Numbness and Tingling

Dr. Steven Rueda is one of the most sought after doctors for hand numbness and tingling in Palm Beach. Sensation to the hands is provided by three nerves: the median nerve, ulnar nerve, and radial nerve. Symptoms of numbness and tingling arise when these nerves are irritated by injury or compression. This irritation can also result in pain or shocking sensations going down the hand and fingers. Treatment of numbness and tingling focuses on identifying which nerves are affected and the location at which this irritation or pinching is occurring.

Numbness and Tingling Symptoms and Diagnosis

Although numbness and tingling is the main symptom, it can also be accompanied by:


  • Pain in the hands and fingers
  • Electrical shooting sensation in the hands
  • Feeling of heavy or weak hands

In some cases patients present with symptoms that overlap different nerve areas and fingers. This is not unusual and reflects that there are some cross connections between these nerves. It is very important to make sure the problems are not arising from spine or neck problems. Numbness and tingling that starts in the neck and travels down to the hand is suggestive of spine problems.

The cause of numbness and tingling can usually be determined by history, physical examination, and nerve studies. A typical history and examination performed by a hand surgeon are usually enough to diagnose the condition. Nerves studies, also known as nerve conduction studies and electromyography (NCS and EMG), may be ordered to confirm the diagnosis or grade de severity. In some patients neck xrays or MRI may be necessary as well.

WHAT CAUSES Numbness and Tingling?

Nerves have very reliable patterns of function and symptoms that help pin point the problem areas. The median nerve provides sensation to the thumb, index, long, and half of ring finger. Numbness and tingling in these fingers usually indicates there is pinching in the median nerve.

Identifying the location of the pinching is more difficult and is usually done with a combination of imaging studies, nerves studies, and physical exam. The most common cause of a pinched median nerve is carpal tunnel syndrome.

The ulnar nerve provides sensation to half of the ring finger, and the pinky. Numbness and tingling in these fingers indicates pinching of the ulnar nerves. The most common location for pinching is at the elbow, also known as cubital tunnel syndrome.

The radial nerve provides sensation to the majority of the back of the hand. Numbness and tingling in these fingers indicates pinching of the radial nerve, however, problems with this nerve are much less common than the median and ulnar nerve. Pinching most frequently occurs at the wrist and forearm.
In some situations these nerves may be pinched in other locations including the neck or spine and cause similar symptoms.

Numbness and Tingling Treatment Options

The treatment of numbness and tingling depends on the nerve involved, the location of the problem, and the nature of the injury. In general, treatment begins with conservative measures like activity modification and use of splints. If these measures fail, options like steroid injections and surgery have to be considered.
Steroid injections work by decreasing nerve inflammation, however, they are not an option for every type of nerve injury. Injections work best for pinched median nerve at the wrist. Surgery is the final step of treatment for most of these conditions. Unfortunately, surgery is not an option for every injury and is mostly indicated for pinched nerves. If the injury is not from pinching it is less likely that surgery can be effective.
Some of the most common causes for numbness and tingling are:

  • Carpal Tunnel Syndrome
  • Cubital Tunnel Syndrome
  • Radial Tunnel Syndrome
  • Pronator Syndrome
  • Cervical Radiculopathy

Numbness and Tingling Procedure

Procedures for numbness and tingling are offered once a formal diagnosis has been made. Most patients suffer from carpal tunnel syndrome or cubital tunnel syndrome. The incisions for these procedures are reviewed in their individual sections. You can learn about them by clicking in each link. In the images below you can see the incisions used for the different carpal tunnel and cubital tunnel procedures. For those who suffer from other syndromes like radial tunnel or pronator syndrome, the treatment options are more complex and Dr. Rueda prefers to discuss them during the office visit.

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Most procedures for numbness and tingling are outpatient procedures. The patients are actually surprised at having less pain that they expected. There is tightness, swelling and bruising for first few days after surgery. An elastic bandage is applied and removed in a day or two and patients are free to wash their hands. Numbness, tingling, and pain gets better rapidly after the surgery for those with mild to moderate carpal tunnel or cubital tunnel syndrome. Those with severe carpal or cubital tunnel syndrome usually improve but may have residual symptoms.

Most patients generally return to work in 1 week. Exercise is not allowed until 3 weeks after the surgery.

Why Choose Precision Hand Center for your Numbness and Tingling Procedure?

Dr. Rueda, a Hand Fellowship trained surgeon who has 7 years and 2,000 procedures of experience will be your safe and best choice for numbness and tingling. Successful results in this procedure requires a surgeon that is experienced and knowledgeable in hand surgery and hand anatomy. Dr. Rueda has published articles in expert peer reviewed journals and his work has been presented in several national conferences. Dr. Rueda’s passion for patient education and custom centered approach will guarantee you feel comfortable every step of the way. Dr. Rueda also believes in treating his patients as if he was treating his own family; you can trust you will enter a trusting and long-term relationship and have some of the best numbness and tingling treatment Palm Beach can offer.


Nerve studies can be very useful for helping diagnose the cause of numbness and tingling. These are called nerve conduction study and EMG. In some cases the cause can be very clear from physical examination alone, and Dr. Rueda may postpone obtaining these additional studies. 

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