Numbness brought on by pressure, such as lying on your arm, lasts a few minutes and usually stops once the pressure is taken off; numbness in the hand and fingers that is constant or keeps coming back should be assessed [1]. Which fingers go numb points to the cause: numbness in the thumb, index and middle fingers, especially at night, suggests compression of the median nerve at the wrist (carpal tunnel syndrome) [2][3]; numbness in the little and ring fingers suggests compression of the ulnar nerve at the elbow [4]; numbness together with pain travelling from the neck down the arm suggests a trapped nerve root in the neck [5]; and numbness in both the hands and the feet suggests a general cause such as diabetes [1][6]. Numbness that starts suddenly together with drooping of the face, a change in speech or weakness down one side of the body can be a sign of a stroke; emergency help should be called at once [7].
What causes numbness in the hand and fingers?
Numbness and tingling (pins and needles) come on when the blood supply to the nerves is cut off; this usually happens when you sit or lie on part of your body, lasts only a few minutes and usually stops once the weight is taken off [1].
Numbness that is constant or keeps coming back, however, may have a medical cause [1]. The main causes in the hand and fingers are:
- Compression of the median nerve at the wrist (carpal tunnel syndrome) [2][3]
- Compression of the ulnar nerve at the elbow (cubital tunnel syndrome) [4]
- A trapped nerve root in the neck (cervical radiculopathy) [1][5]
- Diabetes [1][6]
- Low levels of vitamin B12 or other vitamins, heavy drinking over a long period, an underactive thyroid gland and some medicines [1][6]
- Nerve damage after an injury or illness [1]
What is numbness a sign of: which fingers, and when?
Which fingers go numb, when, and in which position shows where the cause should be looked for:
- Thumb, index finger, middle finger and the thumb-side half of the ring finger: the median nerve supplies feeling to these fingers; this suggests carpal tunnel syndrome [2]
- Little finger and half of the ring finger: the ulnar nerve supplies feeling to these fingers; the commonest place for this nerve to be compressed is behind the inner side of the elbow [4]
- Numbness in the hand at night: very common in carpal tunnel syndrome, because many people sleep with their wrists bent; shaking the hand brings relief for many people [2]
- Numbness while holding a phone, driving or reading a book: carpal tunnel symptoms come on when the wrist stays bent for a long time [2], and ulnar nerve symptoms when the elbow stays bent [4]
- Tingling together with burning or sharp pain that travels from the neck down the arm: this suggests a trapped nerve root in the neck [5]
- Numbness, tingling or pain in both the hands and the feet: this can be seen in diabetes [1]
Carpal tunnel syndrome
In carpal tunnel syndrome the median nerve is compressed in a narrow passage at the wrist [2][3]. Weakness and clumsiness of the hand and dropping things may be added to the numbness, tingling and pain [2]. The symptoms often start slowly, come and go, and are usually worse at night [3].
According to the American Academy of Orthopaedic Surgeons (AAOS), it gets worse over time in most patients; if it is left untreated for too long, the loss of feeling and the weakness can become permanent [2]. Splinting, steroid injection and surgery are described in detail in the carpal tunnel syndrome article in this guide.
A numb little finger: compression of the ulnar nerve at the elbow
The ulnar nerve passes through a narrow tunnel (the cubital tunnel) behind the bony bump on the inner side of the elbow; there is little protective tissue over it there, and when the elbow is bent the nerve is both stretched and compressed [4].
Numbness and tingling in the ring finger and little finger are common symptoms; they often come and go and happen more often when the elbow is bent [4]. In more severe cases the grip weakens; if the compression is severe or long-standing, muscle wasting can develop in the hand, and this wasting cannot be reversed [4]. It is therefore important to see a doctor if the symptoms are severe, or if they are less severe but have lasted more than six weeks [4].
Numbness that comes from the neck
Compression or irritation of a nerve root where it branches away from the spinal cord in the neck (cervical radiculopathy) can also cause numbness in the hand; its main causes are age-related wear and tear and a herniated (slipped) disc [5]. The pain usually starts at the neck and travels down the arm; it may be accompanied by tingling in the fingers or hand, loss of feeling and muscle weakness [5].
The AAOS reports that the majority of these patients get better over time [5]. Numbness thought to come from the neck is assessed by the specialties that deal with disorders of the spine.
Diabetes, vitamin deficiency and other general causes
Numbness, tingling or pain in the hands and feet can be seen in diabetes [1]. According to the UK National Health Service (NHS), diabetes is the most common cause in the United Kingdom of damage to the nerves in the extremities (peripheral neuropathy) [6].
Other causes include low levels of vitamin B12 or other vitamins, excessive drinking for years, an underactive thyroid gland and some medicines [6]. With these causes the problem is not in the hand or wrist; assessment is carried out by the relevant specialties, such as internal medicine or neurology, and treatment depends on the cause [1].
