Hand Numbness: Causes and When to Seek Help

Numbness in the fingers of both hands?

Hello, Doctor.
I often carry heavy objects with both hands or shoulders.
Recently, I woke up one day to find that my left hand fingers were numb.
After a few days, the fingers of my right hand also started to feel numb.
For the left hand, the symptoms include occasional tingling in the joints of fingers 1, 2, and 3, or slight numbness in the first joint of the fingers, which can vary and sometimes involve fingers 4 and 5 as well.
There is no fixed pattern for which fingers are affected.
For the right hand, fingers 4 and 5 occasionally experience slight numbness, and sometimes fingers 1, 2, and 3 can also feel this way without a fixed pattern.
My wrist sometimes feels sore or slightly numb when exerted or bent, and the joints may experience sharp pain.
Both arms have two fixed points that occasionally feel sore or warm, while the rest of the arms are fine.
I also have slight soreness in my shoulders and neck.
I have seen a neurosurgeon who performed an X-ray and some simple tests, and they mentioned that 1.
there are bone spurs at cervical vertebrae 5 and 6, but they are not affecting the nerves, and 2.
there are no symptoms of cervical disc herniation affecting the numbness in my five fingers.
I would like to ask the doctor if my hand numbness is due to an issue with my hands or my neck, and which specialty I should consult for further examination.
Thank you.

Niming, 20~29 year old female. Ask Date: 2019/02/16

Dr. Shi Guozheng reply Orthopedics

Numbness in the fingers is related to the nerves in the hand.
If the median nerve near the wrist is compressed, the second, third, and fourth fingers may experience numbness.
Pressing on the palm side of the wrist can elicit numbness (carpal tunnel syndrome).
If the compression occurs in the cervical spine, any finger may become numb, and there may also be numbness in the shoulder, neck, or hand, sometimes accompanied by muscle atrophy in the hand.
X-rays of the neck can initially screen for cervical spinal stenosis.
To further assess if there is nerve compression, MRI or CT scans may be necessary, and a visit to an orthopedic specialist is recommended.

Reply Date: 2019/02/16

More Info

Understanding hand numbness can be quite complex, as it can stem from various causes, including nerve compression, poor circulation, or even systemic conditions. Given your symptoms of numbness and occasional tingling in your fingers, along with the history of carrying heavy objects, it is essential to consider several potential underlying issues.

One common cause of hand numbness is carpal tunnel syndrome, which occurs when the median nerve is compressed as it travels through the wrist. This condition often presents with numbness, tingling, or pain in the thumb, index, middle, and part of the ring finger. Given that you mentioned symptoms in the first three fingers of your left hand, this could be a possibility. However, since you also experience symptoms in the fourth and fifth fingers, it may suggest involvement of the ulnar nerve, which can be affected by conditions such as cubital tunnel syndrome, where the ulnar nerve is compressed at the elbow.

Another consideration is cervical radiculopathy, which can occur when a nerve root in the neck is compressed due to herniated discs or bone spurs, as you mentioned having cervical spine issues with bone spurs at C5-C6. This can lead to symptoms radiating down the arm and into the hand, potentially causing numbness and tingling in various fingers depending on which nerve root is affected.

Given your symptoms and the history of neck issues, it would be prudent to consult with a neurologist or an orthopedic specialist who focuses on spine health. They may recommend further imaging studies, such as an MRI of the cervical spine, to assess for any herniated discs or other structural issues that could be contributing to your symptoms. Additionally, nerve conduction studies or electromyography (EMG) can help evaluate the function of the nerves and muscles in your arms and hands, providing further insight into whether the issue is peripheral (in the arms and hands) or central (originating from the neck).

In the meantime, consider some conservative measures to alleviate your symptoms. Ergonomic adjustments to how you carry heavy objects, ensuring proper posture, and taking regular breaks can help reduce strain on your neck and arms. Stretching and strengthening exercises for the neck and upper back may also be beneficial, but these should be done under the guidance of a physical therapist to avoid exacerbating your symptoms.

If you notice any worsening of your symptoms, such as increased pain, weakness, or changes in coordination, it is crucial to seek medical attention promptly. Early intervention can often lead to better outcomes and prevent further complications.

In summary, your symptoms could be related to nerve compression either at the wrist or the neck, and it is advisable to consult with a specialist who can provide a comprehensive evaluation and appropriate diagnostic tests. This will help determine the exact cause of your hand numbness and guide you toward an effective treatment plan.

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