Tingling hands and fingers: 8 possible causes and when to see your doctor

What do tingling hands and fingers feel like?

Tingling is a signal from your nerves. Nerves act like wires that send signals from your skin to your brain. If a nerve temporarily malfunctions, for example due to pressure on it, those signals can be transmitted differently. You may feel this as pricking, itching, a numb feeling, or a dull sensation.

It matters where you feel the tingling. For example, tingling in your thumb, index finger, and middle finger may have a different cause than tingling in your little finger, or tingling in your hands and feet at the same time. Therefore, pay close attention to which fingers are affected, when the symptoms start, and whether they disappear on their own. This information can help determine the cause.

The most common causes of tingling hands and fingers

Tingling hands can have many different causes. Below are a number of important causes, ranging from relatively harmless to causes that may require further investigation.

1. A temporarily pinched nerve

A common and harmless cause is temporary pressure on a nerve. For example, you may have been lying on your arm, kept your elbow bent for a long time, or leaned on your wrist for an extended period. Your hand may then go ‘asleep’.

If you change position and move your hand, the tingling usually disappears within a few minutes.

2. Carpal Tunnel Syndrome

In carpal tunnel syndrome, the median nerve is trapped in a narrow passage at the wrist. This can cause tingling, pain, or numbness, especially in the thumb, index finger, and middle finger, and part of the palm. Sometimes people experience symptoms in a larger part of the hand or arm.

The symptoms are often worse at night. Some people wake up with tingling or pain and notice that moving or shaking their hand helps.

Carpal tunnel syndrome occurs more frequently during pregnancy and in people with diabetes or obesity, among other conditions. Repetitive movements of the hand and wrist can also play a role.

A general practitioner can often recognize carpal tunnel syndrome based on the pattern of symptoms and a physical examination. A blood test is not necessary to diagnose the syndrome itself.

3. A pinched nerve in your neck

The nerves that run to your arm and hand originate in your neck. If a nerve root in the neck becomes irritated or pinched, for example due to changes in an intervertebral disc or wear and tear, tingling or pain can radiate through your shoulder and arm to your hand.

The symptoms are often on one side. Sometimes you also experience neck pain, but this is not always the case.

4. Breathing too fast due to stress or tension

During stress, anxiety, or a panic attack, people may unknowingly start breathing faster or deeper. This is called hyperventilation. As a result, the amount of carbon dioxide in the blood changes temporarily.

This can cause tingling in both hands or around the mouth. Dizziness, lightheadedness, palpitations, or a feeling of tightness in the chest may also occur.

Hyperventilation due to stress is usually not dangerous in itself, and the symptoms often subside when breathing becomes calmer again. However, rapid breathing or shortness of breath can also have a physical cause.

Do you have pain or a heavy, oppressive feeling in the chest that does not go away when you sit quietly, especially in combination with sweating, nausea, or severe shortness of breath? Then call 112.

5. Cold and Raynaud's phenomenon

In some people, the blood vessels in the fingers temporarily constrict strongly due to cold or sometimes due to stress. This is called Raynaud's phenomenon.

The fingers may first turn white and then turn blue or purple. They may also feel cold or numb. When blood flow resumes, the fingers often turn red and may start to prick or tingle.

An attack often lasts a few minutes, but can sometimes last longer.

Contact your GP if you experience severe pain, attacks last a long time, your fingers continue to tingle for an extended period, or if sores appear on your fingers without a clear reason.

6. Diabetes and high blood sugar

Prolonged high blood sugar can damage nerves. This is called diabetic neuropathy.

The nerve damage often begins in the feet and lower legs and can later spread to the hands. People may experience tingling, pain, a burning sensation, or conversely, reduced sensation.

Diabetes is one of the most common known causes of polyneuropathy. In addition, diabetes increases the risk of carpal tunnel syndrome.

7. A deficiency in vitamin B12 or folic acid

Vitamin B12 is important for the proper functioning of the nervous system and for the production of red blood cells.

