Hand numbness at night is a common issue that affects many individuals, causing discomfort and disrupting sleep. This sensation of tingling or loss of feeling in the hands can be particularly bothersome when it occurs during nighttime hours. Understanding the causes and potential treatments for hand numbness at night is crucial for those seeking relief and improved sleep quality.

This article explores the common reasons behind nighttime hand numbness and provides insights into diagnosis and treatment options. Readers will learn about various factors contributing to this condition, including carpal tunnel syndrome and nerve compression. Additionally, the article covers nonsurgical treatments, such as nerve gliding exercises and activity changes, as well as more advanced options like open carpal tunnel release. By delving into these topics, individuals experiencing hand numbness only at night can gain valuable information to address their symptoms effectively.

Common Causes of Nighttime Hand Numbness

Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve is compressed in the carpal tunnel, a narrow passageway in the wrist. This condition often causes tingling, numbness, and weakness in the hand and fingers ^[1]. Symptoms typically worsen at night, with many individuals experiencing discomfort that may wake them up. Repetitive hand motions, such as typing or using machinery, can trigger carpal tunnel syndrome. Carpal tunnel Syndrome causes are unknown most of the time. Pregnancy-related carpal tunnel is due to fluid/hormonal imbalance

Peripheral Neuropathy

Peripheral neuropathy involves damage to the nerves outside the brain and spinal cord. It can cause numbness, tingling, and pain in the hands and feet. This condition may result from various factors, including diabetes, vitamin deficiencies, and alcohol misuse. Symptoms often begin gradually and can worsen over time, affecting a person’s ability to perform daily tasks ^[4] 

Cervical Radiculopathy

Cervical radiculopathy occurs when a nerve root in the neck becomes inflamed or compressed. This can lead to numbness, tingling, and weakness in the shoulder, arm, hand, and fingers. The condition may be caused by age-related changes in the spine, such as cervical spondylosis, which can narrow the space for nerve roots.

Vitamin B12 Deficiency

Vitamin B12 is essential for nerve health, and a deficiency can result in neurological symptoms, including numbness and tingling in the hands ^[5]. This deficiency is more common in individuals over 40 and can be associated with a wide range of neuropsychiatric issues ^[6]  Strict vegetarians and vegans are at higher risk of developing B12 deficiency if they don’t consume fortified foods or take supplements ^[7] 

Nerve related Symtoms

• Pins and needles sensation in hands
• needle-like pain in fingertips
• tingling sensation in the hands
• numbness in hand while sleeping, disturbed sleep
• Numbness in fingers during daytime and activities
• hand weakness or thumb weakness
• radiating or migrating pain from hand to shoulder

Diagnosing Hand Numbness

Physical Examination

Diagnosing hand numbness begins with a thorough physical examination. Healthcare providers inspect the hands for signs of muscle atrophy, particularly in the thenar eminence ^[1] They assess sensory distribution using a rating system from 0 to 10, with 0 indicating no feeling and 10 representing normal sensation. Several provocative carpal tunnel syndrome test may be performed, including Phalen’s test, Tinel’s test, and the carpal compression test or median nerve compression test, to evaluate for carpal tunnel syndrome.

Nerve Conduction Studies

Nerve conduction velocity (NCV) tests measure how fast electrical impulses move through nerves. During the test, electrodes are placed on the skin to stimulate nerves and record their responses. Electromyography (EMG) is often performed alongside NCV to assess muscle function. ^[4] These tests help differentiate between nerve and muscle disorders and can identify conditions such as carpal tunnel syndrome.

Imaging Tests

Imaging tests provide detailed views of the hand and wrist structures. Ultrasounds detect structural abnormalities in the median nerve and surrounding tissues, especially in rheumatoid arthritis. MRI scans offer comprehensive images of soft tissues, helping to identify nerve compression or swelling ^[5] . X-rays, while unable to directly show carpal tunnel syndrome, can rule out other causes of wrist pain, such as fractures in carpal bones or arthritis ^[6] 

Blood Tests

Various blood tests aid in diagnosing underlying conditions that may cause hand numbness. These include complete blood count, thyroid function tests, and vitamin level assessments ^[7]. Tests for inflammation markers, such as erythrocyte sedimentation rate and C-reactive proteins, can indicate autoimmune disorders ^[8]  Additionally, glucose tolerance tests help diagnose diabetes, a common cause of peripheral neuropathy ^[9] 

Treatment Options for Hand Numbness at Night

Conservative Treatments

Conservative approaches often provide relief for hand numbness at night. Wrist splinting (night splinting) can help by keeping the wrist straight during sleep, reducing pressure on the median nerve ^[1]. A ready-made or commercial wrist splint is useful. Physical therapy and hand exercises may strengthen muscles and improve flexibility. Applying heat or cold therapy for 15 minutes multiple times a day can alleviate discomfort.

