The right diagnosis is key when you feel your hand go numb, an expert says.
When your hand starts to tingle or go numb, it’s natural to assume that carpal tunnel is to blame.
But it could be cubital tunnel instead, says University of Rochester Medical Center hand surgeon Hannah M. Smith. A misdiagnosis can lead to delayed treatment, the wrong splint, or continuing symptoms that affect your quality of life.
Smith, a fellowship-trained hand surgeon and assistant professor in plastic surgery and Orthopaedics at UR Medicine, helps patients understand what their symptoms mean and what to look for to get the right diagnosis.
Carpal tunnel and cubital tunnel require completely different treatments. Getting the right diagnosis at the right time helps prevent:
- Permanent nerve damage
- Muscle wasting (muscles shrinking because the nerve is not working well)
- Loss of grip strength
- Progression that may require surgery
Cubital tunnel vs. carpal tunnel
Understanding which nerve is affected is the first step toward proper treatment for your symptoms.
Carpal tunnel syndrome
What it is: Compression of the median nerve (the nerve at the wrist that controls the thumb and gives feeling to the thumb, index finger, middle finger, and half of the ring finger).
This often feels like:
- Tingling, burning, or numbness in the thumb, index, middle finger, and half of the ring finger
- Symptoms that feel worse at night
- Trouble with small tasks like buttoning shirts or pulling zippers
- Dropping objects
Cubital tunnel syndrome
What it is: Compression of the ulnar nerve (the nerve that runs along the inside of your elbow and controls many small hand muscles and gives feeling to the pinky finger and half of the ring finger).
This often feels like:
- Numbness, tingling, or burning in the ring and little fingers
- Aching pain in the elbow
- Trouble spreading the fingers apart
- Symptoms that worsen when the elbow is bent (driving, holding a phone, sleeping)
What causes cubital tunnel, and who’s at risk?
Cubital tunnel occurs when the space around the ulnar nerve at the elbow becomes too tight or irritated. You may be more likely to develop it if you frequently keep your elbows bent or lean on hard surfaces, have a history of elbow injuries or arthritis, or play sports or work jobs that require repeated or prolonged elbow use.
What else can cause hand tingling?
Carpal tunnel and cubital tunnel are common, but not the only causes.
Conditions with similar symptoms to carpal tunnel
- Pronator syndrome (median nerve compression in the forearm instead of the wrist)
- Cervical radiculopathy (a pinched nerve in the neck that travels down the arm)
- Diabetic neuropathy (nerve damage caused by diabetes)
Conditions with similar symptoms to cubital tunnel
- Guyon’s canal syndrome (ulnar nerve compression at the wrist instead of the elbow)
- Thoracic outlet syndrome (pressure on the nerves or blood vessels near the collarbone)
- Problems with the network of nerves that run from the neck to the arm
Less common but important causes of numbness and tingling
- Thyroid disease
- Vitamin B12 deficiency
- Autoimmune disorders
- Effects of chemotherapy
- Circulation problems that mimic nerve symptoms
- Double crush syndrome: the nerve is compressed in more than one place
When to see a hand specialist
Seek medical help if:
Symptoms last more than a few weeks or interfere with daily tasks
Tingling happens daily or wakes you from sleep
You feel weakness or hand clumsiness
Source: University of Rochester
