Most of us have come across the problem of a numb hand while we sleep. We wake up and find that our hand has become numb. There can be many reasons why this happens but usually it is due to lying on our hand that causes compression of the nerve and blood circulation of our hand. This usually settles in a few minutes and we are back to sleep again. But occasionally you will find that this numbness is associated with pain in one or both hands.
There are many possible causes in addition to sleeping posture. Carpal tunnel syndrome, Cervical spondylosis and a ‘pinched nerve’ are other causes.
Carpal Tunnel Syndrome:
This is caused by compression of the nerve that runs in front of your wrist. There is tingling and numbness of your hand and fingers. It can affect one or both hands. The pain in the hand and wrist wakes you up in the middle of the night. Repeated shaking of your hands relieves the pain.
This is otherwise known as cervical osteoarthritis caused by wear and tear of the discs in your neck with age. The inflammation from the arthritis can press on the nerve coming out of your spine in the neck. As these nerves supply sensation to your arms, hands and fingers, compression of these nerves causes tingling, numbness and pain in your arms hands and fingers.
Pinched Nerve in your Neck:
The problem of waking up with numb hands can also be due to a pinched nerve in your neck. The spinal nerves that arise from the spinal-cord in the neck exit through small holes in the cervical spine and supply your arms hands and fingers. These nerves can be trapped or pinched at the exit. This gives rise to the same symptoms like a Carpal Tunnel Syndrome.
What does a Nerve root injection do?
The most likely cause is usually Carpal tunnel syndrome. When we all sleep, we keep our hands in various positions and our wrist folds onto itself and presses on the nerve that supplies sensation to our hand and fingers. This is the reason why your hands go numb and hurts mostly in the night.
What is the main difference between cervical spondylosis and Carpal tunnel syndrome?
The most crucial difference between the two is that in cervical spondylosis there is pain that radiates from the neck down to the shoulders, elbows, wrists, hands and fingers. On the other hand, in a Carpal tunnel syndrome, the pain around the wrist hand and fingers typically appears in the night and you have to shake your hand to get rid of the pain. There is numbness of the thumb, index, finger, middle finger and part of the ring finger. Usually the sensation in your little finger is spared.
Can Cervical Radiculopathy cause Carpal tunnel syndrome?
It is highly unlikely that cervical radiculopathy causes carpal tunnel syndrome but it can present with features very similar to carpal tunnel syndrome. There is pain in the wrist hands and numbness around the index finger middle finger and part of the ring finger. There is no associated weakness of the hand in a carpal tunnel syndrome.
What is ‘double crush syndrome’?
‘Double Crush Syndrome’ was just an idea that suggests that if the nerve is pinched at one site (at the neck) is more prone for damage at another site (neck). Scientific research has supported this idea that in patients who have carpal tunnel syndrome also have a ‘pinched nerve’ in the neck. Usually there is pain radiating from the neck down to the shoulder elbow and hand along with pain in the wrist and fingers at night.
How do I manage the pain in my hands at night?
1) You can apply warm or ice packs for 15 minutes once or twice an hour.
2) Gentle stretching of your hands and wrists in all directions will help ease the pain and swelling.
3) Simple painkillers like paracetamol and non-steroidal anti-inflammatory drugs like nurofen will help.
4) Wrist splints to keep your wrist straight at night while sleeping so that your wrist does not fold onto its self. This avoids compression of the nerve around the wrist