Neuropathy in Hands: Feeling, Causes, Slowing Damage

Jul 16, 2023

Neuropathy of the hands can occur alone or with neuropathy of other extremities

Peripheral neuropathy is a type of nerve damage. Most peripheral neuropathies affect the fingers, hands, toes, and feet, but carpal tunnel syndrome is a type of neuropathy that specifically affects the hands.

The symptoms can include tingling, diminished sensation, and weakness, and it can happen as a consequence of many different underlying medical conditions, such as malnutrition, untreated diabetes, and alcohol.

Medical treatment can alleviate discomfort, and some therapies may help prevent the progression of peripheral neuropathy. This article will discuss the symptoms of neuropathy in the hands, causes, treatment, complications, and specialists to see for the condition.

Peripheral neuropathy is damage of the peripheral nerves. These include nerves that travel throughout the body to detect and relay sensory information from the skin, as well as nerves that directly stimulate muscle movement.

Neuropathy is usually a gradual process. The nerve damage can begin months or years before symptoms develop. There are a few types of rapidly progressive peripheral neuropathy, and treatment is more likely to cure the condition when neuropathy occurs very quickly than when it happens gradually over time.

Symptoms of hand neuropathy usually begin in the tips of the fingers before progressing to the hands or arms.

Neuropathy of the hands feels like:

The uncomfortable symptoms can often fluctuate, and it can feel worse when you are tired. Sometimes, the variation in discomfort can occur without any pattern.

With peripheral neuropathy, the loss of sensation and weakness tend to worsen over time, and you shouldn't expect improvement in these symptoms when they've occurred.

It’s common for people with neuropathy in the hands to also have neuropathy of the feet. Peripheral neuropathy can affect the feet before it affects the hands.

Generally, neuropathy affects distal parts of the body—these are the parts that are farthest from the center of your body, such as the fingers and toes or the hands and feet. These distal areas have tiny nerve branches that facilitate movement and sensation. Tiny distal nerve branches are more susceptible to damage.

Neuropathy develops due to nerve damage. Several different medical conditions and risk factors can cause damage to the body's nerves.

Nerve damage can occur due to inflammation, lack of proteins, or toxin exposure.

Common causes of hand neuropathy include:

Nerves are protected by fatty insulation called myelin. Usually, demyelination (myelin damage) occurs before the nerve cells are damaged. Some types of neuropathies are reversible with treatment, such as the inflammatory demyelinating neuropathy of GBS or CIDP.

Many types of neuropathies—such as diabetic neuropathy or alcoholic neuropathy—are not reversible, but the symptoms of discomfort can be managed with medication.

Neuropathy in the hands can be diagnosed based on symptoms, physical, examination, and diagnostic testing. Usually, with hand neuropathy, the physical examination will identify diminished sensation in the fingers and hands. Additionally, reflexes are diminished, and weakness may result.

Diagnostic testing may include electromyography (EMG) and nerve conduction velocity (NCV) studies, which may show changes indicative of nerve damage.

The treatment for neuropathy in the hands is the same as for neuropathy anywhere else in the body. It is directed toward the cause.

Treatments include:

These treatments may help prevent neuropathy from getting worse. If intervention begins at an early stage, it can prevent the condition from causing significant symptoms.

In addition to preventing further nerve damage, treating neuropathy in the hands may also involve pain control.

This type of pain is described as neuropathic pain, and the treatment for it is different than it is for pain from a cut or a broken bone. It’s important that you talk to a healthcare provider to make sure that your pain management is appropriate for neuropathy.

Additionally, some treatments might be contraindicated if you have an underlying disease, so you need to be sure that you don’t have any contraindications—even before you start using over-the-counter (OTC) therapies.

Therapies for pain from hand neuropathy can include:

Hand neuropathy can have consequences that affect your abilities and your health. Sensory loss and weakness can lead to injuries and infections. You can have an increased chance of hurting your hands without full strength.

When your hand sensation is diminished, you might not be able to feel injuries or early symptoms of an infection—and if these issues go untreated, they can become serious.

Complications of hand neuropathy can include:

You can also lose your ability to manage day-to-day tasks and self-care. Doing things like buttoning buttons or shaving can be difficult when you lose motor control.

If you have neuropathy of the hands, you need medical care from a team of specialists. Your care involves medical treatment of the underlying condition causing your neuropathy, pain control, and therapy exercises to help you manage the disability of living with neuropathy.

Specialists you might need to see include:

Neuropathy of the hands is common. It can develop as part of peripheral neuropathy that affects the hands and feet. Hand neuropathy can develop specifically due to carpal tunnel syndrome.

Peripheral neuropathy may cause discomfort, diminished sensation, and weakness. If you have any of these symptoms, a healthcare professional can diagnose your condition with a physical examination and possibly diagnostic testing.

Treatment of peripheral neuropathy includes symptomatic management and treatment of the underlying cause. You may need physical and occupational therapy to help you maintain the best control of your movements when living with peripheral neuropathy.

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By Heidi Moawad, MDHeidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.