Hand Numbness

A common complaint patients share is occasional numbness in one or both hands. The most serious causes of numbness in the arm or hand would typically be associated with other symptoms such as chest pain, sweating, shortness of breath, severe headache, visual changes, confusion or changes in speech. These could indicate heart attack or stroke and need to be evaluated by a medical professional immediately.

Hand Numbness Overview

However, the vast majority of hand/arm numbness complaints are not medical emergencies. A typical cause of numbness is nerve irritation. Nerve related symptoms include numbness, tingling, “pins and needles” and sometimes burning sensations. Nerves can be irritated by inflammation, compression, stretching or direct trauma.

Hand Numbness & Carpal Tunnel Syndrome

The most common cause of hand numbness is carpal tunnel syndrome, which is an irritation of the median nerve as it crosses the wrist. This will usually cause numbness in the thumb, index and middle fingers. Patients will complain of numbness at night or when they wake up in the morning. They may also experience numbness with driving.
Another common source of numbness is cubital tunnel syndrome, which is an irritation of the ulnar nerve at the elbow. The distribution of numbness for this problem is the pinky finger and ring finger. This is frequently associated with holding your elbow flexed for prolonged periods (like talking on the phone) or resting the inside of the elbow on an armrest or table.

Hand Numbness & Nerve Irritation In The Neck

Other reasons for hand numbness include nerve irritation from the neck. In this case, the hand symptoms are typically combined with neck complaints, but not always.
Hand numbness, tingling or burning is usually a self-limited problem and will resolve on its own. If the symptoms are not resolving, they should be evaluated by a physician. The most concerning problem that is sometimes associated with hand numbness is weakness or atrophy (shrinking) of muscles. This usually indicates that the nerve has partially lost its connection to the muscle it is supplying. Again, any development of weakness or atrophy needs to evaluated by a physician.

Diagnosing Hand Numbness

If you are having any of the above complaints, your doctor may refer you for an EMG and NCS (Electromyography and Nerve Conduction Studies). This diagnostic test is excellent for evaluating entrapment neuropathies such as carpal tunnel syndrome or cubital tunnel syndrome as well as cervical radiculopathies, which are nerve problems radiating from the neck.
We provide electrodiagnostic testing (EMG/NCS) here at Sierra Regional Spine Institute and frequently use this to help diagnose the source of patients hand numbness and to help develop a comprehensive treatment program. Let us know if we can help you with any of these problems.

Article written for “We’ve Got Your Back Magazine”

By Dr. Chris Twombly