By: Charles Lascano, MD, CAQSM, DABFM.
Sports Medicine Specialist.
Numbness in the hands can have many causes. The most common cause is damage or compression of a nerve in the wrist known as carpal tunnel syndrome. Other causes of numbness in the hands include nerve damage in other parts of the arm, herniated disc that puts pressure on the spinal nerves, nerve pressure caused by tumors, infection, or enlarged blood vessels, shingles, hardening of the arteries causing a lack of blood to the area, poor circulation from diabetes, stroke, migraine headaches, thyroid conditions, animal or insect bites, certain medications, lack of vitamin B12, abnormal levels of calcium, potassium, or sodium, and excessive alcohol use.
If hands numbness persists, prompt medical attention is needed. It could be a sign of a serious medical condition. Healthcare providers will begin the examination by taking a medical history to determine the numbness duration and other possible symptoms.
Since the most common cause of numbness is damage or compression of the nerves, Electromyography (EMG) and nerve conduction studies (NCS) remain the most effective means of identifying the affected nerve and how badly is that nerve affected.
It is very important that these tests are performed and/or supervised by the right specialist, like a neurologist or a physiatrist, with training on these tests, and with the right machine. If the patient is sent to the wrong place like an imaging center or is done at the office of a doctor without the proper training, it is very likely that the test findings will not be reliable.
Imaging testing like radiographs or MRI are the best first study to obtain in some patients. As an example, an MRI of the cervical spine is probably the best first test in a patient with radiating neck pain, with hand numbness. Also, cervical spine radiographs may be helpful in sorting out cervical instability and will give a sense of the degree of degeneration.
If someone is suspected to have carpal tunnel syndrome it is recommended that this person wears wrist braces at bedtime while waiting to be seen by the medical provider. This will help for symptomatic relief and preventing more nerve damage.
Scientific evidence does not support the use of vitamins, supplements, or even over-the-counter analgesics for the treatment carpal tunnel syndrome, so it is very important a prompt visit to the medical provider.