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Hand Numbness: Causes & When to See a Doctor

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Hand numbness is commonly the result of an injury or conditions that put pressure on nerves in one or both hands (nerve compression). Often this can feel like a dull burning sensation, numbness and tingling, or pins-and-needles. Here, we will discuss a few categories of causes - diabetes, neurologic, autoimmune, vascular - and will review numb hands treatments.

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Symptoms of hand numbness

Hand numbness can be described as a loss of sensation in the fingers, hand, or arm. Many people have experienced this sensation when falling asleep for too long on a crooked arm or after activities such as prolonged typing. Symptoms of hand numbness can be initially alarming. Hand numbness may be associated with other symptoms that may feel strange and concerning.

Common accompanying symptoms of hand numbness

If you're experiencing hand numbness, it can likely be described by the following.

  • Burning
  • Tingling
  • Pins-and-needles sensation
  • Sensitivity to touch
  • Weakness or clumsiness

Often these symptoms are temporary. Many of us are familiar with shaking out our hands after a long day of typing or massaging the fingers to find quick relief from numbness. However, if your hand numbness happens frequently or persists, make an appointment with your doctor to follow up on your hand numbness symptoms and get appropriate care.

Timing and onset of symptoms of numbness in both hands

If you are experiencing numbness in both hands, take note of the timing and pattern of your symptoms:

  • Timing: Does the numbness and any associated symptoms occur in both hands at the same time? Or at different times?
  • Severity: Is the numbness and any associated symptoms more severe in one hand versus the other? Or about the same?

Numbness affecting both hands should always be promptly followed-up by your physician, especially if you find the numbness occurring in both hands with the same frequency and severity.

Hand numbness causes and conditions

Hand numbness is the result of injury, compression, or irritation of a nerve or a branch of one of the nerves in your arm or wrist. The hand is composed of many nerves and small blood vessels that begin higher up in the shoulder and arm and branch off in various directions for blood flow and sensation throughout the hand. Conditions that result in hand numbness are therefore varied, but can be divided into the following categories.

Systemic disease causes

Hand numbness may be due to underlying conditions.

  • Metabolic: Poor glucose control in diabetes can damage the peripheral nerves causing numbness in the hands and other parts of the body (peripheral neuropathy).
  • Tumors: Cancerous and noncancerous growths in the body can directly compress nerves as high as your shoulder and arm that can affect the nerves in your hand and fingers, resulting in numbness.
  • Hereditary: Some uncommon inherited disorders such as Charcot-Marie-Tooth disease can affect multiple nerves in the body and result in numbness. Sometimes anatomical defects that you are born with (for example, an extra rib) can compress nerves and blood vessels in the arm resulting in hand numbness.
  • Neurologic: Syringomyelia is a rare disorder in which a fluid-filled cyst forms within the spinal cord [3]. This cyst can grow outward, compressing and damaging the nerves of the spinal cord and resulting in pain, weakness, and numbness. Often the loss of sensation and numbness is described as being in a "cape" (over the tops of the shoulders and into the hands and arms).

Inflammatory causes

Inflammatory causes of hand numbness may include the following.

  • Autoimmune: Many inflammatory diseases that result in the body attacking itself can also affect the nerves and cause injury that results in numbness. Conditions such as multiple sclerosis and lupus are examples of such autoimmune diseases.
  • Infections: Bacterial infections such as Lyme disease and multiple viral infections such as shingles can cause inflammation and nerve injury that results in hand numbness symptoms.
  • Vascular: Raynaud's is a condition in which the arteries in the fingers narrow in response to triggers (often cold weather related). This narrowing prevents blood from circulating properly to the fingers which can result in bilateral numbness and loss of sensation. The fingers often feel extremely cold and can change colors from white to blue to red.

Environmental causes

Environmental causes of hand numbness may be due to lifestyle habits or certain exposures.

  • Toxins: Toxins that cause injury to the nerves include heavy metals such as lead and substances such as alcohol. Too much exposure to either can cause nerve damage that leads to numbness.
  • Vitamin imbalance: There are certain vitamins that are essential to healthy nerve function such as vitamins E and B12. Deficiencies in these vitamins over time can lead to nerve damage and injury. Conversely, exposure to too much vitamin B6 can cause hand numbness symptoms.
  • Trauma: Any situation where the hand or arm is crushed or damaged will result in hand numbness and nerve pain. Furthermore, repetitive actions such as typing or using crutches can cause trauma to the nerves via compression resulting in hand numbness symptoms.

This list does not constitute medical advice and may not accurately represent what you have.

