Managing Nerve Pain and Discomfort in Hands and Feet

Numbness and pain in the hands and feet?

Hello Dr.
Jiang,
I previously underwent rehabilitation treatment for my cervical spine issues, during which the numbness and tingling in my fingers were not as severe.
However, after moving, I have had less opportunity to continue rehabilitation.
Recently, with the sudden changes in weather, I have been waking up with a painful tingling sensation extending from the tips of my fingers to my arms.
I also experience similar sensations in my toes and the soles of my feet, which only improve when I lie down.
Lifting heavy objects and walking exacerbate the numbness and pain in my fingers, which has become quite bothersome.
Additionally, I have been struggling with autonomic nervous system dysregulation and insomnia due to my busy work schedule, leaving me with little time to seek medical attention.
I would like to ask the doctor how I can improve my condition.

Peng, 30~39 year old female. Ask Date: 2022/11/19

Dr. Jiang Junyi reply Neurology

Dear Ms.
Peng,
You mentioned that "I must lie down to feel better, and lifting heavy objects or walking exacerbates the numbness and pain in my fingers, which has recently become unbearable." Your symptoms may suggest peripheral nerve compression, and there could also be spinal cord involvement.
I recommend that you visit a neurology clinic for further evaluation of your peripheral nerve compression symptoms.

1.
The pain is characterized by burning and tingling sensations.
2.
The symptoms have a specific dermatomal distribution, and touching or pressing can trigger them.
3.
There may be accompanying muscle weakness and fatigue.
Examinations for peripheral nerve issues typically include electrophysiological studies to assist in diagnosis.

- Nerve conduction studies: These assess the conduction velocity and waveform of large fiber nerves.
- Electromyography (EMG): This evaluates the muscle response in the areas supplied by the affected nerves.
I also suggest increasing your intake of B vitamins and remind you to get up and stretch every half hour to avoid exacerbating symptoms due to nerve compression and muscle tightness.

Thank you for your inquiry, and feel free to discuss any related questions further! Wishing you good health and peace.
Sincerely,
Dr.
Jiang Junyi
Department of Neurology, Taoyuan Hospital

Reply Date: 2022/11/19

More Info

Managing nerve pain and discomfort in the hands and feet can be quite challenging, especially when it is compounded by other health issues such as cervical spine problems and autonomic nervous system dysregulation. Your symptoms of numbness and pain extending from the fingertips to the arms, as well as similar sensations in the feet, suggest that you may be experiencing peripheral neuropathy or nerve compression, possibly related to your cervical spine condition.

Understanding Your Symptoms
1. Nerve Compression: The cervical spine houses nerves that extend down into the arms and hands. If there is any compression or irritation of these nerves, it can lead to symptoms such as tingling, numbness, and pain. This can be exacerbated by activities that put strain on the neck or shoulders.

2. Peripheral Neuropathy: This condition can arise from various causes, including diabetes, vitamin deficiencies, or even stress. Given your busy lifestyle and the stress you mentioned, it’s possible that your symptoms are also influenced by your overall health and stress levels.

3. Autonomic Nervous System Dysregulation: This can lead to symptoms such as increased sensitivity to pain, changes in circulation, and even sleep disturbances, which can further complicate your situation.

Recommendations for Management
1. Physical Therapy: Since you previously found relief through rehabilitation, it may be beneficial to resume physical therapy. A physical therapist can provide targeted exercises to strengthen the neck and shoulder muscles, improve posture, and alleviate nerve compression. They can also teach you stretching techniques to relieve tension.

2. Ergonomic Adjustments: Evaluate your workspace and daily activities. Ensure that your workstation is ergonomically designed to minimize strain on your neck and arms. Proper chair height, monitor level, and keyboard placement can make a significant difference.

3. Regular Breaks and Movement: If your work involves prolonged sitting, make it a habit to take breaks every 30-60 minutes. Stand up, stretch, and move around to promote circulation and reduce nerve compression.

4. Pain Management: Over-the-counter pain relief medications such as NSAIDs (e.g., ibuprofen) can help manage pain and inflammation. However, consult with a healthcare professional before starting any medication, especially if you have other health conditions.

5. Stress Management Techniques: Since stress can exacerbate your symptoms, consider incorporating relaxation techniques into your routine. Mindfulness, deep breathing exercises, and gentle yoga can help reduce stress and improve your overall well-being.

6. Sleep Hygiene: Given your sleep disturbances, establishing a regular sleep routine is crucial. Aim for a consistent sleep schedule, create a restful environment, and limit screen time before bed. If necessary, consult with a healthcare provider about sleep aids or therapies.

7. Nutritional Support: Ensure you are getting adequate nutrition, particularly vitamins B12 and D, which are essential for nerve health. If you suspect a deficiency, consider discussing supplementation with your healthcare provider.

8. Consultation with Specialists: If your symptoms persist or worsen, consider seeing a neurologist or a pain specialist. They can conduct further evaluations, such as nerve conduction studies, to determine the underlying cause of your symptoms and recommend appropriate treatments.

Conclusion
Managing nerve pain and discomfort requires a multifaceted approach that includes physical therapy, ergonomic adjustments, stress management, and possibly medical intervention. By addressing these aspects, you can work towards alleviating your symptoms and improving your quality of life. It’s important to listen to your body and seek professional help when needed, especially if your symptoms are impacting your daily activities and well-being.

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