‘Pins and needles’ is a symptom that often identifies injury to the nerve. Other symptoms include: burning, numbness, tingling, hypersensitivity or lack of sensation. There are three main nerves that supply the arm and hand called the median, radial and ulnar nerves. The location of your pins and needles, or numbness, can determine which nerve has been affected.
Any injury or long-term compression to these nerves can result in sensory or motor impairment. Nerves most commonly incur injury or compression when running through tunnels, over bones or between muscles. These land marks often have names and tests to identify if a nerve is being impacted at that point.
The thumb is innervated by both the sensory branch of the median and radial nerves. The ulnar nerve supplies some muscles to palm of the thumb.
The median nerve runs along the palm of the hand and thumb up to the tip. A common compression of the median nerve is known as carpal tunnel syndrome, as it gets squashed passing through a small tunnel on the wrist. Carpal tunnel syndrome is associate with tingling or nerve pain to the palmar thumb, index finger and middle finger.
The radial nerve supplies the dorsal or back of the thumb. It is associated with tingling over the back of the hand, thumb, index and middle fingers. The radial nerve dives between 2 muscles in forearm near the elbow, called the radial tunnel. It can also be compressed at the wrist on the thumb side.
It is important to identify which nerve and which area of the body the nerve is being compressed to target exercises and therapy. Your therapist will perform special tests which target different nerves and muscles to identify the injury and impact.
Therapy can assist alleviate symptoms by relieving the compressed nerve. These include:
Nerve gliding exercises
Reducing swelling or inflammation
Reducing tight muscles with massage or stretching
Splinting to correctly position joints
InterX therapy (an interactive neuro stimulus device that we have in our rooms)
Nerves are slow to heal and can take time to recover from long term compression so early management when you first start to notice changes is recommended.