Medications

Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage mild pain and inflammation. For more severe cases, corticosteroid injections into the carpal tunnel may provide relief by reducing swelling and pressure on the median nerve. Steroid injections are relatively safe in these conditions. Some antidepressants and anticonvulsants can also be effective in treating neuropathic pain such as pregabalin or gabapentin.

Surgical Interventions

When conservative treatments fail, surgical options may be considered. Carpal tunnel release surgery involves cutting the carpal ligament to reduce pressure on the median nerve ^[4] . For cervical spondylosis, procedures like cervical discectomy may be necessary to relieve nerve compression. Carpal tunnel release surgeries can be performed by a trained hand surgeon by open surgery, endoscopic surgery or ultrasound-guided surgery.

Lifestyle Changes

Simple lifestyle modifications can make a significant difference. Improving sleep posture, using a supportive mattress and pillow, and avoiding sleeping on the arms can help prevent nighttime numbness. Taking frequent breaks during repetitive hand activities and maintaining a nutritious diet rich in vitamin B12 can also contribute to symptom management ^[5] 

Conclusion

Hand numbness at night can have a big impact on sleep quality and overall well-being. This article has shed light on the common causes, such as carpal tunnel syndrome and peripheral neuropathy, and outlined various diagnostic methods to pinpoint the underlying issue. Understanding these factors is key to finding the right treatment approach and getting relief from those pesky nighttime symptoms.

From conservative treatments like wrist splinting to more advanced options such as surgery, there are several ways to tackle hand numbness at night. What’s more, simple lifestyle changes and proper sleep posture can make a world of difference. By exploring these options and working with healthcare providers, individuals dealing with this issue can take steps to improve their sleep and hand comfort, leading to better overall health and quality of life.

FAQs

What are effective home remedies for hand and finger numbness?

To alleviate numbness in your hands and fingers at home, you can try several approaches:

• Take over-the-counter pain relievers such as ibuprofen or acetaminophen (anti-inflammatory medications).
• Wear wrist splints on your hands as recommended at night.
• Apply heat or cold therapy.
• Rest your hands, especially if your activities involve repetitive tasks.
• Perform strengthening exercises for your hands.

What nutritional deficiencies can lead to hand numbness during sleep?

Numbness in the hands while sleeping can be caused by a deficiency in vitamin B12, which is essential for nerve health. A severe lack of B12 can result in numbness in both hands and feet. Deficiencies in potassium and magnesium may also contribute to this condition. Additionally, fatigue is a common symptom of vitamin B12 deficiency.

When should hand numbness be a cause for concern?

It is advisable to consult a healthcare provider if you experience numbness in your hands that:

• Starts gradually, worsens, and persists.
• Spreads to other parts of your body.
• Affects both sides of your body.
• Occurs intermittently.

Can numbness in the hands resolve without medical intervention?

Numbness in the hands can be caused by issues such as injured or pinched nerves, or problems with blood flow, among other medical conditions. This sensation might be harmless and disappear on its own. However, if the numbness recurs, it is important to discuss it with your doctor to rule out any underlying conditions.

References

[1] – https://www.health.com/hand-numbness-8363668 https://www.health.com/hand-numbness-8363668
[2] – https://www.sleepfoundation.org/physical-health/numbness-in-hands-while-sleeping https://www.sleepfoundation.org/physical-health/numbness-in-hands-while-sleeping
[3] – https://www.medicalnewstoday.com/articles/numbness-in-hands-while-sleeping https://www.medicalnewstoday.com/articles/numbness-in-hands-while-sleeping
[4] – https://my.clevelandclinic.org/health/symptoms/17824-numbness-in-hands https://my.clevelandclinic.org/health/symptoms/17824-numbness-in-hands
[5] – https://www.healthline.com/health/waking-up-with-numb-hands https://www.healthline.com/health/waking-up-with-numb-hands
[6] – https://my.clevelandclinic.org/health/diseases/4005-carpal-tunnel-syndrome https://my.clevelandclinic.org/health/diseases/4005-carpal-tunnel-syndrome

[7] – https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/carpal-tunnel-syndrome/symptoms.html https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/carpal-tunnel-syndrome/symptoms.html
[8] – https://mydoctor.kaiserpermanente.org/mas/news/pins-and-needles-at-night-you-might-have-carpal-tunnel-syndrome-1894578 https://mydoctor.kaiserpermanente.org/mas/news/pins-and-needles-at-night-you-might-have-carpal-tunnel-syndrome-1894578
[9] – https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061 https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061