With a long-term vitamin B12 deficiency, symptoms may arise such as tingling in the hands and feet, reduced sensation, balance problems, and clumsiness.

A folic acid deficiency is also associated with nerve complaints and can be included in examinations for polyneuropathy. However, neurological symptoms are clearer and better described in the case of a vitamin B12 deficiency.

Further on, you will read more about vitamin B12 and what a blood test can and cannot tell you.

8. Other causes

In addition, there are less common causes of tingling.

Examples include prolonged heavy alcohol consumption, certain medications such as some forms of chemotherapy, excessive vitamin B6 from supplements, kidney diseases, thyroid disorders, and various diseases of the nervous system.

Tingling can also occur with multiple sclerosis (MS). However, tingling alone is not specific to MS. With MS, other neurological symptoms usually occur as well, such as problems with vision, balance, sensation, or muscle strength.

Tingling hands and feet: what could that mean?

Do you have tingling in both hands and both feet? Then there may be a problem where multiple nerves are affected simultaneously. This is called polyneuropathy.

Polyneuropathy usually starts in the feet and lower legs. Some people describe a burning, tingling, or numb sensation, or the feeling as if they are walking on cotton wool. If the nerve damage spreads further, the hands may also become involved later.

Polyneuropathy can have various causes. Examples include diabetes, prolonged heavy alcohol consumption, certain medications, and deficiencies in certain vitamins, including vitamin B12.

In some people, no clear cause is found despite examination.

Do you have tingling in both your hands and feet that persists or slowly worsens? If so, have this assessed by your GP. The GP can perform a physical examination and possibly request blood tests to identify treatable causes.

Tingling hands at night or upon waking

Do you wake up at night or in the morning with tingling or numb hands? Then there are several possible explanations.

A common cause is your sleeping position. For example, you might lie on your arm or sleep for a long time with a severely bent wrist, causing temporary pressure on a nerve.

Another possible cause is carpal tunnel syndrome. In addition, the symptoms are often particularly noticeable at night.

It can help to keep your wrists as straight as possible while sleeping. If the symptoms keep recurring, worsen, or if you experience a loss of strength in your hand, discuss this with your GP.

Tingling hands during pregnancy

During pregnancy, the body retains more fluid. As a result, the space in the carpal tunnel at the wrist can become smaller. Carpal tunnel syndrome therefore occurs relatively frequently during pregnancy.

After delivery, these symptoms usually subside on their own.

However, tingling in the fingers can also occur during pregnancy in combination with symptoms consistent with pre-eclampsia.

Therefore, contact your midwife, gynecologist, or doctor immediately if you experience tingling during pregnancy in combination with, for example, severe headaches, blurred vision or flashes of light, pain in the upper abdomen, nausea or vomiting, or sudden swelling of your face.

Tingling in your left hand or arm: could it be coming from your heart?

Many people are startled by tingling in the left hand or arm because a heart attack can cause pain that radiates to the arm.

Tingling alone, without other symptoms, much more often has a different cause.

During a heart attack, there may be pain or a heavy, oppressive feeling in the chest that does not disappear when you sit quietly. The pain can radiate to an arm, the neck, jaw, back, or shoulder. Sweating, nausea, a pale complexion, and shortness of breath may also occur.

Do you have pain or severe chest pressure that does not go away when you sit quietly, especially accompanied by sweating, nausea, or shortness of breath? Then call 112.

Sudden reduced sensation or tingling in one arm can also occur with a stroke or TIA. Other symptoms may occur in addition, such as a crooked mouth, difficulty speaking, reduced strength in an arm or leg, difficulty swallowing, or sudden vision problems.

Do such symptoms appear suddenly? Then call 112, your GP, or the out-of-hours GP service immediately. Do this even if the symptoms have already disappeared.

Vitamin B12 and tingling: what is the connection?

Vitamin B12 is important for the proper functioning of your nerves and for the production of red blood cells.

