Causes of Numbness by Location

Numbness of Fingers in Hands

Carpal Tunnel Syndrome

Compression of the median nerve at the wrist. Numbness of the thumb, index, middle fingers, and half of the ring finger. Worsens at night, while driving, working at a computer. Positive Phalen's test and Tinel's test. The most common compressive neuropathy — up to 5% of the population.

→ Carpal Tunnel Treatment using a regenerative method

Cervical Radiculopathy

Cervical disc herniation compresses the nerve root. C5-C6: thumb and index finger, outer forearm. C6-C7: middle finger. C7-T1: ring and little finger, inner forearm. Accompanied by neck pain and arm weakness.

→ Cervical Disc Herniation Treatment

Cubital Tunnel Syndrome

Compression of the ulnar nerve in the cubital tunnel (inner elbow). Numbness of the little finger and half of the ring finger. Worsens with prolonged elbow flexion (phone calls, sleeping with bent arm).

Thoracic Outlet Syndrome (TOS)

Compression of the brachial plexus and/or subclavian vessels. Numbness of the entire arm, worsening with arms raised (hair drying, overhead work). Adson's test, Roos test.

Numbness of Feet

Lumbar Radiculopathy

The most common cause of foot numbness. L4: anterior thigh, inner shin. L5: outer shin, dorsum of foot, big toe. S1: posterior thigh, outer foot, heel. L4-L5 and L5-S1 herniated discs — 95% of all lumbar herniations.

→ Sciatica Treatment using regenerative method

Spinal Stenosis

Narrowing of the spinal canal. Numbness and weakness in both legs while walking, relieved by forward flexion or sitting. Neurogenic claudication.

→ Spinal Stenosis Treatment

Tarsal Tunnel Syndrome

Compression of the posterior tibial nerve in the tarsal tunnel (inner ankle). Numbness and burning in the sole of the foot. Analog of carpal tunnel for the foot.

Peroneal Nerve Neuropathy

Compression near the fibular head (habit of crossing legs, tight cast). Numbness of outer shin and dorsum of foot, "foot drop".

Diabetic Polyneuropathy

Systemic damage to peripheral nerves in diabetes mellitus. Symmetrical numbness in "stocking-glove" distribution. Burning, tingling, reduced sensation. Not related to orthopedics — requires treatment of the underlying disease.

Red Flags — See a Doctor Urgently

Cauda Equina Syndrome

Numbness in the perineum ("saddle anesthesia"), urinary and bowel dysfunction, bilateral leg weakness. Emergency MRI and possible decompression within 24-48 hours.

Cervical Myelopathy

Numbness and clumsiness in both hands, impaired fine motor skills, gait changes. Spinal cord compression in the cervical spine — requires emergency MRI.

Rapidly Progressive Weakness

Progressive numbness + paralysis within hours to days. Possible causes: massive herniated disc, tumor, epidural abscess, Guillain-Barré syndrome.

Diagnosis of Numbness

EMG/NCS (Electromyography/Nerve Conduction Studies)

Key diagnostic test. Determines: level of nerve damage (nerve root, plexus, peripheral nerve), degree of damage (demyelination vs. axonopathy), conduction velocity. For Carpal Tunnel Syndrome — sensitivity 95%.

MRI

Cervical spine — for arm numbness. Lumbar spine — for leg numbness. Visualizes herniated discs, stenosis, tumors, spinal cord demyelination. Must be correlated with clinical findings and EMG/NCS.

Nerve Ultrasound

High-frequency ultrasound probe allows visualization of peripheral nerves: thickening, compression, neuroma. Carpal tunnel, cubital tunnel, tarsal tunnel.

Laboratory Tests

Glucose, HbA1c (diabetes), Vitamin B12 (deficiency), TSH (thyroid), rheumatoid factor, antinuclear antibodies. To exclude systemic causes of polyneuropathy.

How it is treated: the cause comes first

Treatment depends on the cause of the pain, so it starts with an examination and, if needed, imaging — X-ray, ultrasound or MRI. The same pain can be caused by osteoarthritis or by a tendon, nerve or disc problem.

Most patients are helped by conservative treatment: exercise therapy, load management, short courses of painkillers and sometimes injections. Regenerative methods (PRP, cell preparations) are discussed once the diagnosis is known and there is at least limited evidence for it; no method guarantees a result.

We send a description of your case and your images to several partner clinics. The clinic doctors give a preliminary opinion, suggest a plan and quote a price, and we help you compare the options.

Who it is not suitable for and possible risks

Contraindications

  • Active infection — at the injection site or systemic, with fever.
  • Active cancer or ongoing chemotherapy.
  • Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
  • Pregnancy and breastfeeding — the procedure is usually postponed.
  • A corticosteroid injection into the same area in recent weeks.
  • Urgent surgery, not injections, is needed if there is progressive leg weakness, numbness in the groin area or bladder dysfunction.

Possible risks

  • Pain and swelling at the injection site for 1–3 days.
  • Bruising where blood or fat tissue is taken.
  • Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
  • The effect may be absent or smaller than expected.
  • Injections into the intervertebral disc carry a rare risk of disc inflammation (discitis).

If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.

Scientific evidence

Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:

  1. Lurie JD et al. Surgical versus nonoperative treatment for lumbar disc herniation: eight-year results for the spine patient outcomes research trial. Spine (Phila Pa 1976), 2014.
  2. Catapano M et al. Effectiveness of Platelet-Rich Plasma Injections for Nonsurgical Management of Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil, 2020.

Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised · Toe pain and numbness

Questions about Numbness

Why do my fingers go numb?

Common causes: Carpal Tunnel Syndrome (digits 1-3), cervical disc herniation C6-C7 (middle finger), Cubital Tunnel Syndrome (digits 4-5). EMG/NCS and cervical MRI are needed for diagnosis.

Is leg numbness always a herniated disc?

Often yes. L4-L5: lateral shin, dorsum of foot. L5-S1: posterior surface, sole. But stenosis, polyneuropathy, and tarsal tunnel are also possible. Lumbar MRI and leg EMG/NCS are needed.

When is numbness dangerous?

Urgent evaluation needed for: perineal numbness, urinary dysfunction, bilateral leg weakness, rapidly progressive weakness. Possible Cauda Equina Syndrome — emergency MRI required.

Can numbness be treated without surgery?

Often yes, if the cause is addressed. For carpal tunnel syndrome a night splint and a corticosteroid injection help; for radicular numbness from a herniated disc — time, exercise therapy and, if needed, a periradicular injection; for polyneuropathy the underlying disease is treated (diabetes, B12 deficiency). Surgery is discussed for increasing weakness, muscle wasting or persistent nerve compression on nerve conduction studies.

What tests are needed for numbness?

EMG/NCS — determines level and degree of nerve damage. Spine MRI (cervical for arms, lumbar for legs). Blood tests: glucose, B12, TSH to exclude systemic causes of polyneuropathy.