Many people, both young and old, find hand numbness quite bothersome. Hand numbness is sometimes persistent, but often becomes worse in specific situations – waking up at night, driving, talking on a cell phone, sporting events, fishing, at work, ect. Usually, patients come to my office thinking that a numb hand is a part of life, but in reality, a numb hand usually means that a nerve is being choked off by abnormal positions and usually abnormal anatomy.
Though many feel that the numbness can be managed, my concern is that the same nerves which provide sensation, also provide valuable strength and dexterity for hand function, which often is already compromised by the time that a patient comes in for evaluation.
How is it diagnosed?
The two most common nerves that are compressed are the median nerve at the wrist, typically known as Carpal Tunnel Syndrome, and the ulnar nerve at the elbow, called cubital tunnel syndrome. There are certainly many other areas of nerve compression which can give a sense of numbness, which can be evaluated with a simple clinical exam or an electrical nerve study. Typically, I perform a full examination of all the nerves of the upper extremity and based on the findings, may order further studies such as a nerve conduction test, X-ray or an MRI to confirm or rule out my diagnosis.
What can be done?
The first key in treatment is to establish the correct diagnosis. Based on the particular nerve at risk, sometimes simple activity modifications or splinting can prevent a particular nerve from being susceptible to compression.
Sometimes, the nerve has been compressed for a long period of time or the nerve is at particular risk and I may offer a nerve decompression to permanently relieve the damaging effects of nerve compression and the numbness and muscle dysfunction that is likely to worsen if left untreated. These surgeries are day surgeries and usually are quite well tolerated.
Most of my patients compare them to dental type procedures, where soreness for several days occurs, but you are able to continue with your routine life. The decompression surgeries can be performed with modern minimally invasive techniques that can greatly minimize the pain and disability resulting from the procedure.
If you have numbness symptoms that you would like evaluated, do not hesitate to contact my office at 206-633-8100
