Ask the Orthopedist: When Hands Aren’t Very Handy

Ask the Orthopedist: When Hands Aren’t Very Handy

- in Health & Wellness, May/June 2018
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By Scott M. Zimmer, MD

QUESTION

Why do I have numbness in my hand at night?

ANSWER

If you ever need to “wake up” your hand and wrist at night because they feel numb and tingly, it could be a result of pressure on the median nerve in your wrist or a condition called Carpal Tunnel Syndrome (CTS). This condition is the most common cause of numbness and tingling in the hand.

If pain is interfering with your ability to get a good night’s sleep, you may be able to make a few simple changes in your sleep routine before seeing a specialist. The easiest thing you can do is wear a wrist brace to bed. This will keep you from compressing the nerve that is causing you pain.

You may also want to think about the position of your arm when you sleep. Propping your arm up on a pillow may help symptoms, while sleeping with your hand under the pillow will likely worsen the pain. Anti-inflammatory medication can ease symptoms but should be used under the care of a physician.

CTS can be associated with a variety of medical conditions, including rheumatoid arthritis, alcoholism, obesity, diabetes and hypothyroidism. In most cases, there is no associated medical condition. Some other daytime symptoms include numbness and tingling when driving or holding a device or book for an extended amount of time. It is common for both hands to be involved, although one side may be worse than the other. Over time, some might experience decreased grip strength.

It is important to see an orthopedic hand specialist to get the proper diagnosis before any permanent nerve damage occurs. There are several clinical tests for CTS they conduct, including manual compression on the nerve and a test for loss of strength and muscle. If CTS is a real concern, your doctor might order a nerve study. This test stimulates the median nerve that then allows them to take measurements to see how well the nerve is conducting its signal.

Treatment Options

Non-surgical treatment options should always be tried first. After splinting, occupational therapy and use of anti-inflammatory medication treatment options have been exhausted, the use of steroid or cortisone injections may be explored.

When these conservative measures fail to relieve symptoms, surgery is recommended. There are several different surgical techniques; they all involve releasing the pressure on the nerve by cutting the ligament that sits above the nerve. This can be done with minimally invasive techniques that serve to relieve symptoms (especially at night) and ease recovery.

If carpal tunnel syndrome is interfering with your life and nothing else is working to improve your symptoms, surgery may be the best option. Most importantly, remember that an orthopedic surgeon — in this case, a hand and upper extremity surgeon — is best able to properly diagnose and offer non-operative treatments prior to doing any surgery.

It can take several months to fully recover from carpal tunnel surgery, although patients may experience relief of symptoms immediately after the procedure. No long-term splinting is done after surgery, and we encourage immediate full use of the hand except for heavy lifting.

Dr. Scott Zimmer is the founding director of Ohio Hand Center with locations in Beachwood, Chardon, Concord, Westlake and Willoughby. For more information, or to make an appointment call 844-542-6363.

About the author

Marie Elium spent 10 years as a newspaper reporter in Virginia and Ohio before switching to freelance writing when her two children were young. The kids are now Millennials, but writing continues to be one of her favorite endeavors. Marie was named editor of Northeast Ohio Boomer and Beyond magazine in November 2015 and is a graduate of Miami University. Marie can be reached at [email protected]

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