers

By Jody Berger, Special to Everyday Health

My fingertips started tingling like they were waking from a deep sleep. The sensation, a slight pins and needles feeling, wasn’t painful but persistent enough that I knew it meant something.

I didn’t have a doctor so I picked one off my insurance provider’s website and went to see her. She spent five minutes with me before referring me to a neurologist, who gave me 15 minutes of his time and attention.

The neurologist ordered some expensive tests and sent me on my way. A few days later, when he had the test results, he called me at home to deliver the news. No small talk, no comforting, and no questions. He led with a bold declaration, “multiple sclerosis,” and added that if I wanted to talk about it I could come see him.

He gave me life-changing news as if it were nothing. My body; however, knew otherwise. The tingling, once subtle and contained, quickly gained volume and size until it was a full-body, full-throttle experience.

I wanted to learn more so I went to his office. He called me Jody and I called him Doctor. He wore a crisp lab coat, while I tried not to cry. To him there wasn’t much to talk about. I only had one choice to make and that was the choice between four similar drug protocols.

‘More of an Art Than a Science’

I went home, cried, panicked, talked to friends, and cried some more. Eventually, days later, I started to remember things I once knew. I remembered that people often seek second opinions and that a white coat doesn’t make a man infallible.

In medicine, like the rest of life, mistakes are not impossible. Studies show that as many as 20 percent of all diagnoses are, in fact, misdiagnoses. And multiple sclerosis presents specific challenges. The disease manifests in dozens of different ways and there is no definitive test. Experts I later spoke to told me that MS is a clinical diagnosis — meaning the doctor must spend time examining and interviewing the patient — and more of an art than a science.

At first I thought my only choice was to take one of the drug options presented to me. I started researching the drugs and what I learned scared me. The odds of them helping — about one in three — were smaller than the odds of them hurting. The list of potential and unwanted effects included headaches, nausea, and liver failure.

Terrified, I found another doctor for a second, third, and then a fourth opinion. By the end of my journey I had seen 12 different doctors. As I went from one to another and another, touring the American medical landscape, I was told I had nutritional deficiencies, heavy metal toxicity, Lyme disease, and depression. It didn’t seem possible that I had all these things at once.

The tingling never grew worse and no new symptoms appeared. I let go of my panic bit by bit. I collected information in pieces, a little here and a little there. I was on a treasure hunt, gathering the clues that would explain the tingling, rule out MS, and give me back my perfect health.

Navigating the Doctor-Patient Divide

As I learned about the human body, I also learned about doctors. Some, it seemed, preferred to talk about test results than talk to or about me. Others, like the first neurologist, didn’t mention non-prescription options.

Fortunately though, every conversation was different. During some of these conversations, the rigid doctor-patient divide fell away and I felt a human connection. In the best conversations, there were two adults in the room who respected on another. One, the doctor, had a wealth of knowledge about bodies in general and the other, me, had a wealth of information about one specific body: mine.

In these conversations, each of us could ask and answer questions, confident that the other had something valuable to contribute. Together, we could start to see a more complete picture of what was happening to create the tingling sensation.

I traveled the country talking to doctors and ultimately, I found two who were nearby and whom I could trust. One is an osteopath who is well-versed in systems thinking and the other is a physician who also trained in ayurvedic medicine, a holistic system of healing.

With each of these doctors, I was able to relax and learn. Together, we devised a plan which included an elimination diet. I’d been tested and was told I didn’t have celiac disease but when I avoided gluten for several weeks and reintroduced it, my body responded poorly. I have what’s officially and awkwardly called non-celiac gluten sensitivity. The tingling, which the first doctor believed to be a sign of MS, is a fairly common symptom of gluten sensitivity.

I stopped eating grain-based protein and my doctors coached me to breathe more, stress less, and exercise differently. I changed my diet and my lifestyle, and I healed.

I wouldn’t suggest my path through a dozen doctors is the right one for anyone but me. It was a very long year. At the same time, the relationship you have with your doctor is so critical to healing. I believe that each of us on the patient side of the divide can decide what type of relationship we want and we can work on finding it.

I like to think that everyone can heal but I don’t know if that’s true. I know; however, that I started to heal in small and powerful ways when I started engaging in the conversation with my doctors and making choices that worked better for my body.

Jody Berger is the author of Misdiagnosed: One Woman’s Tour of—And Escape From—Healthcareland. She has written for national magazines and newspapers and won a Knight Fellowship to Stanford University. Follow her on twitter @jodyberger.

