Carpal tunnel syndrome
Why do my fingers go numb and tingle at night?
Pins and needles in the thumb, index and middle fingers from pressure on the median nerve at the wrist.
What it feels like
Numbness, tingling or burning in the thumb, index and middle fingers, often waking you at night and eased by shaking the hand. Over time grip may feel weaker or you may drop things.
What is actually happening
The median nerve is compressed where it passes through the carpal tunnel at the wrist. Contributing factors include repetitive or forceful hand use, wrist positions held for long periods, pregnancy, diabetes and thyroid conditions.
When to see a doctor
See your doctor if numbness is constant, if the muscles at the base of the thumb are wasting or weak, or if symptoms are in both hands with other new symptoms. Your doctor can also check for related conditions such as diabetes and thyroid problems.
How it is assessed
Assessment includes the pattern of symptoms, sensation and strength testing of the hand, clinical tests for the median nerve, and screening of the neck and elbow, which can cause similar symptoms.
How it is treated
The carpal tunnel syndrome clinical practice guideline supports a night-time wrist orthosis in a neutral position, education on positions and activities that increase pressure on the nerve, and manual therapy techniques. Where symptoms are severe, constant or include weakness, referral to a physician for injection or a surgical opinion is appropriate.
What to do first
Avoid sleeping with the wrists curled, take breaks from sustained gripping and wrist bending, and have it assessed, particularly if numbness is becoming constant.
Where this is assessed
- Athlete's Care Sports Medicine Centres Yonge & Eglinton · Mon/Wed/Fri · 8:00 AM – 2:00 PM Book at Athlete's Care
- Push Pounds Sports Medicine Downtown Toronto · Tue/Thu · 8:30 AM – 6:30 PM Call Push Pounds to book
References
This page is based on the following clinical practice guidelines and research.