Are Your Hands Going Numb?
The following are the 7 most common reasons why your hands might be going numb. There could be a rarer reason (also listed below) for this problem, but you should look into the most common ones first.
In order to better understand what's causing your numb hands it's necessary to consider these 3 questions:
- Do you have numb hands all of the time or just occasionally?
- Is the numbness in the same areas or does it change location?
- Is your hand numbness worse at certain times (e.g., day versus night)?
The goal of asking yourself such questions is force you to look more closely at the numbness. The answers to these questions can pinpoint the reason (cause) for your hands are going numb.
It’s important to note that ANY numbness in your hands is NOT normal. If you experience numb hands occasionally, perhaps once or twice per month, there’s likely not much to worry about. More than likely, you slept in a position which strained your arm or wrist. This frequently causes numb hands upon waking up in the morning (see reason number 1 below).
But having numb hands all (or most) of the time indicates a more serious problem. If your hands are usually numb, or if you feel them going numb while performing a certain task, it means you probably have one of the 7 most common hand-numbing disorders listed below.
This article explains those 7 reasons why your hands may go numb. They range from something simple (like a poor sleeping position) to more serious illnesses (like carpal tunnel syndrome or diabetes). Each reason also explains how you can FIX that problem.
7 Most Common Reasons for Your Hands Going Numb
Except for having a stroke, numb hands alone are usually not life threatening. But the numbness should get your attention in order for you to understand the cause and how to fix the problem.
The 7 most common reasons for your hands going numb are described below. Also described is how to fix each problem.
From most to least common, the reason for your hands going numb are:
- Poor sleeping position
- Carpal tunnel syndrome
- Diabetes induced peripheral neuropathy
- Cubital tunnel syndrome
- Thoracic outlet syndrome
- Hand arm vibration syndrome
- Cervical radiculopathy
Less Common Reasons
Other reasons for your hands going numb are much less common. They include:
Common Reason #1: Hands going numb due to poor sleeping position
This is by far the most common reason why your hands are going numb. But how can you tell for sure?
If numbness is due to a poor sleeping position, your hands will feel numb when you wake up. But after a few minutes, they`ll feel normal again. This phenomenon is temporary and not especially worisome.A poor sleeping position can directly compress the main nerves in your arm which go to your hand (median and ulnar nerves). Here are 3 sleeping positions which can cause nerve compression, resulting in finger or hand numbness:
- Resting your head directly on you hand or wrist (as in the photo).
- Bending one or both wrists at an extreme angle (flexed or extended).
- Lying on your back with your elbow(s) pressed into the mattress.
Your head is heavy. Pressing its weight on your hand (palm up) or wrist joint for hours at a time will likely compress your ulnar or median nerve. So if you must sleep in that position, try putting a thin pillow between your head and hand.
Unconsciously hyper-bending your wrist joint will pinch either the ulnar or median nerve (or both) at the wrist joint. to avoid this, wear a wrist brace at night. Be sure to wear a wrist brace without a palmar spine. (A palmar spine will push into your carpal tunnel space and further damage your median nerve.)
Sleeping on your back will almost certainly result in pushing your elbows into the mattress. This is especially true if you bend your elbow in order to rest your hands on your chest. The result may be a crushed ulnar nerve, resulting in morning numbness on the pinky side of your hand. For some people, changing their sleeping position is a radical adjustment. But "sleep trainers" can help (see next). If you just can’t bear to change from back sleeping, try protecting your elbows instead. Soft, padded elbow protectors will help.
You can train yourself to sleep in a different position to avoid nerve compression. This is called sleep training. You can use one of several types of sleep trainers to help. These are products which can be as simple as taping a tennis ball to your pajama back (to prevent rolling over and sleeping on your back). But more sophisticated electronic "alarm" devices are also available.
