Hand Numbness

Numbness in the hands can be uncomfortable, and the lack of normal sensation can affect your ability to use your hands the way you want to. There are several causes, including nerve conditions, spine problems, disorders that affect the brain, and medication.

Depending on the cause, hand numbness can get worse, and it can also be associated with other symptoms—like pain or weakness. Usually, hand numbness can be treated, and the sooner it’s treated, the better the chance of recovery.

This article will discuss the symptom of hand numbness, possible causes, diagnostic tests, treatment, and when to see a healthcare provider.

Symptoms of Numbness in the Hands 

Hand numbness can affect one or both hands, and it may also affect the arm. It can come and go, and it may be more noticeable at times. 

Hand numbness can feel like: 

• A lack of sensation 
• Tingling, like your hand fell asleep 
• Pain, burning 
• Hot or cold sensation 
• Hypersensitivity to touch 
• Trouble with hand coordination 

Sometimes hand numbness is associated with hand or arm weakness. Systemic conditions, like peripheral neuropathy (damage to peripheral nerves), will usually also cause numbness of the feet. 

Causes of Numbness in the Hands 

The most common cause of hand numbness is pressure on the sensory nerves and small blood vessels in your hand, which can happen when you’re leaning or sitting on your hand. This can cause a temporary sense that your hand fell asleep, which feels like tingling.

This sensation will usually go away within a few minutes. But if you have neuropathy or peripheral vascular disease, it can happen often and last longer than a few minutes.

Any condition that damages the peripheral sensory nerves of the hand can cause persistent hand numbness. Some conditions that affect the sensory regions of the brain or spinal cord can also cause hand numbness. 

Common causes of hand numbness are: 

• Peripheral neuropathy: This disorder damages nerves throughout the body. Usually, the distal (farthest away from the center of the body) nerves are most severely affected. Uncontrolled diabetes, alcohol use, and medications are the most common causes.
• Median nerve impairment, such as carpal tunnel syndrome: This common condition develops due to compression of the median nerve, which runs through the wrist. Overuse, such as during manual work, is a common cause.
• Radial neuropathy: Compression of the radial nerve can occur in the wrist, elbow, or upper arm.
• Cubital tunnel syndrome or ulnar neuropathy: Ulnar nerve compression is most common at the elbow.
• Cervical radiculopathy: Spine disease, like degenerative arthritis, can compress the sensory spinal nerves, impairing sensation in the hand.
• Cervical myelopathy: Damage to the upper spinal cord can prevent sensory messages from reaching the brain. There are many causes, including a tumor or a herniated disk.
• Trauma to the hand or arm: Severe trauma can damage or completely cut any nerves that detect sensation in the hand. Significant blood accumulation can cause compartment syndrome, which squeezes the blood vessels, tissues, and nerves, impairing their function.
• Inflammatory disorders, such as rheumatoid arthritis or lupus: These conditions can cause inflammation around nerves or the spinal cord, often causing fluctuating symptoms that may improve with anti-inflammatory medication.
• Multiple sclerosis (MS): This chronic inflammatory disease damages the sheath that covers nerves in the central nervous system. It can damage areas of the brain or spinal cord that are involved in hand sensation.
• Stroke: Insufficient blood supply can damage the areas of the brain that perceive hand sensation.
• Spinal cord tumor or brain tumor: A primary tumor can damage sensory areas of the brain or spinal cord, and cancer can travel to these areas from other areas of the body (such as breast or lung cancer).
• Trauma to the brain, spinal cord, or nerves of the upper arm: A severe injury can damage blood vessels in the arm, or the brain, spinal cord, or sensory nerves in the upper arm that bring sensory messages from the hand to the spinal cord and brain.
• Severe peripheral vascular disease: Disease affecting the blood vessels can cause diminished blood flow to the nerves and other tissues of the hands. This can cause a feeling of tingling and may lead to nerve damage.

The median, ulnar, and radial nerves are peripheral sensory nerves that detect sensation in the hand. They send the sensory messages to the spinal cord, which transmits them to the brain, making you aware of the sensation. Damage to any part of this pathway can cause hand numbness.

With conditions that cause inflammation of the hands and arms, like carpal tunnel syndrome or rheumatoid arthritis, the numbness can affect one or both sides. Cervical spine problems may cause numbness in one or both hands. Usually, trauma to a nerve or brain issues (like a stroke, brain tumor, or MS) will cause numbness in only one hand.

What Medications Can Cause Numbness in the Hands? 

Most medications that cause neuropathy can cause hand numbness.