Ulnar nerve entrapment of elbow

Ulnar nerve entrapment of elbow is also called cubital tunnel syndrome. The ulnar nerve begins at the spinal cord in the neck and runs down the arm into the hand. This very long nerve can become compressed, or entrapped, by other structures at certain points along the way. Entrapment often happens in the cubital tunnel, which is the narrow passage at the inside of the elbow.

The exact cause for entrapment may not be known. Fluid buildup and swelling inside the elbow; previous elbow fracture or dislocation; or leaning on the elbow for long periods of time can put pressure on the ulnar nerve inside the cubital tunnel.

Symptoms include numbness and tingling of the hand and fingers, sometimes leading to weakness and even muscle wasting in the hand.

Diagnosis is made through physical examination, x-ray, and nerve conduction studies.

Treatment begins with wearing a supportive brace and adjusting activities to avoid further irritating the nerve. Surgery is usually not needed unless the nerve compression is causing weakness and loss of use in the hand.

Rarity: Common

Top Symptoms: hand weakness, weakness in one hand, numbness in one hand, pain in one elbow, pain in one forearm

Urgency: Primary care doctor

Thoracic outlet syndrome

The "thoracic outlet" is the space on either side of the base of the neck where nerves, arteries, and veins travel beneath the collarbone. If these become compressed or damaged, the condition is called thoracic outlet syndrome or TOS.

The most common causes are trauma, such as a car accident or fall; and repetition or overuse, such as a sports injury.

Symptoms vary depending on the structures being compressed:

  • Neurogenic TOS affects the nerves. It is the most common form and creates numbness, tingling, pain, and weakness in the arms, hand, and fingers.
  • Vascular TOS affects the arteries and veins. It creates the same symptoms as neurogenic TOS as well as cold, pale hands and arms with weak pulse.

It is important to see a medical provider about these symptoms so that the damage does not become permanent.

Diagnosis is made through patient history, physical examination, imaging such as x-ray or ultrasound, and sometimes nerve conduction and blood flow studies.

Treatment involves physical therapy, pain relievers, and sometimes surgery.

Rarity: Rare

Top Symptoms: pain in one shoulder, spontaneous shoulder pain, arm weakness, arm numbness, pain in one shoulder blade

Urgency: Primary care doctor

Pinched nerve in the neck

A pinched nerve in the neck is also called cervical radiculopathy. It means that a nerve in the neck, at a point where it branches off from the spinal cord, is being compressed by the surrounding bones, muscles, or other tissues.

It can be caused by a traumatic injury, such as from sports or an automobile accident, especially if the injury results in a herniated disk. It may also arise from the normal wear and tear of aging.

Symptoms include sharp, burning pain with numbness and tingling from the neck to the shoulder, as well as weakness and numbness into the arm and hand.

Diagnosis is made through patient history, physical examination, and simple neurological tests to check the reflexes. Imaging such as x-ray, CT scan, or MRI may be done, as well as electromyography to measure nerve impulses in the muscles.

A pinched nerve in the neck often improves with simply a few days or weeks of rest. Physical therapy, nonsteroidal anti-inflammatory drugs, and steroid injections into the spine can all be very helpful.

Rarity: Common

Top Symptoms: pain in one shoulder, spontaneous shoulder pain, pain that radiates down arm, pain in the back of the neck, severe shoulder pain

Urgency: Primary care doctor

Low calcium level

Hypocalcemia is a condition where there is not enough calcium in the blood. Calcium is a mineral contained in the blood and helps the heart and other muscles function properly. It is also needed to maintain healthy teeth and bones. Low calcium levels can cause bones to become brittle and more easily fractured. Parathyroid issues and vitamin D deficiency are common causes of this condition.

You should consider visiting a medical professional to discuss your symptoms. Low calcium levels can be evaluated with a review of your symptoms and a blood test. Once diagnosed, treatment depends on the cause of your low calcium levels.

Rarity: Rare

Top Symptoms: fatigue, shortness of breath, irritability, general numbness, tingling foot

Urgency: Primary care doctor


Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.

Rarity: Common

Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache

Symptoms that always occur with fibromyalgia: arthralgias or myalgias

Urgency: Primary care doctor

De quervain's tenosynovitis

De Quervain's tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. If you have de Quervain's tenosynovitis, you will feel pain upon turning your wrist, grasping anything, or making a fist.

You should visit your primary care physician to confirm the diagnosis and discuss treatment options. You can also reduce pain and swelling with over-the-counter pain relievers, such as ibuprofen (Advil, Motrin), naproxen (Aleve).

