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What Causes Persistent Numbness In Hands?

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Posted on Tue, 18 Apr 2017
Question: For the last two weeks my hands are getting numb while sleeping, to the point that they hurt and wake me up. It's difficult getting a good night sleep. Also in the morning my hands feel puffy and sore and my left and right middle fingers won't bend properly. It's the oddest thing. Symptoms appeared suddenly, there was no gradual onset of soreness or little numbness here and there. Went to the doctor who ran tests but all seems perfect. No deficiencies or infections. For him the case is closed but my symptoms continue. Any insights would be highly appreciated. Thanks
doctor
Answered by Dr. Dariush Saghafi (1 hour later)
Brief Answer:
Need electrical testing

Detailed Answer:
Good morning and sorry for the problems in your hands.

Although the differential list of potential problems could be even more than a few items the most likely and most commonly diagnosed entity with this type of presentation turns out to be CARPAL TUNNEL SYNDROME which is the compression of the median nerve in both of your wrists which explains both the pain as well as the other symptoms of puffiness, swelling, and also motor symptoms.

I understand you say that the doctor believes the symptoms are trivial and the "case is closed" but did he run the typical tests for NEUROPATHY that I run on my patients? Did he schedule you to see a neurologist for a good neurological exam of the hands to determine whether or not there are signs of median nerve compression and did he talk to you about running any type of electrical studies such as an EMG (electromyogram) and NCV (nerve conduction study)?

If only some or none of these were done then, in my opinion there is still work to do. In fact, I would probably also consider some imaging studies of the neck using both PLAIN FILMS as well as an MRI....depending perhaps upon laboratory results first since treatable forms of neuropathy such as Vit. B12, D, and folate deficiencies can definitely make a difference in how you feel if they are low. As well, thyroid function tests such as a TSH, FT4, TT4, FT3, and TT3 may also be worthwhile getting and a HbA1C (checking for diabetes) just to check on things though it is a little less likely that correction of a hyper or hypothyroid state or even a diabetic state will significantly impact your complaints....but all the same I include it as part of a good checkup for cases of neuropathy.

One other thing I would do for the short run until all these tests and consults get done is get you a pair of wrist braces for support that wrap around the forearms and I have you use them while asleep only at this point.

If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out.

Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.

This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2472 Questions

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What Causes Persistent Numbness In Hands?

Brief Answer: Need electrical testing Detailed Answer: Good morning and sorry for the problems in your hands. Although the differential list of potential problems could be even more than a few items the most likely and most commonly diagnosed entity with this type of presentation turns out to be CARPAL TUNNEL SYNDROME which is the compression of the median nerve in both of your wrists which explains both the pain as well as the other symptoms of puffiness, swelling, and also motor symptoms. I understand you say that the doctor believes the symptoms are trivial and the "case is closed" but did he run the typical tests for NEUROPATHY that I run on my patients? Did he schedule you to see a neurologist for a good neurological exam of the hands to determine whether or not there are signs of median nerve compression and did he talk to you about running any type of electrical studies such as an EMG (electromyogram) and NCV (nerve conduction study)? If only some or none of these were done then, in my opinion there is still work to do. In fact, I would probably also consider some imaging studies of the neck using both PLAIN FILMS as well as an MRI....depending perhaps upon laboratory results first since treatable forms of neuropathy such as Vit. B12, D, and folate deficiencies can definitely make a difference in how you feel if they are low. As well, thyroid function tests such as a TSH, FT4, TT4, FT3, and TT3 may also be worthwhile getting and a HbA1C (checking for diabetes) just to check on things though it is a little less likely that correction of a hyper or hypothyroid state or even a diabetic state will significantly impact your complaints....but all the same I include it as part of a good checkup for cases of neuropathy. One other thing I would do for the short run until all these tests and consults get done is get you a pair of wrist braces for support that wrap around the forearms and I have you use them while asleep only at this point. If I've provided useful and helpful information to your questions could you do me a huge favor by CLOSING THE QUERY and be sure to include some fine words of feedback along with a 5 STAR rating? Again, many thanks for submitting your inquiry and please let me know how things turn out. Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.