Drugs commonly associated with hand numbness as a side effect include:

• Chemotherapy medications
• Cholesterol-lowering medications
• Blood pressure treatments
• Antibiotics
• Immunosuppressants
  

Complications and Risk Factors Associated With Hand Numbness

When you are numb and lack normal sensation in your hands, you might not feel pain when your fingers or hands get hurt. This can cause problems such as allowing an injury to get worse or continue to bleed if you aren’t aware of it.

An injury can get infected, especially if you have diabetes, which lowers your immune system and interferes with wound healing. Normally, an infected wound is painful, but if your sensation is impaired, you might not be aware that a wound is becoming infected.

How to Treat Hand Numbness

If one or both of your hands feels numb occasionally or frequently, it’s important that you get treatment. Treatment can include symptomatic therapy to relieve associated pain in your hands.

If there is an underlying cause that can be medically or surgically managed, it’s also important for you to have therapy to prevent permanent nerve damage, if possible. 

Treatments for hand numbness depend on the cause and can include:

• Optimal positioning during activities like work or sleep to prevent carpal tunnel syndrome, radial neuropathy, or ulnar neuropathy 
• Wearing a splint to ease pressure on the nerve for carpal tunnel syndrome, radial neuropathy, or ulnar neuropathy 
• Medications for neuropathic (nerve) pain for treatment of peripheral neuropathy 
• Anti-inflammatory medications for cervical radiculopathy
• Injections, which may include pain medications or anti-inflammatory medications for carpal tunnel syndrome or radiculopathy
• Disease-modifying therapy for MS 
• Surgery for traumatic nerve injury, severe vascular disease, or to relieve pressure on a nerve of the arm or hand
• Physical therapy to help relieve inflammation and to restore motor control 

You may need a combination of therapies. For example, you would likely need physical therapy after surgery to repair a damaged nerve. 

Are There Tests to Diagnose the Cause of Hand Numbness? 

The diagnosis of hand numbness involves an assessment of the physical signs, such as diminished sensation, reflex changes, and weakness. It also involves a medical evaluation to identify the cause of numb hands. 

Your healthcare provider will discuss your symptoms and medical history and will also do a thorough physical examination. They will be able to determine whether your numbness is associated with a chronic disease (like neuropathy) or an acute problem (like arm trauma) and whether it is due to a problem affecting your nerves, spinal cord, or brain.

You might need diagnostic tests to help identify the exact problem that’s causing your hand numbness. Your medical history and physical examination will determine which tests you would need to have next. 

Tests you may need include:

• Cervical spine X-ray or magnetic resonance imaging (MRI) can identify problems of the spine or spinal cord, including radiculopathy, myelopathy, tumors, or MS.
• Electromyography (EMG) or nerve conduction studies (NCV) can identify neuropathy and nerve injuries. 
• Blood tests can show signs of inflammatory disease, like rheumatoid arthritis or lupus. 
• Vascular ultrasound can identify signs of peripheral vascular disease.
• A brain MRI can identify a stroke, brain tumor, or MS.

Depending on the results of your tests, you might need specific treatments to help relieve your hand numbness and the underlying condition that’s causing it. 

When to See a Healthcare Provider 

You might recognize the feeling that your hand fell asleep. If you are having hand numbness in any other situation, it is not normal, and it’s an indication that you need medical care. Some types of hand numbness could indicate a medical emergency, and you can wait to make an appointment with your healthcare provider for other types. 

Make an Appointment With Your Provider 

Hand numbness due to carpal tunnel syndrome or radial or ulnar neuropathy can fluctuate, usually with a pattern of gradual worsening. While it’s not a medical emergency, the sooner it’s treated, the better the outcome. 

Gradually worsening numbness in both hands can be a sign of worsening peripheral vascular disease, and it can be a complication of diabetes.

This symptom is not a medical emergency if you have already been diagnosed with one of the conditions that can cause hand numbness. But the underlying condition can get worse if it’s not treated adequately—so it’s important for you to make an appointment. 

Summary 

When one or both of your hands feels numb, you can also have pain, tingling, or decreased coordination. Additionally, symptoms involving other areas of your body—like your legs or your arm can accompany hand numbness.

There are many different causes of hand numbness, including diseases affecting the nerves, brain, or spinal cord. Make sure you get prompt medical attention if you develop hand numbness. A timely and accurate diagnosis and treatment can help resolve your symptoms and prevent complications.

A Word From Verywell 

Hand numbness can be a scary symptom. Most of the time, it is treatable and not dangerous. But it's impossible to know whether you should be concerned and what treatment you need until you are evaluated in a healthcare setting.

Diminished sensation can lead to complications, like trouble using your hands or not knowing when you have an injury. Accommodating these issues can be challenging. Work with your healthcare providers to understand what safety measures or rehabilitation steps are best for you.