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It may be a nerve problem or it may be due to a generalized illness (like Diabetes, SLE, rheumatoid arthritis, Alcoholism, toxins like heavy metals, infections, malignancy, parainfectious diseases like the Guillain Barre syndrome and a host of others). The latter category usually causes bilateral symptoms, although diabetes may cause a mononeuropathy - affecting a single or several discrete nerves instead of all of them.

The nervous structures serving the hand may be affected anywhere from the brain to the spinal cord to the peripheral nerves (ulnar, radial and median nerves). They may be compressed (as by a tumor, or after lying unconcious after heavy drinking), severed (in a gang fight), infarcted (in a stroke, or trauma where the limb vasculature is traumatized), stretched and, well, you name it.

Rheumatoid Arthritis may cause bilateral tingling in peripheral neuropathy but it may also cause unilateral tingling and weakness of the hand in the so-called carpal tunnel syndrome, where the wrist soft tissue swell and compress on the median nerve causing pain, numbness at the base of your thumb.

Of course, a complete history taken from you by your local doctor as well as investigations guided by the history is essential in arriving at a definite diagnosis.

Hope this helps.

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