Have you noticed any hand weakness? Are your hands getting weak for no reason? Do you have weak hands now compared to say, a year ago? If so, there might be something serious happening.

Aging, of course, usually results in loss of muscle mass. It’s related to a less active lifestyle most people have with increasing age. That means you no longer use your muscles as vigorously. As a result, normal aging results in generally weaker hands, arms, legs, etc.

But something else may be happening if the loss in your hand strength is noticeably greater than overall weakness elsewhere in your body. And it could be especially concerning if you experience sudden hand weakness. Weak hands might be a sign of an underlying disorder which needs attention now.

The following are the top 11 main causes of hand weakness. They're listed in order of most-to-least common disorders that might result in your hands feeling weak. Each one is discussed in detail below. They are:

1. Arthritis

2. Ganglion cyst 

3. Sarcopenia 

4. Thoracic outlet syndrome (Complimentary self-test for thoracic outlet syndrome)

5. Carpal tunnel syndrome (Complimentary self-test for carpal tunnel syndrome)

6. Cubital tunnel syndrome 

7. Stroke 

8. Peripheral neuropathy 

9. Pinched cervical nerve (cervical radiculopathy) 

10. Epicondylitis 

11. Multiple sclerosis 

(prevalence 19% male, 26% female)

The Arthritis Foundation says there are over 100 different and distinct types of arthritis. The most common types are osteoarthritis and rheumatoid arthritis. Essentially, they refer to a "wear and tear" disorder compared to an autoimmune disease, respectively.

Arthritis symptoms include:

• Pain at or near the affected joint
• Warmth at or near the affected joint
• Hand weakness (loss of grip strength)
• Grinding feeling in the joint
• Redness or swelling
• Cysts under the skin
• Limited range of motion of the affected joint

Treating Arthritis

Treating arthritis is very much tailored to the patient’s needs. This case-by-case approach to treatment should be discussed with your doctor. Treatment options may include any of the following:

• Medications
• Splints
• Various joint injections
• Surgery to repair damaged joints
  

(prevalence 19%, primarily in women)

A ganglion cyst is a nodule that usually forms near a tendon or joint. The cyst is generally filled with jelly-like fluid. A ganglion cyst is the most common form of a lump or bump on the hand.

Ganglion cysts generally form on the back (knuckle side) of the hand. They are also benign. Sometimes, if the cyst is pressing on a nerve, it can result in hand weakness, pain, or tingling. However, this is not a common occurrence.

Symptoms of a ganglion cyst include:

• Moveable lump, usually on the back of the hand, near a joint
• Sometimes the lump is painful
• The lump can be so painful that it causes hand weakness

Treating Ganglion Cysts

Most ganglion cysts will resolve on their own without treatment. But if the cyst is painful, you can treat it by using one of the following options:

• Pain medicines: You can manage the pain from a ganglion cyst with NSAID medicines like Advil, Aleve, Tylenol.
• Immobilization: Moving your hand can make the cyst bigger. This, in turn, can exert more pressure on a nerve and produce more pain. Immobilizing your hand with a wrist and hand brace can relieve the pain.
• Aspiration: Your doctor can remove fluid from inside the cyst. This remedy is used when the cyst is large or causing intense pain. 
• Excision: Your doctor may elect to completely remove the cyst if the above methods fail to provide relief.
  

(prevalence 5-10% over age 65)

Sarcopenia means you are losing muscle mass. With loss of muscle mass comes weakness and decreased muscle function, like loss of hand strength. Sarcopenia can occur naturally with increasing age and inactivity. However, it can also result from:

• Obesity
• Chronic obstructive pulmonary disease (COPD)
• Diabetes
• Kidney disease
• HIV
• Cancer
• Rheumatoid arthritis
• Insulin resistance
• A drop in hormone levels
• Malnutrition or insufficient protein intake

Symptoms of sarcopenia may include:

• Unstable balance
• Trouble climbing stairs
• Muscle weakness
• Decreased endurance
• Reduced muscle size

Treating Sarcopenia

The options to treat sarcopenia center around preventing and managing muscle loss. This can be achieved with physical activity, especially using resistance training. Increasing a muscle's mass improves its strength.

If sarcopenia is due to other disorders (like COPD, for instance), your doctor will address the underlying disorder. Then your doctor will recommend ways to increase your muscle mass based on your overall treatment plan.