Question

I have been suffering over the last four days with a tingling and numbness in the fingertips of my right hand.

I am right handed.

My wife wants me to go to the doctor. She thinks it’s something to do with poor circulation.

The condition is more uncomfortable than painful – but nothing I do seems to make it go away.

Can you give me any suggestions as to what might be the problem?

Answer

Sorry to hear you have this problem, but it’s very unlikely to be anything to do with your circulation, as it is so well localised to your right hand.

Another thing people worry about with these sort of symptoms is a stroke, but I think that too is very unlikely.

With the symptom of numbness as well as tingling it sounds much more as if this is a nerve entrapment.

That means that somewhere along the line of the nerves that supply this part of your hand, there is some pressure on a nerve.

There are two likely places:

The neck is a possibility because the nerves that go to your hand exit the spine in the neck and travel down the arm into the fingers.

A bit of wear and tear, or even a bit if a twist to the ligaments here could cause pressure on the nerves that would then be felt as tingling and numbness in the fingers.

The other likely possibility is pressure in the wrist. The nerves to the fingers go through a small tunnel at the wrist to get into the hand – called the carpal tunnel.

Pressure here will produce similar symptoms.

Usually it is the middle fingers that are most affected. It can be worse at night and cause pain or discomfort that may wake you, or the hand may feel particularly numb and heavy first thing in the morning.

This condition is called carpal tunnel syndrome.

There are usually no serious reasons for these symptoms.

Nevertheless, it would be sensible to tell your doctor about them, so he or she can confirm the likely cause and advise you about treatment if that becomes necessary.

This may be the case if the symptoms do not soon settle on their own.

Yours sincerely

The NetDoctor Medical Team

Last updated 29.09.2014

Carpal Tunnel Syndrome

The carpal tunnel is a space in the wrist that holds tendons and your median nerve. This space is compressed in carpal tunnel syndrome. One symptom of carpal tunnel syndrome is numbness that spreads throughout the hand (see shaded blue area).

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a common condition that causes pain, numbness, tingling, and weakness in the hand and wrist. It happens when there is increased pressure within the wrist on a nerve called the median nerve. This nerve provides sensation to the thumb, index, and middle fingers, and to half of the ring finger. The small finger (the “pinky”) is typically not affected.

Carpal tunnel syndrome was first described in the mid-1800s. The first surgery for the release of the carpal tunnel was done in the 1930s. It is a condition that has been well recognized by orthopaedic surgeons for over 40 years.

What is the carpal tunnel?

The carpal tunnel is a narrow canal or tube in the wrist. Similarly to a tunnel you could travel through by car, this part of the wrist allows the median nerve and tendons to connect the hand and forearm. The parts of this tunnel include:

  • Carpal bones: These bones make up the bottom and sides of the tunnel. They are formed in a semi-circle.
  • Ligament: The top of the tunnel, the ligament is a strong tissue that holds the tunnel together.

Inside the tunnel are the median nerve and tendons.

  • Median nerve: This nerve provides feeling to most of the fingers in the hand (expect the little finger). It also adds strength to the base of the thumb and index finger.
  • Tendons: Rope-like structures, tendons connect muscles in the forearm to the bones in the hand. They allow the fingers and thumb to bend.

Does carpal tunnel syndrome only happen to office workers or factory workers?

No. Many people with carpal tunnel syndrome have never done office work or worked on an assembly line. It affects people who use their wrists and hands repeatedly at work and at play. Anyone can get carpel tunnel syndrome, but it is unusual before age 20. The chance of getting carpal tunnel syndrome increases with age.

Who is at risk for carpal tunnel syndrome?

People at risk for carpal tunnel syndrome are those who do activities or jobs that involve repetitive finger use. Motions that can place people at risk of developing carpal tunnel syndrome include:

  • High-force (hammering).
  • Long-term use.
  • Extreme wrist motions.
  • Vibration.

Many other factors can also contribute to the development of carpal tunnel syndrome. These factors can include:

  • Heredity (smaller carpal tunnels can run in families).
  • Pregnancy.
  • Hemodialysis (a process where the blood is filtered).
  • Wrist facture and dislocation.
  • Hand or wrist deformity.
  • Arthritic diseases such as rheumatoid arthritis and gout.
  • Thyroid gland hormone imbalance (hypothyroidism).
  • Diabetes.
  • Alcoholism.
  • A mass (tumor) in the carpal tunnel.
  • Older age.
  • Amyloid deposits (an abnormal protein).

