Overview of Hand Weakness

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If you have hand weakness or if you have been experiencing a sensation of ‘heaviness’ in one or both of your hands, there could be a number of different reasons for your problem. Sudden hand weakness is very concerning and could be a sign of a stroke which is a serious medical emergency.

However, if you have had a nagging, persistent hand weakness, you will almost certainly find out that your hand weakness is not related to a serious medical problem, such as a stroke. The most common causes of hand weakness are usually not serious or life-threatening.

Causes

Hand weakness that lasts for weeks or months is typically caused by a treatable medical problem. Most of the time, hand weakness can get worse if it is not addressed in a timely manner. This is why you definitely should not postpone getting medical attention if you occasionally have trouble moving your hand or if your hand has been gradually getting weaker.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is one of the most common causes of hand weakness, hand discomfort and hand pain.

Carpal tunnel syndrome is caused by overuse of the hand, arm or wrist, which is often related to repetitive movements such as operating machinery, computer use or typing.

Carpal tunnel syndrome results from swelling on the inside of the wrist. The swelling compresses the nerves that travel through a 'tunnel' of wrist bones. This results in pain, tingling, numbness, weakness, and lack of coordination of the hand. The discomfort and weakness can travel up the arm if the swelling and pressure worsens.

Diagnosis

Your doctor, nurse practitioner or physical therapist can typically diagnose carpal tunnel syndrome by listening to your explanation of your symptoms and examining your hand and arm. Sometimes a nerve conduction study is needed to confirm the diagnosis of carpal tunnel syndrome.

Treatment

Carpal tunnel syndrome is a treatable problem. Rest, ice, and over-the-counter anti-inflammatory medications usually help. A wrist brace and adjustment of the wrist motion during work can prevent carpal tunnel syndrome from getting worse. And for the most severe cases, a fairly simple surgical procedure to relieve the pressure usually takes care of the problem permanently.

Diabetic Neuropathy

Diabetes is a treatable medical illness. One of the complications of diabetes is called diabetic neuropathy. Neuropathy is an injury of one or more nerves of the body, most often affecting the hands or feet. Neuropathy can cause weakness, a sense of heaviness, trouble coordinating the movements of the affected limb, pain, tingling or a burning sensation.

Diagnosis

Most people who have diabetic neuropathy are aware that they have diabetes, but in some instances, diabetic neuropathy can be the first sign of diabetes.

Your doctor can detect diabetic neuropathy based on your description of your complaints and a physical examination. Often, a nerve conduction study is needed to define the severity and the type of neuropathy. Blood tests can identify whether you have diabetes.

Treatment

Next steps include diabetes management, which can help your symptoms of diabetic neuropathy, especially if they have not been present for too long.

Neuropathy

While diabetes is the most common cause of neuropathy, there are a number of causes of neuropathy besides diabetes, and they all can cause hand weakness. Your doctor may need to order some blood tests to determine whether you have neuropathy related to an inflammatory illness, an autoimmune condition, a metabolic problem, a nutritional deficiency, or a medication side effect.

Most of the time, neuropathy causes numbness, pain or weakness of the hands and feet, regardless of the cause. Most neuropathies can improve if the cause is diagnosed and medically treated.

Arthritis

Arthritis causes pain and swelling of the joints. This can result in a sensation of weakness and trouble with movement, particularly in the hands. If you have arthritis, you might have ignored the milder, early symptoms. But arthritis can worsen over time, and for many people with arthritis, it is difficult to continue to ignore it, especially when it starts to cause weakness.

Diagnosis and Treatment

Your doctor can diagnose arthritis based on your account of hand weakness, your physical examination, and possibly blood tests and X-rays. Arthritis is a painful condition that is treatable with anti inflammatory medications and therapy, and it is not life-threatening.

