Numbness in hands refers to numbness in the hands, which may be accompanied by a tingling sensation and a crawling sensation. It is a common symptom, often caused by damage to the nerve function that controls the hands. In severe cases, it may be accompanied by hand muscle atrophy, affecting the fine movements of the hands. Short-term numbness in the hands is mostly physiological. If long-term persistent numbness occurs, it should be considered to be pathological.
symptom
Typical manifestations
Hand numbness is mainly manifested by the following abnormal sensations in the hand without external stimulation:
1. Numbness and stiffness in the hands.
2. The hands’ perception of pain or temperature is reduced. For example, the hands will not feel hot when they touch hot water, and will not feel cold when they touch ice.
3. The patient feels tingling or burning pain in the hands.
4. The patient feels as if ants are crawling on the skin of his hands.
5. The patient’s hands feel as if they are wearing gloves.
reason
Overview
The main causes of hand numbness include neuropathy, vascular disease (such as stroke, cervical spondylosis, etc.), coma, tumors, drugs, chemical stimulation, psychological factors, hypertension, anemia, etc. In addition, physiological reasons such as pregnancy, incorrect sleeping posture, and long-term mobile phone use can also cause hand numbness.
Cause of symptoms
1. Physiological factors
Pregnancy, incorrect sleeping posture, writing with the head down for a long time, or looking at the phone.
2. Pathological
(1) Neuropathy
① Peripheral neuropathy: cervical spondylosis, carpal tunnel syndrome, multiple peripheral neuritis, etc.
②Central nervous system diseases: stroke, etc.
(2) Vascular disease
People with diabetes may experience numbness in their hands and feet, which is mainly caused by vascular disease.
(3) Local nerve stimulation
Numbness occurs scattered in the limbs, such as numbness caused by stimulation of the head nerves due to coma, or stimulation of the lumbar and shoulder nerves.
(4) Tumor
Tumor compression of nerves can cause numbness in the hands.
3. Others
Drugs, chemicals, ion disorders, acid-base imbalance, psychological factors, high blood pressure, anemia, and menopausal syndrome can all cause numbness in the hands.
Common diseases
Cervical spondylosis, carpal tunnel syndrome, multiple peripheral neuritis, stroke, alcoholism, diabetes, menopausal syndrome, thoracic outlet syndrome, etc.
Medical treatment
Outpatient Indications
1. Repeated or persistent numbness in fingers.
2. Accompanied by upper limb weakness, neck and back pain, dizziness, and nausea, consider the possibility of cervical spondylosis.
3. Abnormal sensations occur in multiple fingers, such as numbness, tingling, burning pain, swelling, etc., which may cause waking up at night, which is common in “mouse hand”.
4. When you hold things with your hands, it feels like you are wearing gloves, and when your feet touch things, it feels like you are wearing socks. This is common in peripheral neuritis.
5. Other severe, persistent or progressive symptoms and signs occur.
The above symptoms require prompt medical consultation.
Department
1. If you suspect carpal tunnel syndrome, cervical spondylosis or other musculoskeletal diseases, you can go to an orthopedic department for treatment.
2. If you suspect a neurological disease such as neuritis, you may go to the neurology department or neurosurgery department for treatment as appropriate.
Medical preparation
1. Make an appointment in advance and bring your ID card, medical insurance card, medical card, etc.
2. It may be necessary to examine your hands, arms and other parts of your body. Wear loose clothing to facilitate the doctor’s examination.
3. Blood routine tests may also be performed. Please note that you should fast after 10 pm the night before the test and have your blood drawn on an empty stomach the next morning.
4. If you have had medical treatment recently, please bring relevant medical records, examination reports, test results, etc.
