Tingling or numbness in the hands can show up without warning. Maybe it’s a pins-and-needles feeling when you wake up, or a dull sense of weakness after working at your desk. While the cause can be simple, like temporary pressure on a nerve, it can also point to something that needs attention.
This guide walks through what causes hand tingling, the difference between carpal tunnel vs other causes of pinched nerves, and how physiotherapy for hand numbness can help you figure out what’s going on.
Is Hand Tingling Something Serious?
Most hand tingling isn’t a medical emergency, but certain symptoms require immediate attention. Understanding when to worry can save you unnecessary stress while ensuring you get help when it matters.
When to Seek Emergency Care
Get immediate medical attention if you experience:
Stroke Warning Signs:
- Sudden numbness affecting your entire arm or one side of your body
- Facial drooping, speech difficulties, or confusion with hand symptoms
- Severe headache or dizziness accompanying the tingling
Heart-Related Concerns:
- Chest pain, shortness of breath, or nausea with left arm tingling
- Sweating and anxiety, along with the numbness
Serious Nerve Damage:
- Complete loss of sensation or inability to move your fingers
- Severe weakness preventing you from gripping objects
- Tingling that spreads rapidly up your arm
When It’s Likely Not an Emergency
Most cases develop gradually and relate to nerve compression rather than life-threatening conditions. You can usually manage these with proper care and treatment.
Have questions about your hand tingling? We’re here to help. Contact us to book a session or speak with a physiotherapist.
What Causes Hand Tingling or Numbness?
There isn’t a one-size-fits-all answer. Tingling can come from nerve compression, irritation, or poor blood flow. Sometimes it starts in the hand. Other times, the problem begins further up—at the elbow, shoulder, or even the neck.
The most common reasons people experience tingling or numbness in the hands are:
1. Carpal Tunnel Syndrome
This one gets a lot of attention, and for good reason. Carpal tunnel syndrome happens when the median nerve—which runs through a space in your wrist called ‘the carpal tunnel’—gets compressed, especially for people who:
- Work at a computer
- Use hand tools
- Drive for long hours
- Carry babies or toddlers
- Sleep with their wrists bent
Carpal tunnel syndrome affects the median nerve at the wrist and can cause:
- Tingling in your palm of the hand, thumb, index, and middle finger
- Numbness or burning that wakes you up at night
- Weakness or clumsiness in your grip
2. A Pinched Nerve in Your Neck
If the tingling travels down from your shoulder or starts after a long day at the computer, the issue might not be your wrist at all. It could be your neck. We see this often in people who:
- Sit with a forward head posture
- Drive or look up or down for long stretches
- Sleep without neck support
- Have a history of neck tension, arthritic joints or disc issues in the neck
- Have suffered from an injury, such as a fall or car accident
Common signs include:
- Tingling that travels from your neck down your arm
- Symptoms that worsen with certain neck positions
- Neck stiffness, headaches, or pain
- Weakness in specific finger patterns (depending on which nerve is involved)
3. Thoracic Outlet Syndrome
This condition shows up when nerves (and/or blood vessels) are compressed just above your collarbone, in an area called the ‘thoracic outlet’. This condition is less common, but still something we assess for—especially in people who:
- Work overhead (electricians, painters, hairstylists)
- Carry heavy bags on one or both shoulders
- Have rounded posture from sitting or standing all day
- Have experienced some sort of trauma, such as a car accident
It causes pressure on nerves and blood vessels above the collarbone. You might feel:
- Tingling or numbness in the arm and hand
- A heavy, tired feeling in your arm after working or lifting
- Sensitivity to holding your arms overhead
- Feeling like your hand is cold and may appear slightly purple or discoloured
4. Peripheral Neuropathy
When both hands are affected—or when tingling is accompanied by burning or numbness in your feet too—it might point to a condition affecting your peripheral nerves.
That includes:
- Diabetes
- B12 deficiency
- Thyroid conditions
- Certain medications
- Autoimmune diseases
- Long-term alcohol use
Other signs might include burning, balance changes, or sensitivity in your hands or feet. This type of nerve pain in the hands usually requires a team approach with your doctor and physio.
5. Ulnar Nerve Compression
If your pinky and ring fingers are going numb, the ulnar nerve is likely involved. This nerve runs along the inside of your elbow – it’s often referred to as the ‘funny bone’ when you hit it. The ulnar nerve can get compressed or irritated when you:
- Lean on your elbows
- Sleep with your arms bent
- Work with tools for long periods
- Bang the inside of the elbow
This is sometimes called cubital tunnel syndrome. It is especially common in tradespeople, cyclists, desk workers, and side sleepers.
6. Positioning and Circulation
Sometimes, it’s just how you’re sitting, lying, or holding something.
