Hand Numbness: When to See a Neurologist

Q: Hand Numbness: When to See a Neurologist

Hello： Your symptoms may suggest median nerve pathology, commonly known as carpal tunnel syndrome. <br>Carpal tunnel syndrome refers to the clinical symptoms caused by the compression of the median nerve as it passes through the carpal tunnel, which is formed by the carpal bones

You should consult a neurologist for numbness in the palm of your hand?

Hello Doctor: Since yesterday, I have noticed a slight numbness in my right hand when I make a fist, but it does not affect my daily life.
However, today, even without making a fist, I feel a slight pain in the web space of my hand, and I am unable to grip tightly (there is weakness), although the numbness is not as pronounced as yesterday.
When I clench and then open my hand, I experience a brief sharp pain about 1.5 cm below the space between my middle and ring fingers.
What could these symptoms indicate, and which specialist should I consult? Thank you.

Mr. Zhang, 30~39 year old female. Ask Date: 2020/08/06

Dr. Jiang Junyi reply Neurology

Hello: Your symptoms may suggest median nerve pathology, commonly known as carpal tunnel syndrome.
Carpal tunnel syndrome refers to the clinical symptoms caused by the compression of the median nerve as it passes through the carpal tunnel, which is formed by the carpal bones and ligaments at the wrist.
The median nerve is responsible for the movement of the thumb and provides sensation to the thumb, index finger, middle finger, and part of the ring finger.
Carpal tunnel syndrome typically occurs in individuals who perform repetitive wrist movements, such as mechanics, carpenters, typists, and homemakers, particularly affecting the dominant hand, with symptoms often exacerbated by work activities.
The incidence of carpal tunnel syndrome in females is 3 to 10 times higher than in males.
Other conditions, including diabetes, hypothyroidism, rheumatoid arthritis, and amyloidosis, may also contribute to the development of carpal tunnel syndrome.
It is advisable to consult a neurologist or a rehabilitation physician for discussion and treatment.
Wishing you good health and peace.
Dr.
Tao, Neurology, cares about you.

Reply Date: 2020/08/06

More Info

Hello! Based on the symptoms you described, it sounds like you may be experiencing issues related to nerve compression or irritation, possibly in the context of carpal tunnel syndrome or another form of peripheral neuropathy. The symptoms of numbness, tingling, and pain in the hand, particularly in the area of the thumb, index, middle, and part of the ring finger, are classic signs of median nerve involvement, which is often associated with carpal tunnel syndrome.

Carpal tunnel syndrome occurs when the median nerve, which runs from your forearm into the palm of your hand, becomes pressed or squeezed at the wrist. This can lead to symptoms such as numbness, tingling, weakness, or pain in the hand and fingers. The fact that you are experiencing pain in the "thenar" area (the base of the thumb) and difficulty gripping suggests that the median nerve may be affected.

Given that your symptoms have progressed from mild numbness to pain and weakness, it is advisable to consult a neurologist or a specialist in physical medicine and rehabilitation. These professionals can perform a thorough evaluation, which may include a physical examination and diagnostic tests such as nerve conduction studies or electromyography (EMG). These tests help assess the function of the nerves and muscles and can confirm whether there is any nerve damage or compression.

In addition to carpal tunnel syndrome, other potential causes of your symptoms could include:
1. Cervical Radiculopathy: This occurs when a nerve in the neck is compressed or irritated, leading to pain, numbness, or weakness that can radiate down the arm into the hand.

2. Peripheral Neuropathy: This is a condition resulting from damage to the peripheral nerves, which can cause weakness, numbness, and pain, typically in the hands and feet. Causes can include diabetes, vitamin deficiencies, and exposure to toxins.

3. Tendonitis or Tenosynovitis: Inflammation of the tendons in the wrist can also lead to pain and discomfort that may mimic nerve-related symptoms.

4. Other Conditions: Conditions such as multiple sclerosis or rheumatoid arthritis can also present with similar symptoms, although these are less common.

It’s important to monitor your symptoms closely. If you notice any worsening of your condition, such as increased pain, persistent numbness, or loss of function, seek medical attention promptly. Early intervention can often lead to better outcomes and may prevent further complications.

In the meantime, consider some self-care measures that may alleviate your symptoms:
- Rest: Avoid activities that exacerbate your symptoms, especially repetitive wrist movements.

- Wrist Splinting: Wearing a wrist splint, especially at night, can help keep your wrist in a neutral position and reduce pressure on the median nerve.

- Ergonomics: Ensure that your workspace is ergonomically friendly to minimize strain on your wrists and hands.

- Stretching and Strengthening Exercises: Gentle stretching and strengthening exercises for your hands and wrists may help improve flexibility and strength.

In conclusion, while your symptoms may not currently be severe, they warrant a consultation with a neurologist to rule out any serious underlying conditions and to discuss appropriate management strategies. Your health and well-being are important, and addressing these symptoms early can help you maintain a good quality of life.

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