Why hands go numb at night during sleep and how to treat this condition
The content of the article:
- Causes of nocturnal paresthesias
-
Tunnel neuropathies of the hands
- Carpal tunnel syndrome
- Pronator round syndrome
- Coiled canal syndrome
-
Cervical and thoracic radiculopathy
- Localization of paresthesia
- Etiology of radicular syndrome
- Diagnosis of nocturnal paresthesias
-
What to do if your hands are numb during sleep
- Tunnel neuropathies treatment
- Treatment of radiculopathy
- Video
If hands go numb at night during sleep, then we are talking about one of the types of sensitivity disorder, called paresthesia. With this complaint, patients often turn to a neurologist. The cause of the appearance of pathological sensations can be compression and ischemia of the nerve, vascular disorders, dysfunction of the autonomic nervous system, myofascial changes in the muscles of the shoulder girdle. Since numbness of the upper limbs is only a symptom of various diseases, the success of treatment depends on the correct diagnosis.
Hands during sleep can be numb due to an uncomfortable position of the body, but it can also be a sign of pathology
Causes of nocturnal paresthesias
Feeling of numbness, tingling, burning, painful sensations of varying intensity in the upper extremities at night can be caused by:
- congenital anatomical feature (narrowed bone canal, abnormal bone outgrowth, accessory muscle, tendon constriction);
- neoplasm;
- infectious process (tuberculosis, syphilis, HIV infection, etc.);
- endocrine pathology (insufficient thyroid function, acromegaly, diabetes mellitus);
- metabolic imbalance (lack of B vitamins, atherosclerosis, alimentary starvation);
- osteochondrosis of the cervical and thoracic spine;
- hormonal shift (pathological pregnancy, menopause);
- systemic autoimmune disease (rheumatoid arthritis, systemic lupus erythematosus, systemic vasculitis).
Provoking factors, acting in combination or separately, disrupt metabolism, the functioning of nervous tissue and lead to the occurrence of paresthesias. The connection between impaired hand sensitivity at night and compression-ischemic conditions of the nerves can be traced most clearly on the example of tunnel syndromes of the upper extremities.
Tunnel neuropathies of the hands
Tunnel syndrome, or neuropathy, is a set of sensory, motor, trophic disorders resulting from compression of the nerve trunk in narrow anatomical spaces bounded by bones, muscles and tendons. Normally, vessels and peripheral nerves freely pass through such natural tunnels, but under certain pathological conditions, the lumen of the tunnel decreases, and compression of nerve and vascular formations occurs.
When hands go numb in a dream, the reason is often:
- carpal tunnel syndrome;
- pronator round syndrome;
- spiral canal syndrome.
These neuropathies involving the median and radial nerves are well understood.
Carpal tunnel syndrome
Infringement of the median nerve during the transition from the forearm to the hand in the canal formed by the bones of the wrist and the transverse ligament is called carpal tunnel syndrome, or carpal tunnel. Neuropathy is much more common in women, as their canal is somewhat narrower than in men. The peak incidence occurs during the climacteric period, when hormonal imbalance is added to the anatomical features.
Nocturnal and morning painful numbness of the fingers is a characteristic clinical symptom of this pathology. A tingling, creeping sensation affects the surface of the first four fingers or some of them from the side of the palm. Patients are concerned about pain in the fingers and hands, sometimes spreading higher - to the forearms, shoulders and even the neck.
In the absence of adequate treatment and the progression of the disease, atrophy of the thumb muscles develops, weakness of the short abductor and opposing thumb muscles. This is manifested by a decrease in the force of compression between the thumb and forefinger. As a result, activities such as tying a tie, buttoning up, and winding a mechanical watch are hampered.
Neuropathy occurs against the background of pathological processes that narrow the canal lumen. Among the most common:
- trauma (contusion, dislocation, fracture);
- inflammation of the surrounding tissues (arthritis, tendovaginitis);
- diffuse changes in connective tissue (systemic scleroderma, dermatomyositis, recurrent polychondritis, rheumatism);
- tumor formations (hygroma, lipoma, chondroma).
The course of the disease is aggravated by constant microtraumas arising during the performance of professional activities: repeated brush movements of the same type (flexion and extension), carried out by dentists, pianists, packers, carvers, programmers. During professional overload, the leading hand usually suffers: for right-handers - the right, for left-handers - the left. With the general effect of the pathogenetic factor on the human body, both limbs are affected.
Pronator round syndrome
The pronator circular is a superficial flexor muscle of the forearm. If the median nerve is compressed, passing in the upper third of the forearm between the two heads of this muscle, then the syndrome of the same name develops, also known as Seyfart syndrome. Its appearance is often caused by a significant muscle load associated with repetitive rotational movements of the forearm around the long axis inward. Such types of activities are characteristic of guitarists, flutists, athletes.
The long-term compression of tissues, observed, for example, during sound sleep with the position of the partner's head on the inner surface of the forearm, plays an important role in the formation of the syndrome. The same problem occurs in breastfeeding mothers when the baby's head is on the forearm for a long time, not only during feeding, but also during motion sickness.
The main clinical manifestations of Seyfart syndrome: numbness, burning, pain in the upper third of the forearm, irradiation of pain in the palm and first four fingers, impaired sensitivity in the proximal lateral surface of the hand. Weakness of the abductor thumb muscle is typical.