Carpal tunnel syndrome is also more common in women than in men.

What causes carpal tunnel syndrome?

Carpal tunnel syndrome is caused when the space (the carpal tunnel) in the wrist narrows. This presses down on the median nerve and tendons (located inside the carpal tunnel), makes them swell, which cuts off sensation in the fingers and hand.

How often is hand pain caused by carpal tunnel syndrome?

While carpal tunnel syndrome is a common condition, it has a different set of symptoms from many other sources of hand pain. There are actually several similar conditions that cause hand pain. These include:

  • De Quervain’s tendinosis: A condition where swelling (inflammation) affects the wrist and base of the thumb. In this condition, you will feel pain when you make a fist and simulate shaking someone’s hand.
  • Trigger finger: This condition causes soreness at the base of the finger or thumb. Trigger finger also causes pain, locking (or catching) and stiffness when bending the fingers and thumb.
  • Arthritis: This is a general term for many conditions that cause stiffness and swelling in your joints. Arthritis can impact many joints in your body and ranges from causing small amounts of discomfort to breaking down the joint over time (osteoarthritis is one type of degenerative arthritis).

What are the symptoms of carpal tunnel syndrome?

Symptoms usually begin slowly and can occur at any time. Early symptoms include:

  • Numbness at night.
  • Tingling and/or pain in the fingers (especially the thumb, index and middle fingers).

In fact, because some people sleep with their wrists curled, nighttime symptoms are common and can wake people from sleep. These nighttime symptoms are often the first reported symptoms. Shaking the hands helps relieve symptoms in the early stage of the condition.

Common daytime symptoms can include:

  • Tingling in the fingers.
  • Decreased feeling in the fingertips.
  • Difficulty using the hand for small tasks, like:
    • Handling small objects.
    • Grasping a steering wheel to drive.
    • Holding a book to read.
    • Writing.
    • Using a computer keyboard.

As carpal tunnel syndrome worsens, symptoms become more constant. These symptoms can include:

  • Weakness in the hand.
  • Inability to perform tasks that require delicate motions (such as buttoning a shirt).
  • Dropping objects.

In the most severe condition, the muscles at the base of the thumb visibly shrink in size (atrophy).

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Jose Luis Pelaez Inc / Getty We’ve all been there: You notice something unusual on your body, and suddenly you’re querying all your friends and sleuthing around online to figure out what’s wrong. Does that odd rash mean you should switch moisturizers, or should you be thinking skin cancer?

Even those of us without hypochondriac tendencies tend to get spooked now and again by body oddities. “It’s easy to jump to the worst-case scenario, but it’s always a good idea to take a step back and calm down,” says Renée Scola, MD, an internist at Northwestern Memorial Hospital in Chicago. “Of course, there are some symptoms, like chest pain, that you don’t ever want to ignore. But if you have a rash for a few days without other symptoms , it’s probably safe to wait for a couple more days to see what happens before calling your physician.”

A good rule of thumb: When in doubt, get things checked out—but unless something feels or looks awful, resist that urge to hit the panic button right away. Instead, take a deep breath and follow our expert-approved guide to help you figure out what’s simply annoying and what’s an indication you might need medical help.

Hair Loss

When it’s just strange: “Losing about 100 hairs throughout the day is normal,” says Jeffrey Garber, MD, president of the American Association of Clinical Endocrinologists. Even substantial thinning (think hundreds of hairs a day, possibly in clumps) is nothing to worry about if you’re currently going through hormonal changes. For example, if you’ve recently stopped using hormonal birth control, had a miscarriage or had a baby, hair loss is likely just the result of your body readjusting. Your tresses should return to their former glory within three to four months. It’s also normal for hair texture to change due to hormones, which means you don’t need to worry following a pregnancy if your curly hair no longer needs to be tamed with a flat iron or your once-dry hair seems magically moisturized.

When it’s a warning sign: Not sure if the shedding is excessive? Try the “pull test,” says Dr. Garber: “Carefully grasp a small section and lightly tug to see how many hairs will come out.” Losing more than five telogen hairs, the ones with the root attached, is cause for concern, he says. Unless you can pinpoint an obvious hormonal cause (as mentioned above), call your doctor.