Examples:
- Falling asleep on your arm
- Resting your wrists on a sharp desk edge
- Holding a phone or tablet with bent wrists
- Slouching with your head forward
If tingling goes away quickly after moving or shaking out your hand, it may not be serious—but if it keeps happening, it’s worth getting checked out.
Why Does Hand Tingling Only Happen at Certain Times?
Many people ask: “Why are my hands numb at night?” Here are some common patterns we often see:
Hand Numbness While You Sleep
Sleeping with bent wrists or elbows can compress nerves for hours at a time. Many people wake up with tingling, especially if carpal tunnel or cubital tunnel syndrome is developing.
Waking Up With Tingling Hands
If you wake up and your hand is asleep, it’s likely due to your body position during your sleep. Symptoms may fade as you move but return the next night.
Tingling During Driving or Phone Use
Holding your arm in one position with pressure at the wrist or elbow can irritate the nerves. Small posture changes can help.
Numbness In Both Hands vs. Just One
Single hand tingling often suggests:
- Local nerve compression like carpal tunnel
- Position-related pressure on specific nerves
- Repetitive strain on one side
Both hands simultaneously may indicate:
- Systemic conditions like diabetes
- Anxiety or hyperventilation
- Cervical spine problems affecting both sides
- Medication side effects
Numbness Just in Your Pinky and Ring Finger
This pattern typically indicates ulnar nerve compression at your elbow (cubital tunnel syndrome). The ulnar nerve controls sensation in these fingers, so when it’s compressed, you’ll feel numbness specifically in this area.
Hand and Foot Tingling Together
When tingling affects both your hands and feet, systemic conditions become more likely. Diabetes, vitamin B12 deficiency, and certain autoimmune conditions can cause peripheral neuropathy affecting multiple areas.
Burning Pain Along with Numbness
When tingling shifts into burning, zapping, or “electric” sensations, it often means the nerve is more irritated. This can happen with:
- Ongoing compression in the neck or wrist
- Nerve inflammation
- Certain types of neuropathy
Pain like this usually needs professional assessment and active treatment.
If tingling in your hands is affecting your sleep, work, or day-to-day activities, don’t wait.
How Do I Know if It’s Carpal Tunnel or a Pinched Nerve?
We often get this question. Here’s a basic description of how we usually tell them apart:
| Factor | Carpal Tunnel | Pinched Nerve in Neck |
|---|---|---|
| Location of compression | Wrist | Cervical spine |
| Tingling area | Palm, thumb, index, middle finger | Usually includes parts of the arm or hand |
| Onset triggers | Repetitive hand use, sleep positions | Poor posture, screen time, tilting/rotating head |
| Other signs | Weak grip, wrist stiffness | Neck pain, shoulder tension, hand weakness |
| Timing | Often worse at night | May vary with neck positions |
A full physiotherapy assessment will include nerve tension tests, joint mobility checks, and a look at how your posture may be contributing.
What Tests or Treatment Do I Need?
At your first physiotherapy appointment, we’ll:
- Ask questions about when and where you feel symptoms
- Watch how your body moves through specific tests
- Check nerve tension and joint mechanics
- Review your posture and activity habits
We might also recommend follow-up with your doctor if we suspect a systemic condition.
Common Physiotherapy Treatments for Hand Tingling
Based on your assessment, a customized treatment plan may include:
- Manual Therapy
- Myofascial Release
- Nerve gliding exercises (nerve flossing)
- Posture retraining
- Targeted strengthening, stretching and mobility exercises
- Ergonomic advice, education and prevention
- Dry needling (IMS) or acupuncture
- Cervical Traction
- Massage Therapy
Physiotherapy is often very effective for managing nerve pain in the hands, especially when caught early. If something doesn’t feel right, booking an assessment can help you understand the cause and take the guesswork out of treatment.
What Stretches and Exercises Help with Hand Tingling?
Home tips to try now:
- Keep wrists neutral while sleeping (a wrist brace can help) and while working on your computer
- Avoid leaning on your elbows
- Take frequent breaks from screens and tools
- Use ergonomic positioning for computer work
- Gently stretch your neck, shoulders, and forearms
- Use a proper pillow to keep your neck in a neutral position
We offer customized fitting for pillows through Pillowise that will fit you properly and take into account your sleeping position and bed firmness. Contact us to book a customized pillow fitting.
Physiotherapy can guide you through nerve gliding exercises, posture correction, and hands-on treatments to reduce nerve irritation.
When to See a Physiotherapist for Hand Numbness
Tingling that comes and goes may not need treatment—but if it’s becoming more frequent, sticking around longer, or affecting your ability to use your hand, it’s time for an assessment.
We help people every day who are dealing with symptoms just like yours. Our goal is to figure out what’s behind it and build a plan that fits into your life.