Numbness in the hand
definition
A feeling of numbness in the hand is a sensory disorder that occurs due to impaired transmission of information in the nerves. This disorder occurs because of damage to or irritation of the nerves that supply the hand. A feeling of numbness can also feel furry or like "pins and needles". In some cases, sensory disorders can also be accompanied by abnormal sensations.
If numbness occurs suddenly or symptoms of paralysis occur at the same time, a doctor should be presented.
The causes of numbness in the hand
Basically, numbness in the hand can result from damage to the central (brain and spinal cord) or peripheral nerves. There can be many different reasons for this. A common cause of peripheral damage are so-called bottleneck syndromes, where the nerve is pinched in the course of the arm. Metabolic diseases or autoimmune disorders can also damage the peripheral nerves of the hand.
The central causes include stroke, multiple sclerosis, inflammation and herniated discs among others.
Find out all about the topic here: The numbness.
The carpal tunnel syndrome
Carpal tunnel syndrome (Brachialgia paraesthetica nocturna) is one of the bottleneck syndromes in which the median nerve below the carpal ligament on the wrist is narrowed and thus irritated.Symptoms are mainly nighttime pain and numbness or tingling in the thumb, index finger, and middle finger. Shaking the hand will relieve symptoms for a short time.
In the long term, damage to the nerve can cause the ball of the thumb to degrade. A night splint can be helpful if the symptoms are mild. Otherwise, surgical splitting of the carpal ligament is an option.
Read more on the topic: The carpal tunnel syndrome.
The stroke
A stroke occurs as a result of a circulatory disorder in the brain and usually results in symptoms of paralysis and sensitivity disorders. Typically, only half of the body is affected, and most commonly the face and arm are paralyzed and numb. How long the symptoms last depends on the severity of the stroke and how quickly therapy begins.
If there is any sign of a stroke, a presentation to the emergency room should take place as soon as possible. In some patients the symptoms resolve within the first few days, in others rehabilitation is necessary.
You can find more information on this topic at: The stroke.
The herniated disc of the cervical spine
Herniated discs are more common with age and are mostly located in the lumbar spine. However, in some cases the cervical spine can also be affected, so symptoms can be felt in the arms.
The pressure of the disc on the spinal cord can damage nerves at this level. This causes different symptoms like numbness, tingling sensations and electrifying pain. It can also lead to a decrease in strength and muscle breakdown, as well as decreased reflexes. The nerves of the spinal cord at the level of the cervical vertebrae C6 to C8 supply the forearm and hand. Thus, a herniated disc at this altitude causes numbness and pain in the hand. If you suspect a herniated disc, you should see a doctor.
The symptoms of a herniated disc of the cervical spine? Read more here.
The polyneuropathy
In polyneuropathy, small nerves in the arms and legs are damaged by an underlying disease. The most common are diseases such as diabetes mellitus or alcohol addiction, but drugs, inflammatory or autoimmune processes can also be triggers.
Usually the feet and hands are affected symmetrically. Sensitivity disorders such as numbness, tingling and "pins and needles" occur, as well as abnormal sensations that can be painful. The vibration and temperature sensation is also disturbed and gait disorders can also occur. Therapy consists primarily of treating the underlying disease.
Find out more about the here Polyneuropathy.
The vitamin B12 deficiency
The vitamin B12 deficiency can arise due to several causes. It may be due to insufficient intake due to malnutrition, vegan or vegetarian diet. Insufficient intake due to gastrointestinal diseases can also be the cause or an increased requirement during pregnancy.
The vitamin deficiency can be symptom-free, but it can also have severe courses. Serious neurological and psychiatric symptoms can occur. Patients may develop symmetrical loss of sensitivity of the extremities (arms and legs), pain, gait disorders, and paralysis. Therapy consists of administering vitamin B12 and treating a possible underlying disease.
Read more about the topic here: Vitamin B-12 deficiency.
The burn
The severity of a burn is divided into four degrees. Up to grade 2b, the patients still feel pain. From grade 3, deep layers of the skin are destroyed, so that the surface sensitivity fails because the nerve endings are burned. Those affected no longer feel pain and the skin feels numb. The burned skin now dies and black, white and leathery areas of skin appear.
Immediate presentation to the hospital is extremely important in the event of such a burn! Spontaneous healing is impossible and the risk of inflammation is high.
