Pins & needles in hands, carpal tunnel syndrome?

Hi all. I have constant pins & needles in both hands. Never stops. Been on MTX + folic acid for about 6 months, and the pins & needles started a couple of weeks ago. Had 2 x Vitamin B12 injections which haven't helped at all. I've read that a high percentage of RA sufferers have carpal tunnel syndrome because the inflammation can bulge/press on the medial nerves into the hands.

I'm going to discuss my symptoms with my rheumatologist, but appointment only in October. In the meantime I was wondering if anyone else developed carpal tunnel after getting RA, and, if so, if the routine carpal tunnel operation solved the problem?


23 Replies

  • Oh - sorry - I see that there have been lots of earlier posts (with good answers) on this topic. I must remember to search first, before posting!

  • Hi Seneca, I had carpal tunnel in both hands. They drove me to distraction all night long and I had my left hand released in May this year and it wad the best thing I did. I'm hoping to have the other hand done soon.

    The recovery was slightly longer than the surgeon had said but even so, it was worth the short term pain.

    Have you had steroids injected into the wrist yet? That gave me some temporary relief and confirmed the diagnosis.

    Lots of people said "oh don't have it done" but I'm glad I did because it worked for me and I know it doesn't for everyone though.

  • thanks Crashdoll - so glad the release worked for you. I try to stay away from steroids, but I type a lot at work so might consider it as interim measure

  • I had successful carpal tunnel release in 2013, left hand. At the time the nerve conduction study showed it was also mild in my right but the left was advanced so it was that which was operated on. At a recent NCS it showed my right has worsened, which would fit with the pins & needles I'm experiencing, but it's not advanced yet & just a bit of an inconvenience as I can ease the symptoms by dangling my hand for a few minutes. Like last time it's affecting all but my little finger & I've dropped two glasses & a few plates so far! Last time as it became closer to the op my hand wasn't really useable as it was constantly numb & the pain extended up from my elbow to my shoulder, worse at night for some reason but dangling my arm out of the bed did help a little.

    Recovery time was as expected, first week in a sling & then back to the hospital for a check over & a change of dressing after that my Practice nurse checked the wound & by a couple of weeks the stitches were out. It was recommended I took co-codamol 8/500 but it wasn't painful post op, more of a nagging really so only needed the co-co's for the first few days, after that it was a normal 'knitting' sensation. The scar is barely visible now, it just looks like an extension of my life line. You're correct that it's median nerve entrapment that's the cause. I had an Occupational Therapy appointment last week & was given a splint to wear, as I also was whilst waiting for my previous CT release. Maybe one would help you too, until you see your Rheumy next?

  • It's amazing how quickly and how well the incision heals. My second surgery was done in November last year. It's almost impossible to see either scars on each hand. Wish other parts of our bodies could heal the same way. :)

  • Isn't it? Pleased yours were successful too RG. Should have added mine was open surgery too, took a total of half an hour at most, 20 mins operating. Before the op nights were the worst, as you say, broken sleep pattern was a pain, literally! It's amazing how the compression of one nerve can be so disruptive. How did you manage to drive? Tried it once & felt so unsafe that was it, no more til after the stitches were out!

  • Thanks nomoreheels. Glad you mentioned the difficulty with driving - I must factor that into my plans. So happy for you that your CPS ops have relieved the pain

  • Nomoreheels you said that "I was well controlled on MTX at the time which seemed contradictory as you'd think if there's inflammation to the median nerve it'd be elsewhere too! Not the case with me anyhow so I don't think there was a connection." This is exactly what I was afraid of - it;s v. reassuring to know that carpal tunnel symptoms don't necessarily mean that the RA is raging/escalating. Appreciate all of your helpful input.

  • I suppose having RD we're more likely to have carpal tunnel with the inflammation we can have at any point in time & why I'm not surprised my right is now troubling me as I'm not as well controlled as I was when my left was affected. Other more common links can be diabetes, pregnancy & hypothyroidism but you don't need to have any of them to be diagnosed with CTS, though I think RSI is usually involved.

  • I had CTR surgery on both hands. My doctor advised doing one, healing for about 3 months, then doing the second hand. I had the nerve conduction study first then visited two hand surgeons. The one I decided upon only did the "open" surgery, not the endoscopic surgery. He said and I confirmed through reading lots of online research that in the open surgery, the doctor is able to see and navigate much more precisely and thus, prevent any accidental damage to surrounding tissue, nerves, etc.. Some people swear by the endoscopic route so it's all about personal preference by doctor and patient. Recovery time truly is about the same either way.

    For me the surgery was miraculous!!! The pain I had prior to surgery was extreme. I couldn't sleep an hour straight without having to change positions, get up and shake my hands, get ice, etc.. It was horrible. Pain shooting up my arms, just like yours. Then, during the day trying to drive or do much of anything with my hands or arms I had to constantly shake them out, self massage and beg my hubby to massage and squeeze for only slight relief.

    Immediately after surgery the numbness and tingling was gone. There was some pain from the incision area, but very minor. It worked so well I begged my doctor to let me have the second one done two weeks later. He wouldn't do it and in hindsight I'm glad I took the time to truly heal. Again, I consider the relief I got miraculous.