5. If you have taken some medicine to relieve symptoms recently, you can carry the medicine box.
6. Family members can be arranged to accompany the patient to seek medical treatment.
7. Patients can prepare a list of questions they want to ask in advance.
Questions your doctor may ask you
1. When did your hand numbness begin? Has the numbness gotten worse over time?
2. Will the numbness in your hands spread to your arms and other parts?
3. Under what circumstances are numbness in the hands most likely to occur?
4. In addition to hand numbness, do you also have pain, limited hand movement, etc.?
5. Have you ever had numbness in your hands before? What caused it?
6. Have you had any falls, hand injuries, etc. recently?
7. Do you use medication to treat hand numbness? Which medication?
8. Do you have high blood pressure, diabetes or other diseases? Are you taking medicine to control them?
9. Do you smoke? How long have you been smoking? How much do you smoke every day?
10. Do you like drinking alcohol, coffee, Red Bull or other beverages?
11. Do you use illegal drugs such as cocaine?
Questions patients can ask their doctors
1. What is the most likely reason for my numbness in my hands?
2. Is my condition serious? Will it affect my future hand movements?
3. What tests do I need to do?
4. What treatment do I need now? Can it be cured?
5. Are there any risks with these treatments? Do I need to be hospitalized?
6. If medication is used, what are the usage, dosage, and precautions?
7. I have other diseases. Will they affect my treatment?
8. What should I pay attention to in my daily life? How should I take care of myself after returning home?
9. Do I need follow-up examinations? How often?
examine
Estimated inspection
The doctor will first conduct a physical examination on the patient to make a preliminary assessment of the condition; then, based on the patient’s medical history and chief complaint, the doctor will select and perform other examinations such as X-rays, cranial CT, MRI, blood routine, and cerebrospinal fluid examinations.
Physical examination
1. If the patient is found to have neck muscle spasm and feels pain when pulling the affected limb or doing the “head pressure test”, cervical spondylosis may be considered.
2. If the thumb is found to be adducted, thenar muscle is atrophied, and active thumb abduction, opposition, and finger opposition are limited, carpal tunnel syndrome may be considered.
Laboratory tests
1. Blood routine test
Decreased hemoglobin is an important indicator for diagnosing anemia.
2. Cerebrospinal fluid
Patients with late-stage spinal canal and spinal cord tumors and severe cervical disc herniation that cause cerebrospinal fluid obstruction often have elevated cerebrospinal fluid protein.
Imaging tests
1. X-ray
X-ray examination shows that the physiological curvature of the cervical spine disappears, it becomes stiff, angulated, and the intervertebral space is narrow, which can confirm the diagnosis of cervical spondylosis.
2. Brain CT
It can easily and quickly distinguish ischemic stroke from hemorrhagic stroke.
3. Magnetic resonance imaging
It is the most commonly used examination for diagnosing cervical spondylosis, intraspinal tumors, spinal cord demyelination and other diseases.
Other tests
Neuroelectrophysiological examination: It can determine whether there are abnormalities in nerve conduction function and help to clarify the location, nature, scope and extent of nerve damage.
diagnosis
Diagnostic principles
The diagnosis can be confirmed based on the medical history, typical manifestations of hand numbness and accompanying symptoms, combined with blood routine, cerebrospinal fluid examination, X-ray, CT and other related examinations. During the diagnosis process, the doctor needs to rule out diseases such as carpal tunnel syndrome, cervical spondylosis, stroke, and multiple peripheral neuritis.
Differential Diagnosis
1. Carpal tunnel syndrome
It is more common in women. The main symptoms include paresthesia and/or numbness in the median nerve innervation area (thumb, index finger, middle finger and radial side of ring finger). Finger numbness at night is common, especially in patients who wake up at night due to finger numbness. They often need to get up and move around or shake their hands to get some relief before they can fall asleep again. Finger numbness can also worsen when patients bend their wrists for too long during certain activities during the day.
2. Cervical spondylosis
One of the diseases that are common in middle-aged and elderly people. In addition to finger numbness and paresthesia, cervical spondylosis is also accompanied by other symptoms, such as neck and back pain, upper limb weakness, lower limb weakness, difficulty walking, dizziness, nausea, vomiting, and some patients may have difficulty swallowing. X-ray examination is helpful for diagnosis.
3. Stroke
Patients may have high blood pressure, high blood lipids, diabetes, cerebral arteriosclerosis and other diseases. The most common symptoms of stroke are sudden weakness on one side of the face, arm or leg, sudden fainting, and unconsciousness. Other symptoms include sudden numbness on one side of the face, arm, hand or leg, or sudden facial paralysis, hemiplegia; confusion, difficulty speaking or understanding; difficulty seeing in one or both eyes; difficulty walking, dizziness, loss of balance or coordination; severe headache without cause; fainting, etc. Cerebral angiography is helpful for diagnosis.
4. Multiple peripheral neuritis
In the early stage, the symptoms are usually burning, pain, numbness, or other paresthesias or hyperesthesias at the fingertips (or toes), which gradually decrease or even disappear. The sensory disturbances are distributed in a glove or sock pattern.