Numbness in the hand while sleeping
When sleeping on the side, the radial nerve can be pressed at the level of the middle of the upper arm and thereby irritated. When you wake up, your thumb, forefinger, and half of your middle finger may feel numb or tingle.
If the damage is more severe, symptoms of paralysis can also occur, the so-called hand drop. The hand hangs down and it is not possible to stretch the fingers. Therapy is usually not necessary. The arm should be spared and the symptoms will improve after a few days.
Read more about this under: Hand falls asleep at night
Numbness in the hand during pregnancy
Feeling numb in the hand is not uncommon during pregnancy. Due to hormones, pregnant women have more water retention, which can narrow the carpal tunnel. The median nerve is irritated and there is nightly pain and numbness or tingling of the thumb, index finger and middle finger. It can also occur on both sides. Here you can try a splint as a therapy first.
Carpal tunnel syndrome in pregnancy? Read on here.
Other accompanying symptoms
Other symptoms that can accompany numbness of the hand are tingling and "pins and needles" or a furry feeling. The temperature perception can be disturbed, so that cold and warm can no longer be correctly differentiated. The vibration sensation can also be disturbed, which can be checked by an examination with a tuning fork. The reflexes can be diminished or even extinguished and, finally, a decrease in strength with muscle loss can also occur.
You can find more information about other symptoms here: Tingling in the hand
The pain in my hand
It is not uncommon for sensory disorders to be accompanied by paresthesia and pain. The pain is often shooting and electrifying. This pain is called neuropathic pain because it is caused by nerve damage. Accordingly, they do not respond to normal pain relievers such as ibuprofen or paracetamol.
If you suddenly experience severe pain in an extremity, you should also think of a circulatory disorder. If there is a circulatory disorder in the artery (embolism), the hand suddenly turns white and cold, in contrast to thrombosis of the vein in which the hand becomes red and hot. If you suspect this, you should see a doctor immediately.
Are you interested in this topic? Read more about this under: Pain in hand
The diagnosis
In order to make a diagnosis of sensory disorders, a detailed discussion with a precise description of the symptoms and previous illnesses is necessary. This is followed by a physical examination with an examination of the surface sensitivity, pain, temperature and vibration sensation, as well as the reflexes and degree of strength.
A neurophysiological examination is then carried out to define the damage to the nerve more precisely. Electronurography (ENG) is used to measure the speed of nerve conduction and electromyography to assess muscle damage. Depending on the underlying disease, further tests are necessary.
Which doctor treats this?
In the case of central or peripheral nerve damage, the neurologist is the doctor of choice. The subject deals with the brain, spinal cord and peripheral nerves. You can also diagnose and treat neuropathic pain and sensitivity disorders.
However, if surgical therapy is necessary, the neurosurgeon is called in. In the case of herniated discs, trauma surgeons can also operate.
The treatment
Treatment is always based on the cause. In the case of carpal tunnel syndrome, a nocturnal splint and short-term pain medication are possible. Another option is to apply a local corticosteroid injection in the carpal tunnel. However, in many cases, surgical splitting of the carpal ligament is ultimately performed.
If you feel numb after a stroke, therapy is rather limited. Here it is of great importance to do the exercises for movement and fine motor skills as consistently as possible.
Polyneuropathy is treated by treating the underlying disease. Symptomatically, however, one can treat neuropathic pain with special painkillers. Epilepsy drugs or antidepressants are suitable for this. Special ointments and plasters for anesthesia are also helpful.
In the case of a herniated disc, certain physical therapy exercises and short-term use of painkillers can alleviate the symptoms. In very pronounced cases, surgical therapy can be considered. A sudden decrease in pain and increasing paralysis is an absolute emergency and must be evaluated by a doctor immediately.
These articles might also interest you:
- Therapy of a carpal tunnel syndrome
- Therapy of polyneuropathy
The duration
The duration of numbness or discomfort depends on the cause. After a stroke or a central cause, the symptoms may heal completely over time, but in some cases may persist. In the case of a herniated disc, the symptoms can be recurring and become chronic. In the case of polyneuropathy, healing the underlying disease is important, but it is more of a chronic course.
Prognosis
Sensitivity disorders that arise as a result of an acute illness such as a stroke or inflammation have a better chance of being completely cured than those caused by a chronic illness (diabetes mellitus).
In the case of peripheral nerve damage, it depends on the severity of the damage. In carpal tunnel syndrome, symptoms can go away within days to weeks.