Your physician will examine your scalp and may suggest blood tests to figure out exactly what’s going on. “Deficiencies of zinc, iron or biotin can all cause hair loss, as can an under- or over-active thyroid,” says Dr. Garber.

You should also check in with your doctor if your hair texture has changed and a new baby isn’t in the picture. “Patients often notice texture changes during times of unusual stress or following a serious illness,” or your iron levels could simply be low, explains Dr. Scola.

“Butterfly” Rash

When it’s just strange: Again, blame hormones: Many moms-to-be develop a butterfly-shaped sprawl of freckle-like spots on their cheeks and nose, as do some women who are taking birth control pills or using hormone therapy for menopause symptoms. The rash (sometimes referred to as a mask) is officially called melasma or chloasma, and it’s caused by a ramped-up production of melanin (skin pigment), explains Dr. Scola, who notes that some women develop similar patches of spots along their jawline or forehead. Typically the spots fade within a few months after you have the baby or stop taking hormones. In the meantime, the best way to prevent and/or reduce the rash is to slather on sunscreen.

When it’s a warning sign: If you’re not pregnant or using hormones—and especially if the rash is red and rough—it can signal lupus, a serious autoimmune disorder. “If the mask lasts for several days and you don’t think it’s just dry skin, definitely get it checked out,” says Dr. Scola.

To diagnose (or rule out) lupus, your doctor may test your blood for specific antibodies and/or refer you to a dermatologist or rheumatologist. Although there’s no cure for lupus, there are many medications that can keep the symptoms—which may also include joint pain, memory loss and severe fatigue—in check.

Mismatched or Changing Pupils

When it’s just strange: If you’ve had mismatched pupils for as long as you can remember, don’t sweat it. “Some people are born that way, and while it might make you more light-sensitive, it shouldn’t affect your vision in any way,” says James Applegate, MD, a family doctor in Grand Rapids, Michigan.

When it’s a warning sign: If you hit your head within the last 72 hours (even just a minor bump) or have a high fever and notice that your pupils suddenly start changing size or look mismatched, go straight to the ER, says Dr. Applegate. “Pupil changes following a head injury or during an illness can mean an aneurysm, a cerebral hemorrhage or meningitis, and all are life-threatening,” he explains. Same goes for pupil changes that occur following any type of surgery or are accompanied by other symptoms like pain, nausea or vision loss— it’s best to get checked out immediately.

Didn’t just have an accident or surgery but you definitely weren’t born with mismatched pupils? Make an appointment with your doctor. It’s probably nothing serious, but you could have a nerve disorder called Horner syndrome (in which the eye with the smaller pupil also has a droopy lid). The condition isn’t dangerous in and of itself, but sometimes it’s caused by a brain lesion, spinal cord injury or lung tumor. (If necessary, your doctor can check for these with an MRI or CT scan of the head, neck and chest.)

Discolored Fingernails

When it’s just strange: You may have heard that a smattering of white spots on your nails means you have a vitamin deficiency, but that’s just a myth, says Joseph Jorizzo, MD, professor of dermatology at Wake Forest School of Medicine in Winston-Salem, North Carolina. “White marks on your fingernails are usually related to impact,” he explains.

And don’t panic if you don’t remember the damaging incident: If the nail of a finger caught in a door or drawer gets damaged below the cuticle, the spots won’t be visible until the nail grows out several weeks or even months later.

When it’s a warning sign: If you have discoloration, ridges or other symptoms on both your fingernails and your toenails, see a dermatologist—it could be a fungus or psoriasis. And if your fingernails have a brownish discoloration under the nail bed, along with inflammation and torn cuticles, it’s probably a yeast infection, which needs to be treated. Also be suspicious about finger- and toenails that are naturally colored near the tip of the nail bed but appear dusky white starting about halfway down. “We call them ‘half and half ‘ nails, and they can be a sign of kidney disease.”

Lastly, if you’re Caucasian and notice a black or bluish-black vertical streak (extending out from under the cuticle to the fingertip), it could be melanoma, the most serious type of skin cancer, so you’ll want to see a dermatologist as soon as possible, says Dr. Jorizzo.

Numb or Tingly Extremities

When it’s just strange: If you’re outside in chilly weather or swimming in a cool pool in the summer, you may notice tingling nerves in your hands, feet, fingers and toes. “It just means your nerves are reacting to the cold,” says Dr. Applegate. Pull on a pair of gloves, get out of the water, or head somewhere warmer and you should be just fine.