Common Reason #2: Hands going numb due to carpal tunnel syndrome
One of the major signs of carpal tunnel syndrome is feeling your fingers or hands going numb. Numbness may or may not be accompanied by tingling, pain, and weakness. Usually these symptoms occur when your hand is at rest, like when sleeping or relaxing.
About 5% of the American population has carpal tunnel syndrome. Sometimes it resolves on its own. Other times, it simply progresses at varying rates until it reaches the severe stage.
Nobody knows exactly what causes carpal tunnel syndrome. It`s also a mystery why in nearly identical situations, one person gets it and another doesn`t.However, there is an association between carpal tunnel syndrome and over-use of the fingers and hand. It appears more like this activity "triggers" rather than causes carpal tunnel to appear. That means people who use their hands extensively are at high risk.
You’re also at high risk of getting carpal tunnel syndrome if you:
- are over 70 years old
- are female
- are pregnant
- have a family history of this condition
- have a small body frame
- have rheumatoid arthritis
Whichever reason brought the carpal tunnel syndrome, the reason you have numb hands is because the median nerve inside your wrist joint is trapped and pinched (or crushed) by swollen tendons.
The tendons are swollen due to irritation caused by adhesions between them. Therefore, the only way to effectively relieve symptoms is to remove the compression on the median nerve (i.e., "decompress" the nerve).
Decompressing the median nerve is the only way to relieve finger or hand numbness (and other symptoms) of carpal tunnel syndrome. Nerve decompression can be achieved in one of two ways: non-surgically or surgically. Both methods can be quite effective, but obviously surgery is more aggressive.
There are 4 common ways to decompress the median nerve without surgery. Each method alone can be very effective. However, combining myofascial release massage, carpal tunnel exercises and nocturnal bracing is usually most effective.
Steroid Injections
Steroid (or corticosteroid) injections are often used by doctors to treat carpal tunnel syndrome. The reason is because steroids reduce tendon inflammation. That means as the tendons become less inflamed, they`re not as swollen. Therefore, they don’t push against the median nerve as much, and symptoms lessen.
The problem with steroid injections is they only work on carpal tunnel syndrome about 45% of the time. Even then, its effects wear off in 3-6 months. Over 60% of patients need another injection.
And therein is the second problem with steroid injections. Due to their potential side effects, they should only be used a limited number of times. This is why steroid injections are considered a “temporary” remedy for carpal tunnel syndrome.
Myofascial release massage
Physical therapists, massage therapists, and chiropractors have been using myofascial release massage to successfully treat carpal tunnel syndrome for decades. The reason it works so effectively is because of the way this massage is performed.
The practitioner kneads the tissues over the wrist joint. This action breaks apart adhesions on the tendons beneath. (It’s these adhesions which cause inflammation and swelling the first place.) With daily massage, eventually the adhesions dissolve completely and the tendons are less swollen. That means they no longer push on the median nerve, and symptoms are eliminated.
The only downside to myofascial release massage is that it must be performed daily for 4-6 weeks, depending on how severe your symptoms are. (A medical device called the CarpalRx performs the myofascial release massage automatically, at home.)
Carpal tunnel exercises
Once again, the underlying problem in carpal tunnel syndrome is that adhesions between tendons cause them to get irritated and then swell. This swelling compresses the median nerve at the wrist joint.
However, specific carpal tunnel stretching exercises (sometimes called “tendon gliding exercise”) directly attack those adhesions. In fact, the effect is similar to what myofascial release massage achieves (see above).
The 4 most effective carpal tunnel stretching exercises target the tendons as they pass through the carpal tunnel space inside the wrist joint. These are the prayer stretch, stop stretch, finger interlace stretch, and thumb stretch.
Performing these exercises multiple times a day for several weeks can completely eliminate carpal tunnel syndrome. Of course, the more severe your condition, the more frequently you need to perform the exercises.
Nocturnal bracing
Nocturnal (night) bracing while you sleep is especially effective when carpal tunnel symptoms are still mild. More advanced symptoms might require nocturnal bracing plus other non-surgical remedies listed above.