Pinched Nerve (Radiculopathy)

Most people experience a pinched nerve at some point in life. The medical term for a pinched nerve is radiculopathy. As a nerve enters or exits the spine (backbone) it may be 'pinched' and squeezed by swelling around the spine or by pressure from the bone or joints. This typically results in pain or weakness of the arm or leg.

A pinched nerve in the neck (which is at the level of the cervical spine) may cause hand weakness because the cervical spine controls the hand. Sometimes, a pinched nerve in the neck also causes neck pain.

Diagnosis

Your doctor or physical therapist can tell if you have a pinched nerve based on your physical examination. Usually, nerve conduction studies or imaging tests such as cervical spine CT scan or cervical spine MRI are needed to definitively identify the area and the extent of the pinched nerve.

Treatment

Some people who have a pinched nerve are fortunate enough to have full improvement without any therapy or medication. A pinched nerve during pregnancy, for example, often resolves on its own without any intervention.

Usually, management of a pinched nerve requires physical therapy, which is typically very effective. Sometimes, anti-inflammatory injections or injections with pain medications are needed. In persistent situations, surgery may be necessary.

Herniated Disc

A herniated disc is a displacement of the cartilage that supports and anchors the spine. A herniated disc may press on the spine or on the nerves. Your spine and your nerves control the sensation and movement of your body. So a herniated disc in the upper part of the spine can produce pain and/or weakness of the muscles of the hand or arm.

Diagnosis

Your doctor can diagnose a herniated disc based on your history of symptoms and your physical examination. An imaging test such as a spine X-ray, a spine CT scan or spine MRI is usually necessary to visualize how severe the problem is.

Treatment

A herniated disc can be treated with physical therapy, anti-inflammatory medication, or pain medication. A herniated disc can be a persistent problem, causing nagging pain or weakness.

Surgery may be needed in some situations. However, in many situations of persistent pain and weakness resulting from a herniated disc, surgery might not repair the problem. Thus, surgery is not always the right option for herniated disc, even when the symptoms are persistent.

If you have a herniated disc, it is usually recommended to take extra care when doing physical activities, especially when it comes to lifting heavy objects.

Saturday Night Palsy

Saturday night palsy is a specific kind of nerve compression that happens after one of the nerves in the upper part of the arm, the radial nerve, is compressed, usually from sleeping in a position that presses on the nerve for hours.

Saturday Night Palsy

It is stereotypically associated with falling asleep in a slumped over position after having had too much to drink, hence the term ‘Saturday night palsy.’ However, any cause of sleeping in a position that places too much pressure on the radial nerve for an extended period of time can cause the same type of hand weakness.

Treatment

The condition can resolve without medical or surgical intervention, but sometimes it is associated with serious trauma to the arm, requiring medical or surgical treatment. If you wake up with sudden hand weakness, especially if you have consumed alcohol the night before, it is vital to get medical attention immediately because you could have suffered a traumatic injury that requires immediate medical attention.

Ulnar Neuropathy

Ulnar neuropathy is damage to a nerve called the ulnar nerve. This nerve is located near the elbow and controls arm and hand movement. Mild compression of the ulnar nerve is caused by leaning on the arm, which produces a tingling sensation often referred to as bumping the 'funny bone.'

Damage to the ulnar nerve from traumatic injury, arthritis, compression or infection causes hand and arm weakness and tingling or loss of sensation, particularly affecting the ring finger.

Beyond Carpal Tunnel: Neuropathy of the Wrist and Elbow

A Word From Verywell

If you experience sudden weakness, you need to get emergency medical attention by calling 911. While a stroke can cause hand weakness, there are a number of causes of hand weakness that are more common than stroke and less serious than stroke. Hand and arm tingling, similarly, can be triggered by a number of different causes.

If you have had gradually worsening weakness or pain for weeks or months, you are not having a stroke. Nevertheless, it is important to make an appointment to see your doctor because most of the common problems that cause hand weakness can be more effectively treated if they are diagnosed and medically managed shortly after the symptoms begin.

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