Hands go numb: reasons for what to do
The content of the article:
- Causes of passing paresthesias
- Causes of chronic paresthesias
-
Paresthesia with carpal tunnel syndrome
- Carpal tunnel syndrome
- Pronator round syndrome
- Shoulder supracondylar syndrome
- Guyon's canal syndrome
- Cubital canal syndrome
- Instep support syndrome
- Coiled canal syndrome
- Cervical radiculopathy
- Diagnostics
- What to do if your hands go numb
- Video
Why, when your hands go numb, you can't ignore it? Because numbness is just a symptom called paresthesia. Short-term and long-term paresthesias have different origins. The former are caused by irritation of the superficial nerves and are easily eliminated, the latter are a consequence of diseases that disrupt the normal conduction of nerve impulses and require a comprehensive examination and treatment. Tumor, infectious, autoimmune processes, hormonal, endocrine changes, trauma and features of the anatomical structure can lead to numbness of the hands.
If hands become numb often for no apparent reason, a medical examination is necessary.
Causes of passing paresthesias
Short-term, or passing, paresthesias occur for obvious reasons:
- prolonged stay in one position, fixing the upper limbs;
- the use of clothing, jewelry, squeezing hands;
- long-term carrying of a bag, a backpack in hand, on the shoulder;
- performing work related to raising the upper limbs;
- stay in the cold.
All of these factors disrupt the blood supply to nerve fibers and irritate superficial nerves. The feeling of tingling, burning, crawling creeps quickly disappears after eliminating the traumatic effect: you just need to change the position of the body, unfasten the cuffs, remove jewelry, get rid of a heavy bag, and keep warm. To normalize blood flow, elementary physical exercises and light massage are shown.
Causes of chronic paresthesias
When the problem of hand numbness bothers you constantly, then we are talking about chronic paresthesia. Damage to the peripheral nervous system in this case can be caused by the following:
- an individual anatomical feature (narrow bone canal, bone process, tendon constriction);
- anomaly of a congenital nature (bone spur, accessory muscle, fibrous cord);
- infectious pathology (HIV infection, tuberculosis, syphilis, measles, etc.);
- tumor process;
- endocrinopathy (hypothyroidism, diabetes mellitus);
- changes in hormonal levels (menopause, pregnancy, lactation, use of hormonal contraceptives);
- metabolic imbalance (atherosclerosis, alimentary starvation, deficiency of B vitamins, PP, etc.);
- congenital susceptibility of peripheral nerves to certain adverse factors;
- systemic disease (systemic lupus erythematosus, rheumatoid arthritis, gout);
- osteochondrosis of the cervical and thoracic spine.
The listed etiological factors, individually or in combination, lead to pain, numbness, and movement disorders. Compression and reduction of blood supply to the nervous tissue are the main mechanisms of their negative influence. The connection between the development of local paresthesias of the upper extremities and compression-ischemic states is most clearly traced on the example of tunnel neuropathies.
Paresthesia with carpal tunnel syndrome
Tunnel syndrome, or tunnel neuropathy, is usually understood as a complex of sensory, motor, trophic disorders resulting from a pinched nerve in narrow anatomical spaces bounded by bones, tendons and muscles. This occurs under certain pathological conditions.
The main tunnel neuropathies of the upper extremities include the following syndromes:
- carpal tunnel;
- round pronator;
- supracondylar process of the shoulder;
- Guyon canal;
- a cubital channel;
- instep support;
- spiral channel.
Carpal tunnel syndrome
The carpal tunnel, or carpal tunnel, is located at the base of the hand from the side of the palm and is formed by the bones of the wrist and the transverse ligament stretched over them. With this syndrome, when passing from the forearm to the hand, the median nerve is compressed in the reduced canal lumen.
Sensory branches of the nerve provide sensitivity:
- thumb skin;
- the first three and half of the ring finger from the side of the palm;
- middle and distal phalanges of the index and middle fingers on the back of the hand.
Sensory disturbances during compression of nerve fibers develop in accordance with these features of innervation.
Any pathological process that narrows the lumen of the canal leads to infringement: contusion, dislocation, fracture, inflammation, deforming osteoarthritis, hygroma, lipoma, etc. The peculiarity of the structure of the canal also increases the possibility of developing the disease. In women, the canal is narrower, therefore, carpal syndrome develops in them much more often than in men. Pathology can occur at any age, but during the period of hormonal changes in the body, after 45 years, the likelihood of developing the syndrome is higher.
Typical complaints in this pathology are paresthesias and pains. Patients report numbness, burning sensation in the palmar surface of the first four fingers, weakness and awkwardness when moving in the hand. Pains very often move to the inner surface of the forearm or down - from the wrist to the fingers, appear at night. This is especially unpleasant, since sleep is interrupted and the patient's general condition is disturbed.
Pronator round syndrome
Pronator circular is a muscle belonging to the superficial flexor muscles 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 tunnel syndrome of the same name develops. It occurs in persons forced by the nature of their activity every day to make repetitive movements associated with the rotation of the forearm around the long axis inward.
When the nerve trunk is compressed, it begins to grow numb, tingle, ache in the innervation zone of the median nerve, and it hurts badly in the palmar surface of the forearm. Weakness of the abductor thumb muscle is sometimes observed.
Shoulder supracondylar syndrome
In the lower third of the shoulder, the median nerve may be compressed by an abnormal process of the humerus or Strother's ligament. In this case, the syndrome of the supracondylar process of the shoulder develops. The disease is rare, as the process exists in only one in a hundred people.