Rarity: Uncommon

Top Symptoms: hand numbness, thumb pain, hand weakness, weakness in one hand, numbness in one hand

Symptoms that always occur with de quervain's tenosynovitis: thumb pain

Urgency: Primary care doctor

Chronic idiopathic peripheral neuropathy

Peripheral neuropathy refers to the feeling of numbness, tingling, and pins-and-needles sensation in the feet. Idiopathic means the cause is not known, and chronic means the condition is ongoing without getting better or worse.

The condition is most often found in people over age 60. Idiopathic neuropathy has no known cause.

Symptoms include uncomfortable numbness and tingling in the feet; difficulty standing or walking due to pain and lack of normal sensitivity; and weakness and cramping in the muscles of the feet and ankles.

Peripheral neuropathy can greatly interfere with quality of life, so a medical provider should be seen in order to treat the symptoms and reduce the discomfort.

Diagnosis is made through physical examination; blood tests to rule out other conditions; and neurologic and muscle studies such as electromyography.

Treatment involves over-the-counter pain relievers; prescription pain relievers to manage more severe pain; physical therapy and safety measures to compensate for loss of sensation in the feet; and therapeutic footwear to help with balance and walking.

Rarity: Rare

Top Symptoms: distal numbness, muscle aches, joint stiffness, numbness on both sides of body, loss of muscle mass

Urgency: Primary care doctor

Carpal tunnel syndrome

Carpal tunnel syndrome causes numbness and pain in the underside of the wrist and hand. It is caused by narrowing of the carpal tunnel passageway, which puts pressure on the nerve running through it.

Narrowing and deformity of the tunnel is most often from overuse, especially highly repetitive activities such as typing or working on an assembly line. Wrist fracture or arthritis can damage the carpal tunnel, and so can diabetes and obesity.

Symptoms include numbness and shocklike pain in the wrist, palm, and fingers. There may be weakness in the hand when trying to hold an object.

Carpal tunnel syndrome virtually always gets worse over time. Permanent damage may result, so it is important to be seen by a medical provider.

Diagnosis is made through patient history and physical examination. X-rays or electromyography testing may be used.

Rest and cold packs to the wrist will reduce swelling. Wrist splints and ergonomically correct keyboards and other devices during work are often helpful.

Corticosteroid injections and surgery may also be tried.

Brachial plexopathy (shoulder nerve issue)

A shoulder nerve injury, also called brachial plexopathy, is when damage occurs to a network of nerves in the front of the shoulder known as the brachial plexus. This damage can occur from injury, inflammation, radiation therapy, or other medical conditions. Symptoms include sharp pain in the shoulder, arm, or hand. Numbness or weakness in the shoulder or arm may also occur.

You should consider visiting a medical professional to discuss your symptoms. A doctor can evaluate shoulder nerve issues with a review of your symptoms and medical history. You might also be asked to do an EMG, a test that checks the connection between muscles and nerves. Once diagnosed, some options for treatment include pain or nerve block medication, physical therapy, and braces or splints. Some cases may require surgery. Depending on the severity, recovery times can range from weeks to years.

Rarity: Uncommon

Top Symptoms: pain in one arm, shoulder pain that shoots to the arm, arm weakness, numbness in one arm, shoulder pain

Symptoms that never occur with brachial plexopathy (shoulder nerve issue): pain in the front middle part of the neck

Urgency: Primary care doctor

B12 deficiency

Vitamin B12 deficiency means a shortage of cobalamin, which is one of the complex of B vitamins.

Cobalamin, or B12, is needed to make DNA, nerves, and red blood cells, but the human body cannot make its own B12. It must be consumed in food or as a vitamin supplement.

B12 deficiency is most often seen among vegetarians, since this vitamin is mainly found in animal protein foods. Conditions that interfere with the body's ability to absorb vitamins from food can cause the deficiency, including Crohn's disease; taking proton pump inhibitors for heartburn; and any form of weight-loss surgery such as stomach stapling or gastric bypass.

Symptom include numbness and tingling in the hands; difficulty with coordination and walking; joint pain; jaundice (yellowed skin;) and shortness of breath.

If not treated, B12 deficiency can progressively worsen into memory problems, severe depression, and even paranoia or hallucinations.

Diagnosis is made through physical examination and blood test.

Treatment simply involves supplementing vitamin B12, either with food choices, vitamin tablets, or B12 injections.

Hand numbness treatments and relief

Preventing hand numbness symptoms

The following measures may provide relief for infrequent or temporary symptoms of hand numbness.

