We are familiar with the expression "my foot has fallen asleep". This sensation is caused by a change in the functioning of a sensory nerve and is known in medical circles as paraesthesia. It can occur in any part of the body, but is most common in the fingers and feet. In the former, it may be associated with carpal tunnel syndrome. In the latter, diabetic neuropathy may be the cause. This article will deal with tingling or numbness as it applies to these two conditions, although there are many other conditions such as impingement of the cervical nerves or sciatica that may also produce paraesthesia.
Carpal tunnel syndrome is a repetitive injury which causes the median nerve that supplies the hand to become compressed. Symptoms are pain, numbness and tingling in the palm of the hand and the fingers as well as possible swelling around the wrist crease. Some people have associated muscle weakness that makes it difficult grasping items and pain may also radiate up into the arm. Women are more prone to this condition than men. Forceful, repetitive movements such as is done by manual labour workers or repetitive wrist action such as with factory production line workers or store checkout attendants are usually to blame.
Conservative treatment by a physiotherapist for patients with carpal tunnel syndrome is usually recommended after initial diagnosis. Physiotherapy involves anti-inflammation techniques such as ice and massage, stretching and strengthening exercises to restore function and decrease pain and quite often splinting of the hand is also advised.
If splinting and physiotherapy does not help, you may need surgery. Following surgery, physiotherapy is again prescribed. Your physiotherapist will recommend that you avoid repetitive wrist and hand activities that put strain on the nerve. Exercises that stretch the muscles of the wrist area, and deep tissue massage to get rid of scar tissue are vital in the treatment of this condition after surgery.
Diabetic neuropathy is characterised by loss of sensation in addition to tingling and numbness in the hands as well as the feet. Contractures and hammer toes may sometimes be the result. Physiotherapists aim to reduce pain through massage and joint mobilisation and we provide exercises to decrease the contractures and promote blood flow to the part. Physiotherapists also train patients to examine their feet for sores and blisters which can lead to amputation if left untreated.
Physiotherapy is an invaluable part of any treatment for tingling and numbness. If the advice and recommendations are carefully followed, you can find relief from the discomfort of paraesthesia. Please see us if you have any such health concerns.
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