Hand Numbness: Sympathetic vs. Nerve Compression Issues

Numbness in the hands?

Hello Doctor, I have visited you before and was diagnosed with abnormalities in the parasympathetic nervous system.
Currently, I am taking Fluxel and related vitamins.
I went back to the rehabilitation department where I was previously diagnosed with cervical spine issues, and after taking X-rays of my cervical spine, it appears to be the same as a few years ago without any deterioration (it is straight, but there is no compression).
The rehabilitation department has performed some electrical therapy and neck traction, but the numbness in my right thumb and index finger has not improved.
Today, I have started to feel some numbness extending to my middle finger.
I would like to ask whether this is related to sympathetic nerve issues or nerve compression.
If I perform slow backward bending movements, could that help alleviate the numbness in my hands? Thank you, Dr.
Jiang.

Sheng, 40~49 year old female. Ask Date: 2022/03/27

Dr. Jiang Junyi reply Neurology

Dear Mr.
Sheng,
You mentioned that "the numbness in your right thumb and index finger has not improved," which may indicate the need to consider compression of the median nerve rather than an issue with the autonomic nervous system.
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, and typists, and is especially common in the dominant hand, with symptoms worsening due to work activities.

I recommend that you visit a neurology or rehabilitation clinic for evaluation (such as nerve conduction studies and electromyography) and follow-up treatment.
Thank you for your inquiry, and feel free to discuss any related questions!
Wishing you good health and peace,
Dr.
Chih-Yi Jiang, Taoyuan Hospital

Reply Date: 2022/03/27

More Info

Hello! Thank you for your question regarding hand numbness and the potential underlying causes related to sympathetic nervous system issues versus nerve compression. Based on your description, it seems you are experiencing persistent numbness in your right thumb, index finger, and now extending to your middle finger. This can indeed be concerning, especially when you have a history of cervical spine issues.

To begin with, let's clarify the difference between sympathetic nervous system issues and nerve compression. The sympathetic nervous system is part of the autonomic nervous system, which controls involuntary bodily functions, including heart rate, blood pressure, and digestion. When there are abnormalities in the sympathetic nervous system, symptoms can manifest in various ways, including changes in skin temperature, sweating, and sometimes pain or discomfort. However, numbness in specific fingers is more commonly associated with nerve compression or irritation.

Nerve compression, particularly in the context of your symptoms, often involves the median nerve, which runs through the carpal tunnel in the wrist and is responsible for sensation and motor function in the thumb, index, middle, and part of the ring finger. Given that your symptoms have progressed to include the middle finger, it raises the possibility of median nerve involvement, which could be due to carpal tunnel syndrome or cervical radiculopathy stemming from your neck issues.

Regarding your question about performing backward bending movements to alleviate numbness, gentle neck stretches can sometimes help relieve pressure on the nerves if they are being compressed at the cervical spine level. However, it is crucial to approach this cautiously. If the movements exacerbate your symptoms, it would be advisable to stop and consult with your healthcare provider. Physical therapy may also provide targeted exercises to strengthen the neck and shoulder muscles, potentially alleviating some of the nerve compression.

Since you mentioned that you have been undergoing rehabilitation for your cervical spine and have not seen improvement in your symptoms, it may be beneficial to revisit your healthcare provider for further evaluation. They might consider additional diagnostic tests, such as nerve conduction studies or an MRI of the cervical spine, to assess for any nerve root compression or other abnormalities that could be contributing to your symptoms.

In summary, while your symptoms could be related to sympathetic nervous system issues, the specific numbness in your fingers is more likely indicative of nerve compression. It is essential to continue monitoring your symptoms and seek further evaluation if they persist or worsen. Engaging in gentle neck stretches may provide some relief, but professional guidance is crucial to ensure you are not exacerbating the issue. Please take care, and I hope you find relief soon!

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