Nerve Issues: Neck Pain, Sleep Position, or Vascular Concerns?

Is it related to sleeping posture, cervical spine issues, or vascular problems?

Hello, Dr.
Jiang.

1.
The first issue is a problem that has existed for many years.
I often experience numbness in the fingers of both hands while riding a motorcycle.
It doesn't always happen in both hands simultaneously, but it usually occurs more frequently in the right hand.
When I lower my hands, the numbness sensation disappears quickly.
2.
The second issue occurs occasionally.
Could it be related to my sleeping position? Sometimes, I wake up with numbness from the elbow joint to the fingers, not necessarily on one side, but it is usually the left hand.
3.
Recently, after waking up, I experienced numbness from the left elbow joint to the fingers.
When I sat up and looked down, I felt tightness starting from the right forehead, moving up through the scalp to the right neck and shoulder.
This tightness disappears when I look up but starts again when I look down.
I can turn my head without any issues, and there is no problem with the movement of my left arm or grip strength in my fingers.
This condition resolves itself after a few minutes.
I work night shifts and spend long hours operating a computer, and I am aware that my neck posture is increasingly leaning forward.
I would like to ask Dr.
Jiang, if my issues are related to cerebrovascular problems, would I still be able to move my fingers, have sensation, and control my movements consciously at the moment the blood vessels are compromised?
I appreciate your time in addressing my concerns.
Thank you.

Mr. Zhang, 50~59 year old female. Ask Date: 2021/08/17

Dr. Jiang Junyi reply Neurology

Hello Mr.
Chang,
It seems that there are four issues based on your description:
1.
Carpal tunnel syndrome may need to be considered.
2.
Cubital tunnel syndrome may also need to be considered.
3.
Cervical spine degeneration causing nerve root compression may be a possibility.
4.
Lastly, you mentioned cerebrovascular disease.
The first three conditions are typically associated with prolonged poor posture and inadequate rest.
Cervical nerve root compression is often related to tightness in the cervical muscles and fascia, as well as cervical spine degeneration.
Symptoms may include pain at the affected site, discomfort, muscle stiffness, or neurological sensations.
Symptoms may worsen upon waking or with changes in weather, but can be alleviated with stretching activities, often recurring.
"If it is related to cerebrovascular issues, can the fingers still move at the moment the blood vessels are compromised? Is there still sensation? Can they still move consciously?" This is related to the location of the cerebrovascular embolism; for instance, if it is a cerebellar stroke, symptoms may sometimes only include balance disturbances and dizziness.
If you are concerned about vascular diseases, it is advisable to strictly control risk factors such as blood lipids, blood sugar, and blood pressure, and to avoid exposure to secondhand smoke.
Additionally, I recommend that you visit a neurology clinic for examination and follow-up.
Please ensure to practice self-protection, cleanliness, and disinfection before and after seeking medical care, and adhere to the new preventive measures.
Thank you for your inquiry.
If you have further questions, feel free to discuss them! Wishing you good health, safety, and happiness.
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2021/08/17

More Info

Hello! Thank you for your detailed inquiry regarding your symptoms related to neck pain, numbness in your fingers, and potential vascular concerns. Based on your description, it seems you are experiencing a combination of nerve-related issues, possibly exacerbated by your work environment and sleep posture.

1. Numbness in Fingers While Riding a Motorcycle: The numbness you experience in your fingers, particularly when riding a motorcycle, could be indicative of a condition known as "thoracic outlet syndrome" or "cervical radiculopathy." These conditions can occur when nerves or blood vessels are compressed in the neck or shoulder area. The fact that the numbness resolves quickly when you lower your hands suggests that it may be related to nerve compression due to your arm position while riding. This could also be a sign of repetitive strain injury, especially if you maintain a fixed posture for extended periods.

2. Numbness Upon Waking: The numbness you feel in your arm and fingers upon waking could indeed be related to your sleep position. If you sleep with your arm under your head or body, it can compress the nerves in your arm, leading to temporary numbness or tingling. This is often referred to as "paresthesia." Changing your sleeping position or using a different pillow that supports your neck better may help alleviate this issue.

3. Tightness and Numbness After Waking: The tightness you describe from your forehead to the back of your neck, especially when bending your head forward, could be related to muscle tension or strain. This is common in individuals who spend long hours at a computer, as poor posture can lead to muscle fatigue and tension in the neck and shoulders. The fact that you can move your left arm and fingers without any issues is a good sign, as it suggests that there is no significant nerve damage.

Regarding your concern about vascular issues, it is important to note that if there were a significant vascular problem, such as a stroke or transient ischemic attack (TIA), you would likely experience more severe symptoms, including weakness, inability to move a limb, or loss of consciousness. In such cases, the affected limb would typically not function normally, and you would not have conscious control over it. The symptoms you describe—numbness and tightness that resolve with movement—are less indicative of a vascular issue and more suggestive of nerve compression or muscle strain.

Recommendations:
- Posture Correction: Focus on maintaining good posture while working at your computer. Ensure your monitor is at eye level, and your chair supports your lower back. Take regular breaks to stretch and move around.

- Sleep Position: Experiment with different sleeping positions and pillows to find one that minimizes pressure on your arms and neck.

- Physical Therapy: Consider consulting a physical therapist who can provide exercises to strengthen your neck and shoulder muscles, improve posture, and alleviate nerve compression.

- Medical Evaluation: If your symptoms persist or worsen, it would be wise to consult a neurologist or orthopedic specialist. They may recommend imaging studies, such as an MRI or nerve conduction studies, to assess for any underlying issues.

In summary, while your symptoms are concerning, they appear to be more related to nerve compression and muscle strain rather than a vascular issue. However, it is always best to consult with a healthcare professional for a thorough evaluation and personalized advice. Thank you for reaching out, and I hope this information helps clarify your concerns!

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