Most people bend their hands while sleeping. This, of course, can pinch the median nerve. If you already have signs of carpal tunnel syndrome, the nighttime bending can make the condition much worse. A night brace (or splint) will keep your hand in the neutral position (i.e., straight) while you sleep. Continued use will lessen irritation and swelling. This lets the nerve decompress, and then symptoms resolve.
But be careful: not all braces will do. In fact, most wrist braces sole in pharmacies like CVS, Walgreens, Walmart, Rite Aid, etc. can be harmful. If they have a palmar spine, then the spine can press into your wrist joint and increase compression on the median nerve. Only certified carpal tunnel braces have the supports on the sides of the wrist, not on the palm side.
Surgical decompression of the median nerve is called carpal tunnel release surgery. There are two main types of this hand operation; open or endoscopic carpal tunnel release surgery.
Open carpal tunnel release surgery
Open carpal tunnel release surgery means the surgeon makes a slit in your hand about 2-3 inches long. Then the surgeon cuts a ligament holding your wrist bones together. As the bones snap apart, they decompress the nerve trapped between them. The nerve decompressing then relieves symptoms.
Endoscopic carpal tunnel release surgery
Endoscopic carpal tunnel release surgery achieves the same thing as the open technique with one big difference. That is, the doctor uses an endoscope to make one or two small slits in your palm rather than one large incision.
Each surgical technique has its advantages and disadvantages. They involve different potential complications, recovery times, and length (including degree of) post-surgical pain.
Common Reason #3: Hands going numb due to diabetes-induced peripheral neuropathy
Chronically high blood sugar and diabetes can cause peripheral neuropathy. In fact, it’s the most common complication associated with diabetes.
Nerve damage due to diabetes doesn’t always happen. Some degree of peripheral neuropathy eventually occurs in about half of diabetic patients.The nerve damage of peripheral neuropathy can feel differently from person to person. Some people feel numbness or tingling in their hands or feet. Other patients feel severfe pain, burning or loss of sensations.
It’s important to note that getting diabetic neuropathy is usually a slowly developing process. The changes you feel are subtle and happen over years. This is why, as diabetic patients get older, they often ignore those slight changes. Some attribute the neuropathy to, ”I’m just getting old”.The long-term consequences of diabetic neuropathy can be severe. Many patients completely lose sensitivity in their extremities. That means they cannot feel cold or hot things, nor can they feel cuts, sores or burns. Those patients must take precautions like inspecting their feet daily. Poor fitting shoes can produce ulcers, which can go unnoticed and be infected.
Diabetes and peripheral neuropathy cannot be cured: you have them for life. But you can reduce your risk of having neuropathy by slowing the progression of diabetes. You can also lessen the effects of the neuropathy with certain medicines.
Decades of research has shown that the key to slowing progression is good management of blood sugar. That means you can reduce your risk of neuropathy by maintaining a normal (or as close as possible) blood sugar level.
Talk to your doctor to determine the best target range for your blood sugar. It will be based on certain factors such as your age, overall health, and how long you`ve had diabetes. In other words, your blood sugar levels must be individualized.
Generally speaking, the American Diabetes Association recommends the following target range for your blood sugar levels if you have diabetes:
- Before meals: 80 to 130 milligrams per deciliter (mg/dL)
- After meals: less than 180 milligrams per deciliter (mg/dL)
Common Reason #4: Hands going numb due to cubital tunnel syndrome
Cubital tunnel syndrome is the "less problematic" cousin of carpal tunnel syndrome. Both conditions are caused by nerve compression. Cubital tunnel syndrome occurs when the ulnar nerve becomes trapped and crushed at the elbow joint.