When it’s a warning sign: If the tingling doesn’t seem related to cold, you could have a pinched nerve in the neck or lower back—especially if the sensation runs all the way down one arm or leg. A pinched nerve can be caused by a ruptured disk or a bone spur that’s pressing on a nerve. While it’s certainly not life-threatening, it can be pretty uncomfortable. “It’s like hitting your ‘funny bone’ nonstop, so you get tingles in your nerves,” says Dr. Applegate. Rest, anti-inflammatory meds, physical therapy or even surgery may be needed to fix the problem. (If your internist can’t treat it herself, she’ll probably refer you to a neurologist, orthopedist or physiatrist.)

A tingly sensation in the extremities can also be a sign of type 2 diabetes, though usually this symptom only occurs once the disease has progressed. “Blood sugar levels that are consistently elevated can lead to neuropathy and cause tingling, weakness or even pain,” Dr. Applegate says. So if you already have diabetes, tingling could mean that your blood sugar levels aren’t well-controlled. And if you haven’t yet been tested for the disease (and can’t figure out what else is causing the tingling), a blood test to measure your glucose levels is probably in order.

Numbness and tingling can also sometimes be signs of a heart attack, but if you don’t have at least one other telltale sign—such as chest pressure, nausea or feeling out of breath—you’re probably not having one. Still, a potential heart attack is nothing to play around with, says Dr. Applegate. “Anytime you think a symptom may indicate heart disease, act on it and call 911 ASAP.”

Unusually Colored Urine

When it’s just strange: Perfectly normal urine can be many shades of light yellow, or pink, orange, green or even light tan. So if you’ve been eating a rainbow of produce lately—i.e., carrots, asparagus, blackberries, beets—or taking a new medication or multivitamin, don’t be surprised if your pee reflects that, says Dr. Scola.

When it’s a warning sign: “Dark brown urine or urine that looks blood-tinged most often signals dehydration or a urinary tract infection, respectively,” says Dr. Scola. If your urine has been very dark for more than a day and you know mild dehydration isn’t the culprit (try drinking a few glasses of water and see what happens!), it’s worth seeing your physician.

Dark urine can also be a sign of kidney problems or liver disease, such as hepatitis or cirrhosis, which can be very serious (you may end up needing antiviral medications, dialysis to “clean” your blood or even a liver transplant). The sooner you find out what’s wrong, the better.

Bloody urine may mean a UTI, and you’ll need antibiotics to clear it up. In rare cases it could even indicate bladder cancer or kidney stones (hard mineral deposits that can be extremely painful).

If signs point to either of these conditions, your doctor may want to examine your bladder with a CT scan or cystoscopy—a test in which a miniature camera is threaded into your bladder.

Red Lacy Patterns on Your Skin

When it’s just strange: If your arms or legs look like you have a fishnet pattern tattooed on them, it’s probably something called livedo reticularis. Sounds alarming, but it really just means that your blood vessels are dilated to compensate for sluggish blood flow because you’re cold. “If the pattern temporarily disappears when you press on it or permanently goes away when you get warmed up, there’s nothing to worry about,” says Dr. Jorizzo.

When it’s a warning sign: If the pattern doesn’t disappear when your body temperature rises or when you apply pressure, it can be a sign of an autoimmune disorder, such as lupus or rheumatoid arthritis, says Dr. Jorizzo. If your doctor thinks you might have one of these, he may order a skin biopsy or specific blood tests to check for these conditions. (If rheumatoid arthritis is a likely suspect, your doctor may also want to take X-rays of your joints to see if they’re swollen or damaged.)

Bulging Belly Button

When it’s just strange: If you’ve always had an “outie,” there’s nothing to stress over. Same goes for anyone who’s majorly pregnant: It’s normal for an innie to become a very pronounced outie at some point during the second trimester.

When it’s a warning sign: If you’re not pregnant, a bulging belly button can indicate that you’ve developed an umbilical hernia—meaning that a part of your intestine has pushed through a weak spot in your abdominal wall, says Dr. Scola.

This problem is most common among people who are overweight or do lots of heavy lifting and also among women who have previously been pregnant several times. “A hernia can be dangerous if it cuts off blood supply to part of the intestine, so you should see your physician soon to see if you need surgery,” Dr. Scola says. (Fortunately, the surgery needed to repair this kind of hernia is relatively simple.)

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