(prevalence 3%-6%)

This is perhaps the most commonly known of the various disorders causing hand weakness. Carpal tunnel syndrome is actually a neurological disorder caused by inflamed tendons. 

When the hand and fingers are overworked (like repetitively performing grip and release motions) the flexor tendons in the forearm can become irritated and inflamed. That inflammation and swelling exerts pressure against the median nerve.

Essentially, the nerve gets “trapped” inside the wrist joint. (This is why it’s called an “entrapment neuropathy”.) As a result, the nerve responds (reacts) and produces the characteristic symptoms of carpal tunnel syndrome. 

Symptoms of carpal tunnel syndrome may include:

• Pain, numbness, or tingling in the fingers and hand (but not the pinky finger)
• Hand weakness and loss of grip strength
• Hand clumsiness
• Burning, aching or soreness in hands and fingers
• Shooting electric shocks in the hand
• Any of these symptoms can radiate up the arm

Treating carpal tunnel syndrome

Treatment options for carpal tunnel syndrome depend on which stage of the disorder you have. Early or “mild stage” carpal tunnel can be treated effectively with pain medicines, night braces, and daily stretching exercises. Also, avoid harmful hand and finger activities (see this list).

More advanced stages of carpal tunnel syndrome (“moderate” or “severe” stages) require more aggressive therapy. Usually, all of the above therapies would be used in addition to daily myofascial release massage. If these fail to provide significant relief, then carpal tunnel release surgery may be recommended.

• Already know you have carpal tunnel? This Quiz tells you its severity

(prevalence 2-6%)

Cubital tunnel syndrome, like carpal tunnel syndrome, is an entrapment neuropathy. But in this instance, the ulnar nerve becomes trapped at the elbow. The reasons for entrapment are considered similar to that which happens in carpal tunnel syndrome. That is, over-use and repetitive stress (strain) of the tendons at the elbow joint.

Symptoms of cubital tunnel syndrome include:

• Hand numbness and pinky finger numbness, especially when the elbow is bent
• Weak hands and fingers
• Pain in the hand
• Weak grip strength
• Finger coordination difficulties
• Pain on the inside area of the elbow

Treating cubital tunnel syndrome

• Anti-inflammatory pain medicines
• Elbow bracing
• Stretching exercises
• In more severe stages, cubital tunnel release surgery may be required.
  

(prevalence 3%)

A stroke occurs when a blood vessel in the brain is blocked or bursts. This diminishes the oxygen to the brain cells in that area, causing them to malfunction and often die.

Symptoms of stroke include:

• Since most strokes are silent, overt symptoms may not be apparent. Instead, patients feel a sudden headache, difficulty speaking, have balance or vision problems, and have numbness on one side of their body.
  
• Strokes can also cause numbness or weakness in the face, arm or leg, particularly on one side of your body.
  
• This well-known acronym applies to more overt signs of stroke: FASTER. It means Face, Arms, Stability, Talking, Eyes, React.
  

Treating stroke

Stroke treatment depends on the type of stroke the patient has experienced. The most common type of stroke is called ischemic stroke. 

The main treatment for an ischemic stroke is administering a drug called “tissue plasminogen activator" or TPA. This breaks up blood clots which impede blood flow in the brain. Intravenous TPA must be given within 3 hours after symptoms first appeared.

(prevalence 2%)

Peripheral neuropathy can occur when peripheral nerves (nerves of the limbs) become damaged. The nerve damage can occur:

• Metabolically, as with diabetes
• Chemically, as with Drug Induced Peripheral Neuropathy or DIPN
• With trauma, as when cutting, crushing or stretching the nerve

Symptoms of peripheral neuropathy:

There are over 100 different kinds of peripheral neuropathy. The symptoms of each one depends on which nerve or nerves are affected. The general symptoms include:

• Gradual onset of numbness or tingling in your hands or feet. This can spread into your legs and arms.
• Pain that's sharp, jabbing, burning or throbbing.
• Intense sensitivity to touching objects
• Pain when performing activities that normally don't cause pain, such as foot pain when putting weight on them or while under a blanket
• Poor coordination or falling
• Muscle weakness
• Sensation of wearing gloves or socks when you're not
• Motor nerve paralysis (when motor nerves are affected)

Treating peripheral neuropathy

Your doctor will recommend treating your peripheral neuropathy by addressing the underlying disorder. For instance, if the neuropathy is caused by diabetes, you and your doctor must work to keep your blood glucose well-controlled.