Like the median nerve, the ulnar nerve travels to the hand but first passes near the tip of the elbow. It’s responsible for the sensitive region some people call the “funny bone”.The result of ulnar nerve crushing is symptoms on the pinky finger side of your hand. These symptoms typically include pain, numbness, and tingling on the fifth (pinky) finger side of the hand. You may also feel impaired control of the muscles in your little finger and ring finger.
As with carpal tunnel syndrome, the only way to relieve symptoms of cubital tunnel syndrome is to free the ulnar nerve from being trapped and crushed by surrounding tissues. There are two ways to achieve this; surgery and stretching exercises.
As with carpal tunnel syndrome, an effective non-surgical remedy for cubital tunnel syndrome is dedicated exercises. Cubital tunnel syndrome exercises focus on stretching and strengthening the elbow area.
There are 3 key stretching and strengthening techniques: range-of-motion exercises, muscle strengthening exercises, and nerve gliding exercises.
Most therapists suggest a combination of all 3 exercises applied simultaneously. When a combination regimen is used, symptoms of cubital tunnel syndrome will usually resolve within 6-8 weeks.
The surgery used to relieve cubital tunnel syndrome is called “ulnar nerve release surgery”. As with carpal tunnel release surgery, there are two basic types; open or endoscopic cubital tunnel release surgery.
Open cubital tunnel release surgery
This procedure requires the doctor making a 3-4-inch long incision on the inside part of your elbow. It enables the doctor to see and access the ulnar nerve and its surroundings. Then the surgeon cuts the overlying ligament trapping and crushing the ulnar nerve. As soon as that happens, pressure on the nerve is relieved and symptoms begin to disappear.
Endoscopic cubital tunnel release surgery
This surgery means the doctor makes one or two small incisions in the same area. Then an endoscope is used to view the ulnar nerve and its surroundings. A special scalpel then cuts the ligament which covers (and crushes) the nerve.
These two techniques have their own advantages and disadvantages. They involve varying potential complications, healing and recovery times, and length or degree of post-surgical pain.
Common Reason #5: Hands going numb due to thoracic outlet syndrome
Most people have never heard of thoracic outlet syndrome. Yet the National Institutes of Health says it affects about 3% of the US population.
The thoracic outlet is an area of your body located in the lower neck, between the clavicle and the first rib. Several important nerves and blood vessels pass through this space. But sometimes the space gets compromised for one of several reasons.Thoracic outlet syndrome is actually a collection of disorders causing various symptoms from the shoulder to the fingers. These symptoms include weakness, pain, tingling, and numbness -- primarily in the hands or fingers.
Identifying thoracic outlet syndrome can be complicated. Most general practitioners are not trained to see the symptoms and will refer patients to a neurologist.Test yourself for thoracic outlet syndrome here.
There are 3 types of thoracic outlet syndrome:- Neurogenic, which results from nerve compression and accounts for 95% of patients.
- Venous, which results from vein compression and accounts for 4% of patients.
- Arterial, which results from artery compression and accounts for less than 1% of patients.
There are 2 methods to treat thoracic outlet syndrome, non-surgical and surgical. The most common thoracic outlet syndrome (neurogenic) is almost always treated successfully (and permanently) with physical therapy exercises.
However, if physical therapy fails, neurogenic thoracic outlet syndrome can be treated surgically. The surgery is rather aggressive. It involves removal of muscle tissue and/or the first rib.
In contrast, venous thoracic outlet syndrome is initially treated with blood thinning drugs. Once the blood clot dissolves, the patient may need surgery to correct the underlying anatomical problem which caused the clot so it doesn’t reoccur.
Arterial thoracic outlet syndrome can only be treated surgically. The doctor must remove the first rib and surrounding tissue.
Common Reason #6: Hands going numb due to hand arm vibration syndrome
A major health problem associated with using vibrating tools is a condition known as hand arm vibration syndrome or HAVS. Sometimes the condition is called Raynaud`s phenomenon or “vibration white finger disease” (due to the charasteristic blanched fingertips, as in the photo).