What helps hand numbness?
Treatment depends on the cause [1]. According to the NHS, painkillers may ease carpal tunnel pain in the short term, but there is little evidence that they treat the cause [3]; a pharmacist or doctor can advise which one is suitable. Carpal tunnel syndrome sometimes gets better by itself within a few months, particularly when it has come on in pregnancy [3].
When non-surgical methods are not enough, when the nerve is very compressed or when muscle weakness has developed, an operation that relieves the pressure on the nerve may be recommended [2][4]. The measures that can be applied at home are [3][4]:
- In carpal tunnel syndrome, wearing a splint that keeps the wrist straight at night; it may take up to six weeks before an improvement is felt
- Stopping or cutting down on work that involves frequently bending the wrist or gripping hard
- Avoiding keeping the elbow bent for long periods, and not leaning on the elbow
- Keeping the elbow straight while sleeping at night; a towel can be wrapped around the elbow for this
Which doctor should you see for hand numbness, and how is it assessed?
If the numbness follows the territory of a nerve at the wrist or elbow, it is assessed by orthopaedics and traumatology or hand surgery.
At the examination, feeling and muscle strength in the hand and fingers are assessed, and the doctor checks whether lightly tapping over the nerve produces tingling in the fingers [2][4].
A nerve conduction study and EMG measure how well the nerve is working and help to identify where it is compressed and whether there is muscle damage [2][4]; they also help to distinguish a trapped nerve root in the neck from other conditions that cause similar symptoms [5]. In carpal tunnel syndrome additional tests are needed in some patients, not in every patient [2].
When not to wait
The symptoms of a stroke can come on suddenly: drooping of one side of the face and difficulty smiling, not being able to lift both arms and keep them there because of weakness or numbness in one arm, slurred or confused speech, and weakness or numbness down one side of the body [7]. If any of these is present, or has occurred within the last 24 hours and has now stopped, call emergency services at once (112 in North Cyprus and Türkiye); do not drive yourself to hospital [7].
Do not delay being examined in the following situations either [1][2][3][4]:
- The numbness has become constant or keeps coming back
- Weakness or clumsiness has started in the hand, or you are dropping things
- You have noticed thinning of the muscles at the base of the thumb or in the hand
- The symptoms are severe, have lasted more than six weeks or are getting worse despite measures at home
- The numbness started after an injury
Frequently asked questions
- Why does my hand go numb at night?
- Night-time symptoms are very common in carpal tunnel syndrome; because many people sleep with their wrists bent, the numbness can wake them from sleep, and shaking the hand brings relief for many people [2]. Sleeping with the elbows bent can also aggravate ulnar nerve symptoms [4].
- What is a numb little finger a sign of?
- The ulnar nerve supplies feeling to the little finger and half of the ring finger; numbness and tingling in these fingers are a common symptom of compression of this nerve at the elbow [4].
- Is tingling in the left hand or the right hand dangerous?
- Tingling that is confined to the hand and affects particular fingers is seen with compression of a nerve at the wrist or elbow [2][4]. Symptoms that start suddenly, together with drooping of the face, a change in speech, or weakness or numbness down one side of the body, can be a sign of a stroke; call emergency services at once [7].
- Why does the numbness in my fingers not go away?
- Numbness that does not pass within a few minutes, is constant or keeps coming back may have a medical cause [1]. According to the AAOS, carpal tunnel syndrome gets worse over time in most patients; if the symptoms are not going away or are increasing, see a doctor [2][3].
- Which specialty deals with numb fingers?
- If the numbness follows the territory of a nerve at the wrist or elbow, orthopaedics and traumatology or hand surgery deals with it; feeling and muscle strength are assessed at the examination, and a nerve conduction study is requested in some patients [2][4].
This article is a general summary; diagnosis and treatment decisions are made by the doctor who examines you.
Sources
- Pins and needles. NHS (nhs.uk), 2024. nhs.uk
- Carpal Tunnel Syndrome. American Academy of Orthopaedic Surgeons (OrthoInfo), n.d.. orthoinfo.org
- Carpal tunnel syndrome. NHS (nhs.uk), 2024. nhs.uk
- Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome). American Academy of Orthopaedic Surgeons (OrthoInfo), n.d.. orthoinfo.org
- Cervical Radiculopathy (Pinched Nerve). American Academy of Orthopaedic Surgeons (OrthoInfo), n.d.. orthoinfo.org
- Peripheral neuropathy - Causes. NHS (nhs.uk), 2022. nhs.uk
- Symptoms of a stroke. NHS (nhs.uk), 2024. nhs.uk
This article is general information and does not replace an examination or imaging. If you have symptoms, see a doctor.