Thumb Tremors: Causes and Concerns After Napping

The right thumb is bent and trembling?

This afternoon, I slept on my desk for about 40 minutes, and later in the evening, my right thumb started to tremble when I bent it (but I don't feel weak, and I can use it normally).
The trembling is quite noticeable.
Additionally, when I stretch my thumb, I feel a pulling pain in my palm.
I mention that I slept on my desk because I previously experienced weakness in my left thumb after sleeping in that position, but it resolved after a few days.
After waking up today, I also felt a sense of pressure in my right forearm, and I'm not sure if it's related.
I would like to ask the doctor what this condition might be, as my other fingers are not affected.

1, 10~19 year old female. Ask Date: 2023/05/23

Dr. Wu Mukhan reply Neurology

Your symptoms may be due to compression of the peripheral motor nerves while sleeping on your stomach, leading to weakness and abnormal movements.
It is advisable to avoid this sleeping position.
Typically, rest, heat therapy, and massage can help alleviate the symptoms.
If there is no improvement, it is recommended to seek medical attention at a hospital.

Reply Date: 2023/05/23

More Info

Thumb tremors, especially after a period of napping in a position that may have put pressure on your arm, can be concerning but are often benign. The symptoms you describe—tremors in your right thumb when bent, along with a pulling sensation in your palm—could be attributed to several factors, including nerve compression, muscle fatigue, or even a temporary disruption in blood flow.

When you nap with your arm in a position that compresses nerves or blood vessels, it can lead to a phenomenon known as "paresthesia," which is often described as tingling, numbness, or weakness in the affected area. This is commonly experienced when pressure is applied to the ulnar or median nerves, which can happen if your arm is bent awkwardly or resting on a hard surface. The fact that you previously experienced similar symptoms in your left thumb suggests that your sleeping position may be a contributing factor.

The tremor itself, particularly if it is only in the thumb and not accompanied by weakness or loss of function, may be a result of muscle fatigue or overactivity. When you wake up, the muscles may be slightly "confused" or fatigued from being in a static position for an extended period, leading to involuntary movements or tremors. This is usually temporary and should resolve as you use your hand more throughout the day.

The pulling sensation in your palm when you stretch your thumb could indicate tightness in the muscles or tendons, possibly due to the position you were in while napping. Stretching and gentle movements can help alleviate this discomfort.
If the tremors persist, worsen, or are accompanied by other symptoms such as significant weakness, pain, or changes in sensation in other fingers or parts of your hand, it would be advisable to consult a healthcare professional. They may perform a physical examination and possibly recommend nerve conduction studies to rule out conditions like carpal tunnel syndrome or other neuropathies.

In summary, while your symptoms are likely related to your sleeping position and temporary muscle or nerve compression, monitoring the situation is key. If symptoms do not improve or if you have any concerns, seeking medical advice would be the best course of action. Regular stretching, maintaining good posture while sleeping, and avoiding prolonged pressure on your arms can help prevent recurrence of these symptoms.

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