A long-term deficiency can lead to nerve damage. This can cause symptoms such as tingling in the hands and feet, reduced sensation in the fingers or toes, balance problems, or clumsiness.

A vitamin B12 deficiency can also cause anemia. This can lead to symptoms such as fatigue, shortness of breath during exertion, or dizziness.

A deficiency can occur because your body does not absorb enough vitamin B12, for example, due to certain stomach or intestinal disorders or after some stomach or intestinal surgeries.

Certain medications can also affect the absorption or availability of vitamin B12. Additionally, people who eat a completely plant-based diet without sufficient vitamin B12 supplementation are at risk of a deficiency. Frequent use of nitrous oxide can also disrupt the function of vitamin B12.

It is important to know that tingling hands are not a specific sign of a vitamin B12 deficiency. There are many other possible causes.

A vitamin B12 deficiency is primarily investigated as a possible cause when the pattern of symptoms matches, for example, in the case of prolonged tingling or sensory disturbances in both the hands and feet.

Because neurological damage caused by a long-term vitamin B12 deficiency does not always fully recover, it is important to recognize a deficiency in a timely manner when appropriate symptoms are present.

What a blood test can and cannot tell you about tingling

A blood test cannot directly determine why your hands are tingling.

Carpal tunnel syndrome, a pinched nerve in the neck, or hyperventilation, for example, cannot be detected with a standard blood test. In these cases, the pattern of symptoms and any physical examination are more important.

Blood tests can, however, provide information about conditions that can cause nerve complaints.

When investigating polyneuropathy, for example, glucose and HbA1c, vitamin B12, folic acid, thyroid function, and kidney function can be examined. Which tests are necessary depends on the symptoms, medical history, and findings during the physical examination.

An abnormal blood value is not automatically the cause of the tingling. Conversely, a normal blood test result does not mean that all possible causes have been ruled out.

A vitamin B12 value must also always be interpreted in the correct context. If the result is unclear and there is a suspicion of a deficiency, a doctor may sometimes perform additional tests, for example by determining methylmalonic acid (MMA).

Do you want to know the status of your vitamin B12, folic acid, and blood sugar? At Zample, vitamin B12 and folic acid are measured in the Premium Blood Test and the Premium Blood Test Woman, along with glucose, HbA1c, and thyroid values, among others.

Vitamin B12 is also included in the Women's Blood Test Essential.

Do you have symptoms? Then discuss your symptoms and the results with your GP. A blood test does not replace a medical assessment.

When to see your GP about tingling hands?

Tingling that disappears quickly after changing position is usually not alarming.

Make an appointment with your GP if:

• the tingling persists, keeps recurring, or gets worse;
• you lose strength in your hand or regularly drop things;
• both your hands and feet tingle;
• you also develop other neurological symptoms;
• you have diabetes and notice new tingling or loss of sensation;
• the symptoms clearly disrupt your sleep or daily functioning.

Call 112 immediately for sudden onset of neurological symptoms such as a crooked mouth, difficulty speaking, sudden loss of strength, or severe sensory disturbances.

Also call 112 for chest pain or severe pressure that does not go away when you sit quietly, especially if this is accompanied by shortness of breath, sweating, or nausea.

Conclusion

Tingling hands and fingers often have a harmless cause, such as temporary pressure on a nerve due to your posture.

If the symptoms return regularly, carpal tunnel syndrome, another nerve compression, or hyperventilation caused by stress may play a role.

Do you have tingling in both your hands and your feet, or are the symptoms gradually worsening? Then there may be a problem involving multiple nerves. Diabetes and a vitamin B12 deficiency, among other conditions, can play a role in this.

Blood tests can help identify some possible causes, but usually cannot determine on their own why your hands are tingling.

Do the symptoms persist or worsen? Then discuss them with your GP.

Do you experience sudden loss of strength, a crooked mouth, difficulty speaking, or severe sensory disturbances? Or do you have chest pain or heavy pressure that does not go away when you sit quietly? Then seek immediate medical attention.