Doctors' Choice Physical Medicine

Schuylkill County: Hand Pain, Tingling, and Numbness

Pottsville PA: Do you have hand problems that have their cause from pinched or irritated nerves?  Arthritic pains from joints occur with these symptoms.  Sometimes there is no hand pain at all, just tingling and numbness.  Many patients think they may have poor circulation.

When hand pain strikes, it can be a difficult problem to deal with since we use our hands for so much: our work, our play.  It can also be distressing psychologically to have a part of your body not working as it should.  Here are three causes.

Hand Pain From Carpal Tunnel, Thoracic Outlet, or a Pinched Nerve in the Neck?

Hand pain can be a difficult thing to diagnose since there are many causes of hand pain. One familiar cause is a carpal tunnel syndrome. This is where the bony tunnel in the wrist is narrowed, pinching or irritating the nerves that pass through and go into the hand.

Another cause for hand pain is a thoracic outlet syndrome. The thoracic outlet can be compressed in the shoulder girdle region causing hand pain.  Many times raising your hands above your head can bring on the symptoms.

Another problematic area to consider with hand pain is in the neck.   This could be a disc lesion compressing the nerves in the neck causing referred or radicular (nerve root) pain into the hand. 

All of these problems have very similar symptoms in the hands.  Here are some others.

These three problems can independently cause hand symptoms or they can all co-exist to varying degrees.  You are entitled to more than one cause, correct?  Getting a proper diagnosis is the first key to a full correction of a problem.  If your hand pain is being treated with an anti-inflammatory, there may be a reduction in symptoms but pain medications cannot release a pinch or irritated nerve.

You might also want to consider that pain or tingling is a signal.  The problem that is causing the symptom should be your focus.  When the fire alarm goes off at home, do we think to turn off the fire alarm, or put out the fire?  Pain or a symptom is the fire alarm, not the fire.

Find The Cause Of Hand Pain

Recent research (Nord KM, et. al. False positive rate of thoracic outlet syndrome diagnostic maneuvers. Electromyogr Clin Neurophysiol 2008;48:67.) has shown that differentiating between these three unique disorders with clinical tests can be problematic, since false positive tests are more a rule, rather than an exception. Patients with carpal tunnel syndrome were one of the most frequently misdiagnosed groups of patients.

You may also need special x-rays views of your of your wrist and neck region to fully get at the cause of your hand pain or symptoms and determine the best course of action.  Sometimes more advanced tests like Electromyograms and Nerve Conduction Velocity Studies (EMG and NCV) are necessary.

Conservative Care Before Carpal Tunnel Surgery  For Hand Pain 

All of these three problems respond well to conservative care, like chiropractic and physical therapy, is an often-overlooked form of care.  At our office, we use a type of stretching device to stretch the shortened ligament at the wrist.  It carries very low risks.  This type of therapy should be a first option for anyone who is considering wrist surgery.  We have helped many people avoid carpal tunnel surgery.

We may be able to help.  Check out or blog on this website for more information.

Doctors’ Choice Physical Medicine and Rehab

Dr. David Novatnak

Glee Pascual, Physical Therapist

Pottsville, Schuylkill, PA