    On a side note, it was my hand surgeon who noticed a painful, swollen area on the top of my hand as synovitis. He referred me to my rheumy and now I know I have RA. Glad he knew what he was seeing, not so glad to have RA!

    Get the release surgery!!!! You will be so glad you did it, I promise. (Naturally, I am not a doctor so I probably shouldn't "promise" anything. It just sounds to me like you are suffering like I was. :) )

    Blessings to you. Keep us posted, ok?


  • Thanks so much radiogirl. That's really encouraging to hear. Very interesting about the open surgery route. (Sorry for delay in response - my internet was out of action for awhile)

  • Hi. I have had rheumatoid arthritis for 28 years and started with pins and needles and numbness in both hands at night, almost 3 years ago. I saw the plastic surgeon at the hospital hand clinic.

    I had the day surgery by local anaesthetic five months ago on my right hand and having the left hand done in 8 weeks.

    The good pain from the surgery was gone within a few days and the pain from pins and needles etc was gone next day. My grip improved in strength daily and I am no longer dropping things with my right hand.

    I massaged my hand four or five times a day with Rosehip oil and had no problems at all. Scar looks great and very happy.

    I stopped taking Methotrexate and Xeljanz 14 days before and didn't start taking again for 21 days after to avoid infection.

    Hope this helps you

  • Oh - thanks Lesley. Good to know the good results of your release ops have lasted. Also, thanks for the input about stopping the meds beforehand - I hadn't thought of that. Your input is very encouraging!

  • I'm reading this with interest as I'm getting pins and needles in my hands and a dead arm/dead hand feeling in both arms when I lie on my side at night. Also get it lying on my back to a lesser degree.

    Also getting fuzzy feeling and pins and needles in little and ring fingers on both hands during the day, worst in morning when I've just woken up. No pain though.

    Is this carpel tunnel? It started 3 months in taking Methotrexate, but when I mentioned it at Rheumatology they looked at me like I was mad.

  • As far as I'm aware Carpal Tunnel Syndrome (median nerve entrapment) doesn't affect the little finger & only half the ring finger, well it didn't mine anyhow. Commonly initially there's a pins & needles sensation in the thumb, index, middle & half (lengthwise) of the ring finger. As it becomes more trapped by inflammation they become numb & painful (contradictory I know), the pain then travels up to the elbow & finally the top of the arm. It's a really distruptive pain eased a little I found by dangling my arm over the arm of an armchair. Nightimes were worst.

    I was well controlled on MTX at the time which seemed contradictory as you'd think if there's inflammation to the median nerve it'd be elsewhere too! Not the case with me anyhow so I don't think there was a connection.

    Do you have disc or neck problems?

  • I had a neck X-ray ten years ago which revealed an unstable vertebra, where the bone was very worn down. Means that the vertebra doesn't stack up in line with the others and I've lost the normal curvature of the spine. I had some oestophytes too.

    So that could be causing problems. Goodness knows what an X-ray would reveal now, ten years later and with RA!

    I've noticed a difference with numbness and tingling with different pillows, so maybe I need to experiment more with that.

    Thanks for your reply.

  • Could be. Definitely worth bringing it up at your next appointment.

  • Will do. Especially as it seems to be getting worse.


  • Hi my rheumatologist diagnosed RA and secondary carpal tunnel. I'm hoping that once all the swelling goes down the CT issues will resolve...18months on and wrists are still visibly swollen! M x

  • Hi Marie - so frustrating, isn't it? I was diagnosed beginning of the year and my swelling (mostly ankles) is still pretty much the same too. Judging from the other forum members' answers on this topic, it seems like the carpal tunnel symptoms don't resolve easily on their own, but the release operation sorts it out for good (?) . Hope you see some improvement soon.

  • Hi, I looked it up online and I read that it doesn't normally resolve and needs fixing sooner than later.

    My understanding of the carpal tunnel problem is that the tendons and ligament sheaths thicken and the space becomes constructed as they all converge at the wrist. That's why it happens.

    But has anybody else noticed their hands have changed? I have had it for 28 years and been on methotrexate that long and I know I am nearly 60 but you can see and feel your hands becoming bigger and the tendons that go along the fingers and tops of the hand in the beginning were 'normal' but my specialist told me in the very beginning about the thickening, like a coating on each tendon. I could see and feel these 'thick ropes' under the skin and they have only become thicker with time.

    I was diagnosed 6 months after symptoms started so I was told I already had lost range of movement in hands and feet and that he could feel the thickening already.

    There is no cure for RA just slowing it down. So even though I have been on medication for so many years slowly but surely things become worse.

  • I can't answer your question about long-term changes in the hands Lesley, but can confirm the thickened tendons issue. I was diagnosed after a year, and my ankle MRI showed significant "synovial thickening". I can feel that "ropey" effect which is making it so difficult to bend/flex the foot. Not looking foward to the thickening getting gradually worse - thankfully I'm already 50, not diagnosed young like you. I suppose the only consolation is that without your many years of methotrexate the condition would be much worse. P.S. Thanks for your info about carpal syndrome not resolving on it;s own - that's what I needed to know.

  • You are very welcome. I love this site. It's so helpful to share information like we have been doing.

    You are correct in that it would probably be much worse. On a bad day I fear not but on a good day I try to be philosophical.

    It's an awful disease and I guess we should be happy that research is now understanding the disease more.

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