In the zone innervated by the median nerve, paresthesias, pains appear, and the strength of flexion of the hand and fingers decreases. Complaints are similar to those associated with pronator round syndrome. The difference is that under the Strother's ligament, compression of the vessel, the brachial artery, is also possible, with the occurrence of corresponding circulatory disorders.
Guyon's canal syndrome
Tunnel syndrome, called Guyon's canal syndrome, occurs when the deep branch of the ulnar nerve is compressed in the tunnel formed by the pisiform and the hook bones, the short palmar muscle and the palmar metacarpal ligament. Its manifestations: numbness, crawling creeps in the ring finger and little finger, sharp pains, difficulties with pinching, drawing fingers.
The appearance of the disease is typical after using a cane or crutch, constant work with a screwdriver, forceps, vibrating instruments. This type of activity is carried out by tailors, leather carvers, gardeners, violinists, miners and road workers dealing with a jackhammer.
Cubital canal syndrome
When the ulnar nerve is pinched in the cubital canal, the tunnel syndrome of the same name develops. The canal is formed in the area of the elbow joint, it is limited by the inner epicondyle of the shoulder and the ulna. Pathology is in second place in frequency of occurrence after carpal tunnel syndrome.
Pain, numbness and tingling along the lateral surface of the shoulder, in the little finger and half of the ring finger are the main complaints of patients with this type of compression. In the beginning, all of these symptoms appear only with pressure on the elbow or after prolonged flexion, then constantly. Weakness may develop in the right or left arm, depending on which one is subjected to stress.
Instep support syndrome
The instep support syndrome is a lesion of the deep, or posterior, branch of the radial nerve in the sub-ulnar region. Muscle overloads provoke its development, leading to a dystrophic process in the area of muscle attachment to the external epicondyle of the humerus.
The syndrome manifests itself with paresthesia and pain in the forearm, weakness and hypertrophy of the extensor muscles of the forearm. Active extension of the middle finger while pressing it and simultaneously extending the arm at the elbow joint provokes intense pain in the elbow and upper forearm.
Coiled canal syndrome
Infringement of the radial nerve in the tunnel formed by the spiral groove of the radius and the heads of the triceps brachii is a spiral canal syndrome, or "park bench" or "Saturday night paralysis". Compression occurs:
- with forced repetitive movements in the shoulder and elbow joints;
- during deep sleep, including after drinking alcoholic beverages;
- in the absence of a soft bed;
- when the partner's head is located on the outer surface of the shoulder.
Characterized by a violation of all types of sensitivity of the thumb, index and half of the middle fingers. The patient cannot straighten the hand, take the thumb away.
Cervical radiculopathy
Paresthesias of the hands can be the result of radiculopathy - compression of the roots of the spinal nerves in the cervical spine. The main reason is osteochondrosis. Neck pain occurs sharply, radiating to the arm, suprascapular region. Numbness, tingling in various areas of the upper limbs is characteristic. The localization of pathological sensations depends on which root is squeezed.
The most common paresthesias are the fingers. Cough, sudden movements of the head, with one or both hands, stress in the neck area provoke increased pain and impaired superficial sensitivity.
Cervical radiculopathy is one of the common causes of hand numbness
Diagnostics
How is hand numbness treated? The therapeutic tactics depend on the etiology of the process, which means that it is very important to make the correct diagnosis before starting therapy. It is necessary to consult a neurologist, but consultations of doctors of other specialties may be required: an orthopedist, traumatologist, vascular surgeon, therapist, endocrinologist, rheumatologist.
Patient survey and neurological examination are complemented by:
- electromyography;
- electroneurography;
- X-ray of the spine, upper limb;
- Magnetic resonance imaging;
- ultrasound dopplerography of the vessels of the upper extremities;
- laboratory examination (detailed clinical, biochemical blood test).
What to do if your hands go numb
Paresthesias that have developed as a result of infectious, systemic diseases can be cured only by acting on the root cause. Recommendations are usually given by a neurologist and therapist. In case of malfunction of the endocrine glands, one cannot do without the help of an endocrinologist and the normalization of hormonal levels. The same is required when hands become numb during menopause.
| Pathology type | Therapeutic tactics |
| Paresthesia in pregnant women | Since they usually appear against a background of increased pressure and edema not only on the arms, but also on the legs, correction of microcirculation, stabilization of pressure, joint supervision of a gynecologist and a neurologist before childbirth and in the postpartum period is necessary. |
| Tunnel neuropathies |
Etiological treatment is impossible, since they are provoked by constant microtraumatization of the nerves during daily or professional work, which is difficult to completely exclude. Symptomatic therapy includes non-steroidal anti-inflammatory drugs, decongestants, analgesics, glucocorticoid injections directly into the tissues surrounding the nerve. A radical method of treating tunnel neuropathies is an operative method - decompression or neurolysis of the nerve trunk. The operation is resorted to when conservative therapy is ineffective. |
In the treatment of hand numbness, physiotherapy and folk methods are widely used. In case of a deficiency of B vitamins, foods that contain them in sufficient quantities are included in daily food. Treatment success is facilitated by:
- normalization of weight;
- to give up smoking;
- elimination of alcohol;
- therapeutic exercise.
Timely seeking help and refusal of self-medication are the key to recovery.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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