Tingling Fingers

[hDOG]

Three Months ago I  believe I injured my hand walking my 90 lb lab because I was holding his leash with one hand and pushing my daughter' s stroller with the other.  I began to experience tingling in my thumb, middle and index fingers.  It occured on and off since it occured three months ago.  I am also having to hold and pick up my daughter as she is 21 months old.  

Could the tingling I am still experiencing be from three months ago?  It is better than what it was.  How long should I wait before going to see a specialist regarding this matter?

[Lama Chahine, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history I can not comment on the exact cause of the tingling in your hand but I will try to provide you with some information. It sounds like you have some tingling in your thumb, index, and third digit.

There are several nerves that supply innervation (electricity) to the arm. These nerves are made up of different root nerves as they exit the spinal cord. The particular nerve that supplies the first 3 digits of the hand is called the median nerve. This nerve starts at the elbow (coming off a bundle of nerves) and runs to the wrist, giving of branches. It supplies both sensory and motor innervation: it allows you to feel the inner part of your forearm and hand and allows you to carry out particular movements.

The median nerve can be injured anywhere along its course. If your symptoms are confined to just your hand, it may be the nerve was injured somewhere at the wrist. It is possible that the nerve was injured during the incident 3 months ago when you were walking your dog; the type of injury in this case would most likely be a stretch or pulling type of injury. However, other possibilities that might explain your symptoms include carpal tunnel syndrome. the carpal tunnel is the area in the wrist that the median nerve passes through. If the median nerve is compressed in the carpal tunnel, it causes symptoms similar to yours. The symptoms are often worst at night. Carpal tunnel syndrome can be caused by repetitive movements at the wrist like typing. Treatment includes wearing a wrist brace and in severe cases surgery.

The benefit of being evaluated for your symptoms is to make sure that there is no associated problem that you may not have picked up on, like subtle weakness in your fingers or other muscles. This would imply that the nerve damage is more severe. On the other hand it may be minor injury and all you might need is observation at this point. You might benefit from a wrist brace or other methods to provide you some relief of your symptoms. At this point evaluation by a general physician would allow for you to get an opinion from him/her regarding the need to see a neurologist. If you are seen by a neurologist he she may decide to do further testing based on your examination, such testing would test the function of the nerves (the text is called a nerve conduction study (NCS) and an electromyography (EMG)).


Thank you for the opportunity to answer your questions, I hope you find this information useful, good luck.

[hDOG]

I went to an orthepedic surgeon, and he did examine my wrist and hand, and found that I had carpal tunnel syndrome.  Gave me some stretches to do.  Can he make a correct diagnosis based on an exam in the office?  

He said it was not very severe, and to just keep a watch on it.