Numbness in Hands and Feet: Causes and Solutions

Numbness in the hands and feet?

Dear Sir/Madam,
I frequently experience swelling in my palms and soles, particularly noticeable in the morning upon waking.
There is a feeling of stiffness when I extend my palms, and some joints experience sharp pain.
Even riding a bike for just ten minutes can cause my palms to feel numb.
These symptoms have been present for several years, but have become more pronounced in the past month.
I would like to inquire whether this condition is related to a sports injury, vascular issues, or neurological problems, and how I should address it.
Additionally, my spouse underwent a left partial glossectomy and neck lymphadenectomy due to tongue cancer earlier this year.
Currently, there is no sensation on the left side of her head, from the scalp to the chin.
Is there a possibility for this condition to improve?
Thank you!

danny, 40~49 year old female. Ask Date: 2003/12/10

Dr. Lai Lunxiang reply Neurology

1.
You may have carpal tunnel syndrome.
2.
There may not be much improvement.
Lai Lun-Hsiang, December 16, 1992.

Reply Date: 2003/12/10

More Info

Numbness in the hands and feet can be a concerning symptom, and it often arises from various underlying causes. Based on your description, it seems that you are experiencing persistent numbness and stiffness in your hands and feet, particularly noticeable upon waking and after activities like cycling. This condition has been ongoing for several years but has recently worsened. Additionally, you mentioned that your spouse has undergone surgery for tongue cancer, resulting in loss of sensation on the left side of the head.

Possible Causes of Numbness
1. Nerve Compression or Entrapment: Conditions such as carpal tunnel syndrome, where the median nerve is compressed at the wrist, can lead to numbness and stiffness in the hands. Similarly, conditions affecting the cervical spine, like herniated discs, can compress nerves that innervate the arms and hands.

2. Peripheral Neuropathy: This condition can arise from various factors, including diabetes, vitamin deficiencies (especially B vitamins), and exposure to toxins. It often presents as numbness, tingling, or pain in the extremities.

3. Circulatory Issues: Poor circulation can lead to numbness and swelling in the hands and feet. Conditions such as Raynaud's phenomenon can cause blood vessels to constrict excessively in response to cold or stress, leading to numbness.

4. Musculoskeletal Issues: Repetitive strain injuries from activities such as cycling or other repetitive motions can lead to inflammation and pain, contributing to numbness.

5. Systemic Conditions: Conditions like rheumatoid arthritis or lupus can cause joint pain and stiffness, which may also affect sensation in the hands and feet.

6. Neurological Conditions: Given your spouse's recent surgery and the associated loss of sensation, it’s important to consider that neurological issues could also be at play. Conditions affecting the central nervous system, such as multiple sclerosis or stroke, can lead to numbness and sensory changes.

Recommendations for Management
1. Medical Evaluation: It is crucial to consult a healthcare professional for a thorough evaluation. A neurologist can perform tests such as nerve conduction studies and electromyography (EMG) to assess nerve function and identify any underlying issues.

2. Physical Therapy: Engaging in physical therapy can help improve strength and flexibility in the affected areas. A physical therapist can provide exercises tailored to your specific needs, which may alleviate symptoms.

3. Ergonomic Adjustments: If your symptoms are exacerbated by activities like cycling, consider adjusting your bike setup to ensure proper posture and reduce strain on your hands and wrists.

4. Lifestyle Modifications: Incorporating regular breaks during repetitive activities, maintaining a healthy diet rich in vitamins, and staying hydrated can support overall nerve health.

5. Medication: Depending on the underlying cause, medications such as anti-inflammatory drugs, neuropathic pain medications, or corticosteroids may be prescribed to manage symptoms.

6. Monitoring and Follow-Up: Regular follow-up with your healthcare provider is essential, especially if symptoms persist or worsen. This is particularly important in the context of your spouse's health issues, as they may have implications for your own health.

Regarding Your Spouse's Condition
The loss of sensation following surgery for tongue cancer may improve over time, but it largely depends on the extent of nerve damage and the body's healing process. Rehabilitation and sensory retraining exercises may help in regaining some sensation. Consulting with a speech therapist or occupational therapist who specializes in post-surgical recovery can provide additional strategies for managing these changes.

In conclusion, numbness in the hands and feet can stem from various causes, and a comprehensive evaluation is necessary to determine the appropriate course of action. Early intervention can lead to better outcomes, so seeking medical advice promptly is advisable.

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