An intricate network of nerves in the arms and fingers carry signals between the brain and skin, enabling the perception of an array of sensations. The nerves of the arms, hands and fingers arise from the spinal cord in the neck. Injuries or damage to the arm and hand nerves can lead to abnormal sensations, including tingling. Some causes of tingling in the arms and fingers prove temporary; others persist, potentially progressing to numbness or a complete loss of sensation.
Radial Nerve Compression
The radial nerve enables movement and sensation to part of the arm and hand. The nerve enters the arm on the underside of the shoulder, courses next to the upper arm bone, crosses the elbow, and continues through the forearm to the hand and fingers. Compression anywhere along the course of the radial nerve can lead to tingling in the arm and fingers. Falling asleep with the head resting on the arm, for example, often compresses the radial nerve, leading to tingling in the arm and fingers on awakening. Draping the arm across the back of a rigid chair, improper use of crutches and lying on the arm for a prolonged period while under the influence of intoxicants can also cause radial nerve compression and tingling.
Brachial Plexus Injuries
The brachial plexus is a large nerve cluster in the neck, which gives rise to the three nerves that enable movement and sensation in the shoulder, arm and hand. Stretching injuries to the brachial plexus commonly cause abnormal sensations, including burning, stinging or tingling. The duration of the sensations varies, depending on the severity of the injury.
Diabetes mellitus can cause nerve damage throughout the body, a condition known as diabetic neuropathy. Involvement of the sensory nerves of the arms often leads to tingling or numbness of the arms, hands and fingers. Diabetic neuropathy affecting the fingers, hands and arms often progresses to numbness, increasing the patient's susceptibility to unperceived injuries.
Certain medications can damage the sensory nerves of the body, leading to feelings of numbness, burning, pain or tingling. With upper extremity involvement, abnormal sensations usually begin in the fingers and hands, with gradual progression up the arm. Medications associated with a risk of peripheral neuropathy include the cancer drugs cisplatin (Platinol) and vincristine; the HIV/AIDS medications didanosine (Videx), ritonavir (Norvir), stavudine (Zerit) and zidovudine (Retrovir); the antibiotics isoniazid, metronidazole (Flagyl) and nitrofurantoin; and amiodarone (Pacerone), used for the treatment of heart disease or high blood pressure. Discontinuation of an offending drug may enable partial or complete nerve recovery and resolution of symptoms.