Hand arm vibration syndrome is a result of damage to the nerves and blood vessels in your fingers and hand. When such damage occurs, its symptoms include having your hand or hands going numb, feeling some degree of pain, and blanching in your fingertips.The prevalence of hand arm vibration syndrome or HAVS occurs is about 60% of people who use vibrating tools on the job. This enormously high incidence makes it one of the most common job-related illnesses in America. Ironically, most people have never heard of it.
You are at risk of getting HAVS if you regularly use hand-held power tools. In fact, the National Institutes of Health says that 1.5 to 2 million people use such tools regularly in the USA. The Centers for Disease Control says the tools most commonly associated with hand arm vibration syndrome are powered hammers, chisels, sanders, chain saws, grinders, riveters, drills, breakers, sharpeners, compactors, and shapers.Hand arm vibration syndrome a chronic and progressive disorder which usually takes years of vibrating tool use to fully develop. To keep it from occurring, you must curtail or stop using the vibrating tools. Or at the very least, fully protect your hands (see below).
Unfortunately, in its advanced stages, hand arm vibration syndrome is not reversible. This means that once hand arm vibration syndrome progresses to a certain point, you will lose most of your hand function. Necrosis (death of tissue, like skin) in the fingers will result. This is why prevention of HAVS is crucial.
The National Health Service (UK) provides comprehensive guidance for preventing HAVS. It focuses on minimizing risk, and makes a number of recommendations.
The most important recommendation is that workers in high risk occupations (i.e., using vibrating tools) must be proactive and take precautions. One of these is to seek alternative work methods to eliminate or reduce exposure to vibration, such as using automated tools. Another recommendation is to change tools for those which produce less vibration. Also workstation schedules can change to limit a worker’s exposure to vibration.
Finally, and perhaps the easiest and most effective recommendation, is to use well-padded, insulated gloves. This simple yet effective fix can protect against vibration and also keep the workers’ hands warm (since cold temperature exacerbates HAVS).
Common Reason #7: Hands going numb due to cervical radiculopathy
Cervical radiculopathy is commonly called a "pinched nerve". It occurs when a nerve in the neck is compressed as it exits the spinal cord. Usually, the pinching is more pronounced when the neck moves.
This condition usually is a result of degenerative changes in the spine called spondylosis. These changes happen for a number of reasons. They can arise naturally from age, or from an injury. An injury may cause an intervertebral disk to bulge or herniate, and push on a nerve root.The symptoms of cervical radiculopathy vary from person to person. Usually, it produces pain which radiates into the shoulder or arm. But it also produces muscle weakness, tingling, and can make your hands go numb. The hand numbness can be either temporarily or last for prolonged periods of time.
There’s good news here. For most people, cervical radiculopathy will respond quite well to conservative treatment. That means instead of surgery, medication and/or physical therapy will relieve symptoms. For many patients, pain and numbness will disappear relatively quickly (days or weeks). Other patients may need more time.
The first treatment of choice for cervical radiculopathy is wearing a soft cervical collar. This is allows your neck muscles to rest and avoid strain. Doing so helps limit pinching at the nerve root when your neck moves. However, prolonged wearing of a collar should be avoided so that neck muscle strength is not compromised.
Physical therapy exercises can also help resolve symptoms. These include exercises to strengthen your neck muscles and improve your neck’s range of motion. Sometimes traction can be used to gently stretch the neck’s joints and muscles.
Certain medicines can also help relieve cervical radiculopathy. Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, naproxen, and ibuprofen can relieve inflammation and provide pain relief.
If these measures don’t provide good results, steroids can be injected near the nerve to decrease inflammation.
Conclusion
If your hands are going numb there are 7 likely candidate conditions causing the problem. Some are more severe than others. The way to reverse the hand numbness ranges from simple avoidance to surgery. But for most of the conditions, non-surgical management works very effectively.
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