5. Thoracic outlet syndrome
It refers to a series of symptoms caused by compression of the subclavian artery, vein and brachial plexus at the upper opening of the thorax. Patients often experience a series of clinical manifestations such as soreness, numbness, weakness, muscle atrophy and signs of compression of the subclavian blood vessels in the hands and upper limbs.
treat
Expected treatment
The key to the treatment of hand numbness is to identify the cause and actively treat the primary disease. Numbness caused by carpal tunnel syndrome can be treated with painkillers or corticosteroids to relieve symptoms, and surgery can be performed in severe cases. In addition to drug treatment, traction therapy can be performed for numbness caused by cervical spondylosis, and surgery can be performed if necessary. Numbness caused by multiple peripheral neuritis can be treated with nerve nourishing drugs.
Treatment
1. Carpal tunnel syndrome
(1) Non-surgical treatment: Oral anti-inflammatory and analgesic drugs and local injection of corticosteroids are commonly used methods.
(2) Surgical treatment: including various incision surgeries, small incision decompression and endoscopic surgery.
2. Cervical spondylosis
(1) Drug treatment: Analgesics, sedatives, and vitamins can be used selectively, which can have a certain effect on relieving symptoms.
(2) Exercise therapy: When the symptoms of various types of cervical spondylosis are basically relieved or in a chronic state, medical gymnastics can be started to promote further elimination of symptoms and consolidate the therapeutic effect. During the acute onset of symptoms, local rest is recommended, and exercise stimulation should not be increased. Exercise is contraindicated when there are obvious or progressive symptoms of spinal cord compression, especially cervical spine backward movement. In the case of vertebral artery type cervical spondylosis, neck rotation exercises should be gentle and slow, and the amplitude should be appropriately controlled.
(3) Traction therapy: “Traction” was one of the first choice methods for treating cervical spondylosis in the past. However, in recent years, it has been found that many patients with cervical spondylosis, especially those who use “traction” for a long time, have not only failed to alleviate their cervical spondylosis, but have aggravated it. Traction not only cannot promote the recovery of the physiological curvature of the cervical spine, but on the contrary, traction straightens the cervical spine and weakens the physiological curvature of the cervical spine. Therefore, traction therapy should be used with caution for cervical spondylosis.
(4) Manual massage therapy: It is a relatively effective treatment measure for cervical spondylosis. Its therapeutic effect is to relieve the tension and spasm of the neck and shoulder muscles, restore cervical spine movement, and loosen the nerve roots and soft tissue adhesions to relieve symptoms.
(5) Physical therapy: iontophoresis, ultrasound, ultraviolet light or intermittent current.
(6) Surgical treatment: For patients with severe nerve root or spinal cord compression, surgical treatment can be performed if necessary.
3. Multiple peripheral neuritis
Actively treat the primary disease (diabetes, uremia, etc.), improve nutrition, correct vitamin deficiency, and avoid contact with harmful metals and drugs. Use symptomatic nerve nutrition drugs such as vitamin B₁₂, B₁, B₆, citicoline, coenzyme Q10, nerve growth factor, etc. Low molecular weight dextran can be used to improve peripheral circulation.
Related drugsCorticosteroids, dextran, vitamin B₁₂, vitamin B₆, citicoline, etc.
daily
Nursing principles
1. Understand the causes and hazards of hand numbness, and pay attention to moisture-proof and keep warm.
2. Maintain an optimistic and positive attitude.
3. Patients and their families should pay attention to daily safety, such as avoiding scalding from hot water and avoiding falling while walking.
4. Eat more fruits, vegetables and other foods rich in vitamins.
5. Closely observe toxic reactions and take medication as directed by your doctor.
prevention
Precautions
1. Pay attention to keeping a regular schedule, eat in moderation, especially avoid overeating fatty and sweet foods, quit smoking and limit alcohol consumption, and prevent “three highs” blood diseases.
2. Keep a happy mood and avoid worry and anger.
3. Participate in sports activities within your ability, such as running, health exercises, outdoor sports, etc. to enhance physical fitness and promote the smooth flow of qi and blood.
4. People who are middle-aged or older, especially those who are obese, should take active treatment measures to prevent stroke if they experience numbness in their index finger, middle finger or the root of the tongue.