  • Take note of certain habits: Avoid repetitive motions, cramped positions that put unnecessary pressure on your nerves, and toxic exposures such as alcohol.
  • Posture: Often relief can be found in improving your posture, buying a support for your wrists while typing, or taking breaks throughout the day in order to lessen compression and irritation of the nerves in your arms/shoulders and subsequently your hands.

When to see a doctor for hand numbness

However, if you experience frequent, persistent episodes of hand numbness, visit your doctor to find the exact cause of your condition in order to get appropriate treatment.

When to see a doctor for numbness in both hands

Visit your physician to discuss the exact cause of your symptoms in order to get appropriate care. Depending on the cause of your symptoms, your physician may suggest:

  • Medications to relax blood vessels: There are many different kinds of medications that can combat constriction in your blood vessels by dilating (relaxing) them and promoting circulation.
  • Anticonvulsants: Numbness is not the result of seizures, but some anticonvulsant medications are useful to treat numbness.

At-home treatments and lifestyle changes for hand numbness

Depending on the cause, your doctor may first suggest other lifestyle modifications such as:

  • Balanced diet rich in essential vitamins to keep the nerves healthy: Fruits, vegetables, grains, and lean proteins can provide your body with the nutrition necessary to maintain your nerves.
  • Regular exercise: Maintaining an optimal weight with exercise as well as a balanced diet can prevent and also control metabolic diseases such as obesity and diabetes.

Further treatments for hand numbness

If the above measures do not provide relief, your doctor may recommend the following.

  • Medications: Your doctor may be able to give you a prescription that can treat tingling and other symptoms related to numbness in the hands.
  • Physical therapy: If your hand numbness symptoms are due to anatomical conditions or trauma that cause compression of the nerves and blood vessels leading to your hands, your doctor may suggest physical therapy to help take the pressure off these body parts, which also may improve your range of motion and posture.
  • Surgery: If other treatments are ineffective and your hand numbness symptoms continue to progress or worsen, your doctor may recommend looking into surgical options to combat your symptoms.

When hand numbness is an emergency

If you experience any symptoms of speech difficulty, facial drooping, or weakness to the point you cannot raise your hand or arm, call 911 immediately. These could be signs of a stroke.

FAQs about hand numbness

Why do my hands go numb when I sleep?

Your hands may go numb when you go to sleep due to nerve irritation or positioning. Carpal tunnel syndrome, a common cause of irritation, can manifest as hand numbness at night. Additionally, we generally do not have control over how we toss and turn during sleep. Some of these tosses may end up with your hands in a position that irritates the nerves or cuts off blood flow, leading to temporary numbness.

Can shoulder pain cause numbness in the hands?

Yes, shoulder pain can lead to numbness in the hands. Your sense of touch is carried by nerves that run from the skin to the spinal cord and up to the brain. The nerves which handle sensation of the hand run in bundles through the shoulder. Shoulder pain can represent an injury to the shoulder that irritates or compresses one of these nerves, leading to numbness in the hand. If you experience this symptom, you should seek medical evaluation to avoid permanent loss of sensation.

Why is my left hand numb?

Left hand numbness may be caused by many conditions. Most commonly, this is due to positioning restricting blood flow to the hand or irritating the nerve. However, if your hand suddenly becomes numb or clumsy, this can be a sign of a more serious condition, such as a stroke or nerve injury. Some autoimmune diseases can also lead to numbness in one hand.

Why do I keep getting a pins-and-needles sensation in my hands?

Pins-and-needles sensations are caused by nerve irritation or damage. This is usually due to positioning such as when you sit on your hand, or it may be caused by a pinched or irritated nerve due to carpal tunnel syndrome or cervical stenosis. More severe or chronic tingling may be due to diabetes (though this usually begins in the feet), Raynauds disease, medications, toxins, infections, autoimmune disease, vitamin deficiency, or injury.

Why do my hands feel tingly and numb when I wake up?

Most often, your hand may feel tingly and numb upon waking up due to the position in which you were sleeping. If you accidentally slept on your hand or bent your wrist inappropriately while asleep, this can irritate the nerves of the hand or cut off blood flow, leading to transient numbness. This may also be a symptom of carpal tunnel syndrome.

Questions your doctor may ask about hand numbness

  • What is your body mass?
  • Have you ever been diagnosed with diabetes?
  • Turn your head toward the side of your body that is hurting. Lift your head up as someone else pushes down on your head. Does this cause greater pain in your upper body? (This is known as Spurling's test.)
  • Have someone feel for your pulse (at the wrist) on the side of your body that hurts. Now, turn your head to that side. Does the pulse go away? (This is known as the Adson's test.)

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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