Introduction
Numbness in the hands can be the result of a chronic medical condition or acute injury. Numbness is an underrated complaint but the truth is that it is as debilitating or more as pain. In some cases, pain can be managed but numbness is not easily manageable. As closely related with circulatory system and nervous system, numbness mostly manifests on extremities. Hand numbness is usually caused by damage, irritation or compression of one of the nerves or a branch of one of the nerves in the arm and wrist. Anyways, tingling hands is extremely common and bothersome. Such tingling can sometimes be benign and temporary. For example, it could result from pressure on nerves when the arm is crooked under the head while sleeping. In such cases, the “pins and needles” effect, usually painless soon gets relieved by removing the pressure that caused it. But in many cases, tingling in the hands, feet, or both can be severe, episodic, or chronic. It also can come with other symptoms, such as pain, itching, numbness, and muscle wasting. In such cases, tingling may be a sign of nerve damage, which can result from various medical conditions. Diseases affecting the peripheral nerves, such as diabetes, also can cause numbness, although with diabetes similar symptoms usually occur first in the feet.
Uncommonly, numbness may be caused by problems in the brain or spinal cord, although in such cases arm or hand weakness or loss of function also occurs. Numbness alone isn’t usually associated with potentially life-threatening disorders, such as strokes or tumours.
Signs & symptoms
Tingling and a prickling feeling, as if the person’s fingers were lightly touched by a needle.
Mild burning sensation often.
Inability to hold small things with fingers or to pick things up.
Weakness
Loss of strength in hands.
Causes
Possible causes of numbness in one or both of your hands include:
Brain and nervous system conditions
Cervical spondylosis
Paraneoplastic syndromes of the nervous system
Peripheral neuropathy
Spinal cord injury
Stroke
Trauma or overuse injuries
Brachial plexus injury
Carpal tunnel syndrome
Cubital tunnel syndrome
Frostbite
Chronic conditions
Alcoholism
Amyloidosis
Diabetes
Raynaud’s disease
Sjogren’s syndrome
Infectious diseases
Lyme disease
Syphilis
Treatment side effects
- Side effects of chemotherapy or HIV drugs
Other causes
- Ganglion cyst
- Vasculitis
- Vitamin B-12 deficiency
- Toxins like heavy metals such as lead, arsenic, mercury, and thallium, and some industrial and environmental chemicals.
- Autoimmune diseases like Guillain -Barre syndrome, Lupus, Multiple sclerosis and rheumatoid arthritis.
- Inherited disorders of nervous & locomotory system known as Charcot-Marie-Tooth disease.
- Injury. Often related to trauma, nerves can be compressed, crushed, or damaged in other ways, resulting in nerve pain. Examples include nerve compression caused by a herniated disk or dislocated bone.
Pathophysiology
Sensory processing areas within the brain connect with cranial nerves or spinal cord sensory pathways. Sensory fibres exiting the spinal cord join just outside the cord to form dorsal nerve roots except for C1. These 30 dorsal sensory roots join with corresponding motor ventral roots to form spinal nerves. Branches of the cervical and lumbosacral spinal nerves join more distally to form plexuses and then branch into nerve trunks. The intercostal nerves do not form plexuses; these nerves correspond to their segment of origin in the spinal cord. The term peripheral nerve refers to the part of the nerve distal to the nerve root and plexus.
Spinal nerve
Nerve roots from the most distal spinal cord segments descend within the spinal column below the end of the spinal cord, forming the cauda equina. The cauda equina supplies sensation to the legs, pubic, perineal, and sacral areas (saddle area).
The spinal cord is divided into functional segments (levels) that correspond approximately to the attachments of the pairs of spinal nerve roots. The area of skin supplied mostly by a particular spinal nerve is the dermatome corresponding to that spinal segment.
Sensory dermatomes
Numbness can occur from dysfunction anywhere along the pathway from the sensory receptors up to and including the cerebral cortex. Persistent or recurrent numbness in hands and fingers mostly develops due to damage, a blockage, infection, or compression of a nerve that travels to the hand. The area of numbness corresponds to the dermatome and supplying nerve anatomically.
Medical history
Physical examination including examination of arm, hand, spine and finger.
X ray
MRI
Blood tests may also help diagnose conditions that cause finger numbness, such as diabetes, RA or vitamin B-12 deficiency.
CSF examination to identify antibodies associated with peripheral neuropathy.
An electromyogram to test muscle activity
Nerve conduction velocity (NCV)
Computed tomography (CT)
Nerve biopsy
Treatments
Accurate diagnosis and treatment of the cause of the tingling is very important. As long as the peripheral nerve cells have not been killed, they can regenerate.
Although there are no treatments for inherited types of peripheral neuropathy, many of the acquired types can be improved with treatment. For example, good control in blood sugar levels can help keep diabetic neuropathy from getting worse, and vitamin supplements can correct peripheral neuropathy in people with vitamin deficiencies.
General lifestyle recommendations include keeping weight in check, avoiding exposure to toxins, following a doctor-supervised exercise program, eating a balanced diet, and avoiding or limiting alcohol. Recommendations also include quitting smoking, which constricts blood supply to blood vessels supplying nutrients to peripheral nerves.
In some cases, tingling and other symptoms of peripheral neuropathy may be eased with prescriptions developed for treating seizures and depression. Prescriptions like nonsteroidal anti-inflammatory drugs, such as ibuprofen help to reduce inflammation.
Another option is wearing a brace or splint to keep good posture and to avoid nerve compression
Steroid injections can help relieve inflammation.
Surgery may decrease the nerve damage, or remove or reduce bones that are pressing on the nerve. These procedures include:
- cubital tunnel release
- ulnar nerve anterior transposition
- medial epicondylectomy
Prognosis
Finger numbness is usually treatable if it isn’t associated with serious underlying medical conditions like stroke. Rest can help reduce overuse injuries.
Complications
Complications depend upon the cause of numbness.
In neuropathies, worsening of signs and loss of voluntary movements like writing may develop.
Loss of sensation can cause severe injuries and burns.
In circulatory deficit, like in diabetes, severe complications like gangrene or frost bite can happen
Disease & Ayurveda
Supti in hasta and anguli
Nidana
Causative factors for the vitiation of Kapha and Vaata
Purvaaroopa
Not mentioned
Samprapti
When the vitiated Kapha causes obstruction and Vaata causes degeneration, and both of these get lodged in hands & fingers, supti (numbness) manifests.
Lakshana
Numbness and loss of touch sensation in hands and fingers
Divisions
Not mentioned
Prognosis
Sadhyam in new and without any complications.
Yaapyam in chronic and complicated cases.
Samana
Lepanam with Rookshana dravyas if Aama or vitiated kapha present
Abhyanga or pradesikadhara with oil in conditions without aama or kapha
Sodhana
Snehanam
Swedanam
Ashtapanavasti
Anuvasanavasti
Agnikarma
Commonly used medicines
Maharasnadi kashayam
Sahacharadi kashayam
Ksheerabalatailam avarthy
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Getting enough rest for the hand and wrist
Applying hot water bag or ice packs can ease the discomfort
Stretching exercises like:
- stretching out your fingers as wide as you can and holding the position for about 10 seconds
- moving your hands around in a clockwise direction about 10 times, then reversing the direction to reduce muscle tension
- rolling your shoulders backward five times, and then forward five times to keep them relaxed
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups.
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active.
Yoga
Regular stretching and cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
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