Are Your Hands Going Numb?

Numbness in hands is far from a rare occurrence. The following are the 7 most common causes of hand numbness. While it’s possible there could be a rarer reason for this problem (also listed below), 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 numbness in 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 to force you to look more closely at the numbness. The answers to these questions can help pinpoint the hand numbness causes.

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 your hands 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. 

Hand Numbness Causes

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:

1. Poor sleeping position
2. Carpal tunnel syndrome (Click here to take a quick self-test)
3. Diabetes induced peripheral neuropathy
4. Cubital tunnel syndrome
5. Thoracic outlet syndrome
6. Hand arm vibration syndrome
7. Cervical radiculopathy

 Want to know how severe your carpal tunnel really is?

  Take this 60 second Quiz designed by Dr. Z.

Other reasons for your hands going numb are much less common. They include:

1. Guillain-Barre syndrome
2. Paraneoplastic syndromes of the nervous system
3. Spinal cord injury
4. Stroke
5. Frostbite
6. Brachial plexus injury
7. Lyme disease
8. Alcohol use disorder
9. Amyloidosis
10. Multiple sclerosis
11. Sjogren's syndrome
12. Lupus
13. Vasculitis
14. Vitamin B-12 deficiency
    

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.

Take this self-test to see if you have carpal tunnel syndrome.

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.

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.

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 nerve damage 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)
  

As with carpal tunnel syndrome, the only treatment for numb hands 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.

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.

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).

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. 

When it comes to numbness in hands, there are 7 likely candidate conditions causing the problem. Some are more severe than others. For most conditions, however, treatment for numb hands involves non-surgical management, although in some instances surgery may be necessary.