When hands tingle, is it always a carpal tunnel issue or are there other common causes?

Lots of causes: Carpal tunnel syndrome is probably the most common cause of tingling hands. Irritations of any of the nerves in the arm and also of nerves at the level of the spinal cord/brain can also produce such symptoms. Irritation of the ulnar nerve at the elbow commonly occurs in people who drive a lot, causing tingling in only fingers 4 and 5 as another common example.

Hand tingling: The most common cause of hand tingling and nocturnal pain is carpal tunnel syndrome, the distribution of the tingling is important for diagnosis, in carpal tunnel syndrome, the tingling usually in the thumb, index, middle and 1/2 of the 4th finger. Emg test confirm the diagnosis.