Numbness and pins and needles are common symptoms affecting the hands and fingers, particularly at night. Generally, these symptoms suggest nerve compression somewhere. Sometimes, however, the cause can be different and potentially severe. For example, heart attacks and multiple sclerosis can also cause hand numbness. So, what causes pain and numbness in arms and hands while sleeping, and how do we manage it?
Symptoms
Firstly, you need to define what numbness means. Does it mean a total lack of feeling or altered sensations such as pins and needles? Also, we need to ask exactly where and when these symptoms occur. For example, carpal tunnel syndrome causes symptoms mostly at night or while sleeping and with repeated hand movements. Generally, the thumb and three fingers are affected, while the pinky finger is fine.
Also, we need to ask about other symptoms, such as pain or weakness in the hands or fingers. For example, does the pain or weakness move to the upper arm or neck?
In addition, we need to rule out other medical conditions that would make nerve pressure more likely. For example, diabetes or an underactive thyroid can cause stress on the median nerve or inflammation of the small nerves in the fingers.
Common causes of pain and numbness in arms and hands while sleeping
Carpal tunnel syndrome
Carpal tunnel syndrome is the most common cause of pain and numbness in hands while sleeping. The median nerve pinching in the carpal tunnel often causes numbness and pins and needles in the thumb and 2-3 fingers, usually sparing the little finger. However, in more severe cases, pain and muscle weakness occur.
Damage to the superficial branch of the radial nerve
This branch supplies sensation to the base of the thumb and two fingers on the dorsum of the hand. Pressure on the nerve usually occurs after an injury – either a wrist fracture or an injection that has hit the nerve.
Usually, as the superficial branch supplies only skin, there is often no muscle weakness or wasting.
Cubital tunnel syndrome
Generally, pinching the ulnar nerve at the inside of the elbow causes cubital tunnel syndrome. Symptoms include numbness and pins and needles affecting the ring and pinky fingers. Also, wasting and weakness occur in the small muscles between the fingers.
Peripheral neuropathy
In addition to nerve pinching or trapping, the sheath surrounding the nerves (myelin) can become inflamed, also called peripheral neuropathy. There are many causes of inflamed nerves, including diabetes, underactive thyroid, specific medication, vitamin deficiencies, and high alcohol intake.
Spinal cord and brachial plexus cause of numbness in hands while sleeping
Nerves supplying the hand run up the arm to the spinal cord and brain. Before the nerves reach the spinal cord, they form a complex array of nerve groups called the brachial plexus.
Nerve problems in the brachial plexus or the spinal cord can cause numbness in the hands. However, as both structures contain many grouped nerves, the damage will likely generate more than just numbness in the hand. Instead, we would expect numbness over a larger area or associated weakness and wasting in the hand, arm, or shoulder parts.
How do you sort out numbness in your hands while sleeping?
Generally, we order these tests to determine the cause of the numbness and treat it appropriately.
Nerve conduction studies and EMG test the speed of messages through the nerves and the muscle contraction at the end of the nerves. In addition, it often tells us where and why the nerve messages are abnormal.
An ultrasound can see the path and thickness of the nerves that supply the arm and hand. The peripheral nerves examined under ultrasound include median, ulnar and radial nerves. Pinching the nerves leads to the thickening of the nerve just before the entrapment zone.
If numbness is thought to be coming from the spinal cord or brain, an MRI might be needed to rule out a tumour, inflammation, or a stroke.
Finally, blood tests help exclude nerve inflammation.
Other frequently asked questions about numbness in the hands while sleeping:
Carpal tunnel injection: Is it helpful for carpal tunnel syndrome?
Yes. A cortisone injection is effective in 85% of cases of carpal tunnel syndrome. Generally, we recommend carpal tunnel injections be performed with ultrasound to improve accuracy and effectiveness.
Final word from Sportdoctorlondon about numbness in hands while sleeping
Most numbness in hands while sleeping is due to a pinched nerve in the hand or arm, such as carpal tunnel syndrome or cubital tunnel syndrome. However, seeing an experienced doctor to confirm a pinched nerve and rule out more severe conditions is essential.
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