Articles Management of Pins and Needles and Numbness in the Upper Limbs and Hands

April 4, 2019

Pins and needles and numbness into the upper limbs and hands is a common symptom experienced by many. This condition can often be managed through exercise and life style modification.

The nerves in the upper limbs all arise from the neck, as they descend towards the hands they branch off into 3 main nerves :

  • Medial Nerve
  • Ulnar Nerve
  • Radial Nerve

Trauma, compression and/or inflammation anywhere along the nerves can give rise to weakness, pins and needles and numbness into the upper limbs and hands. Common causes include:

  • carpal tunnel (nerve compression at the wrist )
  • cubital tunnel (nerve compression at the elbow)
  • injuries to the cervical spine 
  • sedentary postures 
  • repeated/prolonged over head activities 
  • compression of nerves and blood vessels under the collar bone (thoracic outlet) 
  • secondary injuries following fractures or joint dislocations
  • following an episode where the arm was suddenly pulled (brachial plexus traction injury)

It is important to be thoroughly assessed  by a medical professional to identify the causes of these symptoms as this will not only direct treatment but also prevent a deterioration in your condition. 

Things to Try

  • modifying your work station set up
  • have frequent breaks from your desk
  • changing postures frequently
  • supporting your arms when using mobile devices and reading
  • modifying aggravating activities ( repeated/prolonged gripping, reducing overhead activity)
  • wearing wrist splints (for carpel tunnel) or posture braces
  • using heat packs, pain relieving ointments (i.e. Voltaren) and TENS machines can help to lessen the need for pain medications
Have your arms supported when using mobile devices

Exercises

From a physiotherapy perspective we often prescribe exercises to:

1. Improve posture thereby allowing the nerves to travel through the body more freely

2. Promote flexibility and movement of the nervous system

A few basic examples have been provided below to get you started. Please note, it is always best to see a health professional to tailor an exercise program for your specific needs.

Stretches

These exercises can be held for at least 20-30 seconds and performed frequently through out the day. Please note, nerve tissue is very sensitive , you should be very gentle and gradual with these exercises.

Neck and Upper Back

Upper trapezius stretch
Thoracic extension
Pectoral stretch

Upper Limbs 

Posterior capsule stretch
Biceps stretch
Flexor forearm stretch
Ulnar Nerve Stretch- If you experience symptoms into the ring and little finger
Median Nerve Stretch- If you experience symptoms in to the thumb, 1st and 2nd finger

Strengthening

These exercises should be done with a medium/high amount of repetitions (approximately 15-20 repetitions per set) a couple of times per day.

We are trying to target specific muscles and improve your posture, a few things to remember are:

  • try to keep your shoulders down and back, don’t let your shoulders hunch up while exercising (see image below)
  • focus on form, your movements should be slow, smooth and controlled
Reverse fly
Row
Triceps extension

A Few Notes

  • It is normal to have some discomfort and pain when commencing a new exercise routine
  • Start off small and build up gradually, you can cause more problems if you progress your exercises too quickly
  • If any of the above exercises significantly exacerbate your pins and needles and numbness. Please cease the exercise and seek advice from a health professional

Red Flags!

These are signs and symptoms of more serious causes and require urgent medical review:

  • increasing clumsiness and weakness in the hands,
  • symptoms into both upper limbs and hands
  • symptoms are also associated with a lack of balance and changes in gait pattern
  • onset of symptoms following trauma (i.e. fall, car accident)
  • If you get also get symptoms at night that does not change with activity

Please keep in mind the information provided is general in nature and should not be used as a substitute to consult your treating health professional. If you have any specific questions or require assistance with your individual treatment requirements please do not hesitate to contact My Family Physio Mona Vale.

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