In addition to treating the underlying disorder, neuropathy may be relieved in other ways. Many patients use pain relief medicines, gabapentin (a nerve pain reliever - see warnings), braces, massage, and stretching exercises.

(prevalence 0.8%)

A pinched nerve (technically called cervical radiculopathy) occurs when a structure (like a cervical bone, disc, or tumor) presses against a nerve exiting your cervical spine. The pressure causes irritation on the nerve which produces various symptoms.

Sometimes cervical radiculopathy results from aging (called cervical spondylosis). It can also occur from an injury, like a sudden trauma to the neck area which herniates a cervical disc.

Symptoms of cervical radiculopathy include:

• Pain, usually starting in the neck which travels down your arm and into your hand
• Shoulder or hand weakness
• Hand or finger tingling
• Loss of sensation in the arms or hand

Treating cervical radiculopathy

Treatment for cervical radiculopathy depends on the severity of the disorder. Usually, although not always, realignment of the cervical spine is sufficient to reduce pressure on the pinched nerve. This can be achieved with a vertical collar, or with traction.

Other treatments include using NSAID drugs like Advil, Aleve, or Tylenol. But if these methods do not help, physical therapy may be needed. Physical therapy both loosens restrictions and strengthens neck muscles. Pain medicines and physical therapy can also be used in addition to ketosteroid injections in the neck area. Surgery is the last option when the above non-surgical remedies fail.

(prevalence 0.3%)

Epicondylitis can occur when tendons in the forearm near the elbow are damaged. There are two forms of epicondylitis: medial and lateral.

Medial epicondylitis (also called "golfer’s elbow") is an inflammation of the tendons that attach your forearm muscles to the inside of the bone at your elbow. These tendons bend your wrist toward your palm.

Lateral epicondylitis (also called as "tennis elbow") is an inflammation of the tendons that join the forearm muscles on the outside of your elbow. These tendons bend your wrist away from your palm.

These disorders do not necessarily only result from playing golf or tennis. You can get epicondylitis from carrying heavy objects, repetitive activity, or extensive use of hand tools.

Symptoms of epicondylitis include:

• Pain on the inner forearm, from the wrist to the elbow
• Wrist and hand weakness
• Loss of grip strength
• Pain when squeezing a ball or bending your hand toward your little finger

Treating epicondylitis

The first and best treatment for epicondylitis is avoidance. That means discontinuing the activity which caused the disorder to begin with. Continuing the activity will aggravate and worsen it. Other treatments include:

• Bracing your wrist and/or elbow
• Use NSAID drugs like Advil, Aleve, or Tylenol
• Perform forearm strengthening exercises
• Perform arm stretching exercises
• Massage
• Corticosteroid injections
• Surgery, when other options have failed
  

(prevalence 0.03%) 

Multiple sclerosis is a relatively uncommon disorder affecting the central nervous system (brain and spinal cord). Doctors and scientists are not certain what causes multiple sclerosis. However, the best evidence is that is an autoimmune condition. This means your immune system attacks normally healthy nerves. The attack disrupts how the nerves perform.

Symptoms of multiple sclerosis 

Multiple sclerosis can occur at any age, but onset usually occurs at 20 and 40 years old. Women are 3 times more likely have relapsing-remitting multiple sclerosis. Some of the most common symptoms seen at the onset of multiple sclerosis include:

• Fatigue
• Vision problems
• Numbness and tingling in the limbs
• Muscle weakness (such as hand weakness) 
• Muscle spasms or stiffness
• Mobility problems
• Pain
• Problems thinking, planning, and learning
• Anxiety and depression

Treating multiple sclerosis

There is no cure for multiple sclerosis. However, physical therapy and medications which suppress the immune system can help with these symptoms. They can also help slow the progression of the disease.

Weak hands can be a normal part of aging. However, extreme hand weakness or sudden onset of weak hands can be a sign of a more serious condition. If your hands are getting weak, one of the 11 disorders described here can be the cause. Discuss these with your doctor to obtain a proper diagnosis.

• What if I can't identify the cause of my hand weakness?

You should consult with your doctor for thorough diagnosis. The problem could be serious and may require immediate medical attention.

• Can hand weakness come and go?

It's possible that hand weakness can come and go for an extended period of time. But the reason may be more related to how you use or hold your hand (e.g., at a particular angle or position).

• Which disorder causing hand weakness is the worst to have?

The the worst disorders to have are those with no cure, like stroke and multiple sclerosis.