Coiled canal syndrome
Compression of the radial nerve in the canal bounded by the spiral groove of the radial bone and the heads of the triceps brachii muscle leads to sensory disturbances in the innervation zone. The back surface of the shoulder, forearm, thumb, index and half of the middle fingers of the hand is affected, there are difficulties in extending the hand, abducting the thumb. All these disorders are combined into spiral channel syndrome, which has many other names: Saturday night paralysis syndrome, park bench or bench syndrome.
Such figurative names were formed due to the mechanism of the development of the syndrome, in which the compression of the nerve occurs with its prolonged compression:
- during sound sleep caused by alcohol consumption, usually on a weekend;
- in deep sleep on a hard surface;
- when the partner's head is located on the outer surface of the shoulder;
- with intense repetitive movements in the shoulder and elbow joints.
Cervical and thoracic radiculopathy
Paresthesias of the upper extremities at night can be the result of radiculopathy - compression of the roots of the spinal nerves in the cervical and thoracic spine. Usually, hands become very numb when sleeping on an uncomfortable bed or when choosing the wrong pillow.
Localization of paresthesia
Radiculopathy is characterized by the appearance of pain in the neck, radiating to the arm, scapula, heart area, and impaired sensitivity. Often, in parallel with an attack of pain, the hand begins to swell, sweat, and redness of the skin appears. The localization of pathological sensations depends on which root is squeezed.
| Damage level: root | Localization of paresthesia | Localization of pain |
| C5 | Upper outer shoulder | The outer surface of the shoulder, the medial part of the scapula |
| C6 | Thumb and index fingers, lateral surface of the hand and forearm | Lateral surface of the forearm and hand, thumb and forefinger |
| C7 | Thumb, index, middle fingers, back of the hand and forearm | Back of the shoulder and forearm to the index and middle fingers |
| C8 | Ring finger and little finger, inner surface of the hand and forearm | Inner surface of the forearm, hand up to the ring finger and little finger |
| T1 | Inner surface of the shoulder and upper half of the forearm, armpit | Inner surface of the shoulder and forearm, armpit area |
Etiology of radicular syndrome
The most common cause of radicular syndrome, also called radiculopathy, is osteochondrosis. In addition, root infringement can develop against the background of:
- spinal hernia;
- compression fracture of the vertebrae in osteoporosis (decreased bone density);
- spondyloarthrosis;
- tumor formation;
- lateral displacement of the vertebral bodies;
- osteomyelitis - vertebral lesions by an infectious process.
Infringement does not occur immediately, it follows, as a rule, after prolonged degenerative changes in the intervertebral discs.
Diagnosis of nocturnal paresthesias
To treat without a correct diagnosis means to nullify all the effort and money spent. If your hands are numb in a dream, you must first be examined by a neurologist. Sometimes you cannot do without consulting doctors of the following specialties: vascular surgeon, traumatologist, orthopedist, therapist, endocrinologist, rheumatologist, etc.
After the interview and neurological examination, you may need:
- electroneurography;
- electromyography;
- X-ray of the upper limb, spine;
- magnetic resonance imaging;
- CT scan;
- ultrasound dopplerography of the vessels of the hands;
- laboratory examination (clinical and biochemical blood tests).
A specific survey plan is drawn up by a specialized specialist.
What to do if your hands are numb during sleep
Nocturnal paresthesias of the upper extremities is not a separate nosology, but only a sign of a wide range of diseases.
If numbness of the hand during sleep appears for the first time, then it is enough to change the position of the body, do a light massage, several physical exercises to get rid of this sensation. When sensitivity disturbances constantly bother you, a serious approach is needed.
Massage and gentle hand gymnastics can help with numbness.
If the cause of damage to the peripheral nervous system is infectious or systemic processes, then the help of an infectious disease specialist, therapist, rheumatologist is required. In case of a malfunction of the endocrine glands, one cannot do without the recommendations of an endocrinologist and the normalization of hormonal levels. The latter is also mandatory when paresthesias occur during menopause.
Numbness of the extremities at night in pregnant women, accompanied by edema not only of the arms, but also of the legs, usually completely disappears after childbirth. But when observing such pregnant women, it is necessary to control blood pressure, urine, blood, kidney function and normalization of microcirculation.
Tunnel neuropathies treatment
As for the treatment of tunnel neuropathies, for effective treatment, you first need to:
- Stop physical impact in the affected area.
- Provide rest, immobility of the affected limb, using orthoses, splints, bandages.
- Change the habitual motor stereotype of behavior (uncomfortable position of the hands during work, wrong posture).
Sometimes etiological treatment is difficult, since it is not possible to completely exclude daily and professional activities that cause microtraumatization of nerve structures. Symptomatic therapy involves the use of non-steroidal anti-inflammatory, decongestant drugs, analgesics, glucocorticoid injections into the tissues surrounding the nerve. The surgical method - decompression or neurolysis of the nerve trunk - is resorted to when conservative therapy is unsuccessful.
Treatment of radiculopathy
Treatment of radicular syndrome involves the use of:
- non-steroidal anti-inflammatory drugs (Nurofen, Diclofenac, Movalis);
- local irritants in the form of ointments (Kapsikam, Finalgon, Nikoflex);
- muscle relaxants (Mydocalm);
- drugs that improve microcirculation (Pentoxifylline);
- B vitamins (Milgamma, Kombilipen);
- chondroprotectors (Teraflex, Chondroxide);
- therapeutic blockades (intraosseous, paravertebral).
In some cases, surgery is indicated.
For the treatment of numbness of hands in a dream, not only medications are used, but also folk remedies, physiotherapy exercises, reflex and physiotherapy, manual influence. For the success of therapy, it is necessary to normalize weight, give up smoking and alcohol. But what you don't need to do is self-medicate.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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