If it tingles, it’s carpal tunnel, right?

Not necessarily. Hand numbness, tingling or pain can have many causes — and treatments.

By Heidi Tyson, OT, CHT, hand therapy specialist at The Portland Clinic

Woman sitting at a table with laptop open, holding her right wrist with her left hand

In the wake of the pandemic, as more Portlanders have transitioned from ergonomically designed offices to working from home, many also have started experiencing numbness or tingling in their hands and fingers. Kitchen tables, living room sofas and TV trays, as it turns out, are not ideal working conditions for the human body. In addition to causing other problems, sitting in certain positions all day can irritate or compress the nerves that lead to the hands. In short, the pandemic is literally getting on our nerves.

Many folks assume that tingling means carpal tunnel syndrome, but it doesn’t always. Carpal tunnel is just one of many nerve-compression syndromes that can cause tingling, numbness, pain or weakness in the hands or fingers. Sometimes these symptoms aren’t caused by nerve compression at all — often, they’re just the result of temporary, activity-related nerve irritation. Finding out what’s causing your symptoms is the first step toward effective therapy.

What’s behind the tingling?

Poor work ergonomics can play a big role in nerve compression syndromes, but other things can get on your nerves, too, such as: 

  • Performing assembly work or tasks that require tight pinching and gripping
  • Sleeping with an arm bent more than 90 degrees
  • Spending long hours at a keyboard with your wrists bent

Seeing a health care provider to get the right diagnosis is important, because not all nerve syndromes are created equally, and neither are their treatments. Nerve irritation or compression can happen at any point along the nerve, from the neck to the biceps, the inside of the elbow or the wrist. A doctor, physical therapist or hand specialist can help determine where the point of compression is so we can target the right therapies to relieve it.

A handful of treatment options

Depending on where your nerve issue originates, there may be several options for relief. Some common approaches include:

  • Modifying activities: an occupational or physical therapist can take you through your daily routines — from home-maintenance tasks to workouts, hobbies, and even holding the dog’s leash — and coach you in specific ways to do them differently to reduce the irritation on your nerves.
  • Making posture changes: good body posture can make a big difference. Postural exercises can help relieve many types of nerve irritation.
  • Bracing or splinting: many types of nerve compression respond well to splinting or bracing, either during the day or at night. Your health care provider can make sure that the right type of splint or brace is chosen for your specific issue.
  • Manual therapy: several hands-on physical therapy techniques can help relieve discomfort from nerve compression or irritation.
  • Nerve mobilization: nerves need constant motion to stay healthy and avoid adhesions (areas of scar tissue that act like glue). Trained therapists can use different techniques to get the nerve moving and to decrease the irritation.

Some types of nerve compression can be surgically treated, but there are many things we can try together before you get to that point. Often, it’s just a matter of making a few modifications in your day-to-day activities.

If work and life are starting to get on your nerves, pay more attention to your body: move, stretch, take breaks every 20 minutes from sitting and repetitive movements, and avoid contact pressure, such as resting your wrists on the table when typing. If you start to notice tingling, numbness or pain in your fingers, hands or wrists, don’t let it go on too long. As with most health issues, the sooner you address it, the sooner you’ll have one less thing to be irritated about.