Nerve Sensations: Insights on Hand Discomfort and Treatment

There is a tingling sensation near the webbing of my left hand, as if I have been electrocuted?

Hello, Doctor: A few days ago, I inquired about some related issues and would like to ask a few more questions! (The symptoms are still ongoing, my dominant hand is not the left hand, and there are no visible external injuries.) (1) On March 9, I pressed many times on the area near the web space of my left hand, why did I only start feeling electric shock-like symptoms on March 20? (2) I noticed that when water flows over my hand, I do not feel an electric shock, but if the water travels a distance or splashes onto the area near the web space of my left hand, it hurts a lot! What could be the reason for this? My hand can move normally, and only water (each time) and pressure (sometimes, but I have stopped pressing now) cause the electric shock sensation; I have not encountered other stimuli that cause this sensation, why is that? (3) You previously diagnosed "superficial peripheral nerve compression causing nerve inflammation or injury" and advised "to avoid putting pressure on the symptomatic area as much as possible," and mentioned that "nerve compression symptoms may improve with rest." I would like to ask if resting means to avoid using the left hand entirely, or just to avoid using the thumb and index finger (since the sensation is connected to the web space)? Can I still move my middle finger, ring finger, and little finger? (4) Following up on the previous question: since my left hand can move normally and does not hurt, can I still exert force with it? I have been trying to avoid using my left hand and not exerting force for the past few days, but I feel a bit of numbness from my entire left arm to my left hand and fingers.
Is this due to not moving for too long, or could it be a psychological factor making me feel numb when I actually am not? (5) On March 22, I visited a neurologist who prescribed a 7-day supply of B vitamins and said to return if the pain persists.
I would like to know if I buy B vitamins myself after finishing the prescribed course, how long should I take them before returning for a follow-up (if the pain continues)? Or should I return for a follow-up if I still feel pain after the 7-day course? (6) Sometimes I forget that water should not touch my hand while washing, which causes an electric shock sensation.
Will this continuous stimulation of the nerve prevent it from resting? (7) Could this issue possibly be related to autonomic nervous system dysfunction? I have been experiencing some stress from my studies lately.

Ms. Hsu, 20~29 year old female. Ask Date: 2023/03/23

Dr. Wu Mukhan reply Neurology

Hello, at this stage, it is advisable not to intentionally apply pressure to the areas that are numb or have a tingling sensation, as this may worsen your symptoms.
You can still move your fingers in your usual manner.
Contact with water will not prevent the nerves from resting, but if it is uncomfortable, you may want to use a wiping method instead.
The autonomic nervous system is not directly related to sensory nerve abnormalities, but high stress can indeed contribute to certain neurological disorders.
There are many causes of nerve paralysis or pain, and the symptoms can be quite variable; it is not necessarily solely due to nerve compression.
If you wish to determine the cause, it is best to visit a hospital's neurology department for further examination.

Reply Date: 2023/03/23

More Info

Understanding nerve sensations and the discomfort in your hand can be quite complex, especially when considering the various factors that contribute to nerve health and function. Based on your detailed description of symptoms and previous medical evaluations, let's address your questions systematically.

1. Delayed Symptoms After Pressure: The fact that you experienced a sensation of being "electrified" in your hand weeks after applying pressure could be attributed to several factors. Nerve injuries or irritation can sometimes take time to manifest symptoms. The initial pressure may have caused inflammation or irritation of the nerve, which could lead to delayed symptoms as the inflammation progresses or as the nerve becomes more sensitive over time.

2. Water Sensitivity: The pain you feel when water hits a specific area of your hand could be due to heightened sensitivity of the nerve endings in that region. This phenomenon is known as allodynia, where normally non-painful stimuli (like water) cause pain due to nerve irritation or damage. The fact that water flowing over your hand does not elicit the same response suggests that the nerve may be reacting to the pressure or temperature change when water is concentrated on a specific area.

3. Resting the Affected Area: When your doctor advised you to avoid pressure on the symptomatic area, it generally means you should minimize activities that put strain on your left hand, particularly around the thumb and index finger, as these are likely connected to the area of discomfort (the "虎口" or web space between the thumb and index finger). However, gentle movement of the other fingers (middle, ring, and pinky) is usually acceptable, as long as it does not exacerbate your symptoms.

4. Using Your Left Hand: If your left hand can move without pain, it is generally safe to use it for light tasks. However, if you are experiencing a tingling or "numb" sensation, it may indicate that the nerve is still irritated. The feeling of numbness after inactivity could be due to reduced blood flow or nerve compression from maintaining a position for too long. It’s essential to listen to your body; if you feel discomfort, it’s best to rest.

5. Vitamin B Complex Supplementation: The B vitamins are crucial for nerve health, and if your doctor prescribed a 7-day course, it’s advisable to follow that regimen. If symptoms persist after finishing the medication, you can consider continuing with B vitamins, but it’s best to consult your healthcare provider before self-prescribing additional supplements. If pain continues after the initial treatment, returning to your doctor for further evaluation is essential.

6. Impact of Water on Nerve Rest: Continuous stimulation of the nerve, even from something as benign as water, can hinder the healing process. If you are frequently triggering pain responses, it may prevent the nerve from resting adequately, which is crucial for recovery. It’s essential to be mindful of how you interact with your hand during daily activities.

7. Autonomic Nervous System and Stress: Your concern about autonomic nervous system dysregulation due to stress is valid. Stress can exacerbate physical symptoms, including nerve pain and discomfort. It’s important to manage stress through relaxation techniques, regular exercise, and possibly counseling if needed. Stress management can significantly improve your overall well-being and potentially alleviate some of the nerve-related symptoms.

In conclusion, it’s crucial to maintain open communication with your healthcare providers regarding your symptoms and treatment progress. If you notice any changes or worsening of your condition, do not hesitate to seek further medical advice. Nerve recovery can be a slow process, but with appropriate care and management, many individuals experience significant improvement.

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