Why are my hands tingling at night

Many patients report that their hands go numb when they sleep. Should this be something that worries you, or is it no big deal? Here’s why you should be concerned about this problem and what may be causing it.

When any body part goes numb, it means that the nerve supply to that area has been cut off. If your hands are going numb while you sleep, that indicates that some nerve that goes from your neck to the hand is being compressed. Nerves have their own blood supply, so pressure on a nerve cuts off that blood supply and the nerve becomes starved for oxygen and nutrients and shuts down. If this happens for a short period of time, the nerve wakes up again once the pressure is removed. Continued pressure on the nerve can mean that it gets a little damaged with each episode. Months or years of numb hands at night can be a symptom of damaged nerves.

The most significant cause is neck (cervical) stenosis or a disc bulge, leaving little room for the nerves. You don’t have to experience constant neck pain with stenosis or a disc bulge; some patients just notice that their hands are numb. When the neck gets into a weird position at night and the muscles that protect it during the day relax, the nerves become crunched and the hands go numb. Many times a cervical collar worn only at night will reduce the numbness. You may need to experiment with different collars or varying amounts of tightness. If this helps your hands, you likely should have a cervical MRI to check out the cause of the problem.

The second biggest cause is thoracic outlet syndrome. This means that the nerves are getting crunched in the shoulder area. This is a common problem for modern computer users, as the shoulder and head come forward leading to nerve compression. Specific stretching exercises can address this. Other causes can include carpal tunnel syndrome in the wrists. This is when the main nerve of the hand (median nerve) gets pinched in the tunnel that it traverses in the wrist. If this is the cause, simple wrist splints worn at night usually help. Both of these issues may require your doctor to take a closer look at the overarching cause of this problem.

One of the reasons you should be vigilant about addressing hand numbness is that it can lead to other problems. These can appear in the upper extremities and include tennis and golfer’s elbow (lateral and medial epicondylitis) as well as osteoarthritis in the hands and shoulder. Some research indicates that bad nerves may end up dumping nasty arthritis-causing chemicals into the joints.

Numbness in your hands at night is a big deal. Though it’s often ignored by physicians who aren’t experts in the area of musculoskeletal treatment, it should be taken seriously and its root cause identified. Otherwise, your nerves slowly may become less sensitive or your shoulders, elbows, or hands may begin to ache all the time.

Waking up with numb hands is typically a sign of an issue with the circulation or the nerves in the arms. When the cause is simple, such as falling asleep on the arms or with the hands in an awkward position, this symptom should resolve if the person changes their sleeping position.

Less commonly, waking up with numb hands could be a sign of an underlying health condition, such as carpal tunnel syndrome or a form of nerve damage.

Diagnosis generally involves tests to check the nerve function. If the doctor suspects a particular underlying cause, they may also order other tests specific to it. The type of treatment will depend on the diagnosis.

Keep reading to learn more about the causes of waking up with numb hands, as well as the diagnosis and treatment.

Causes

Numbness in the hands generally means that there is compression or a lack of signal in one of the nerves controlling the hands.

The three major nerves that lead to the hand are the ulnar, median, and radial nerves. Compression of these nerves can cause pain and numbness in one or more areas of the hand.

Issues that cut off blood circulation to the area may also cause numbness in the hands, along with other symptoms, such as nerve pain.

Nerve pain is a common issue in the United States. An article in the Journal of Pain Research states that7–10%of people have some form of neuropathic pain. There are several short-term and chronic conditions that can potentially cause symptoms such as numbness in the hands, including the following:

Sleeping posture

Poor sleeping posture is a simple and common cause of waking up with numb hands. People may have slept on top of their hands or with their hands in a strange position.

Sleeping in an unusual position can put temporary pressure on the nerves or slow down circulation to a particular area, such as the hands. This pressure and lack of blood flow can easily cause symptoms, for example, numbness or a tingling sensation.

If sleeping posture is responsible for numb hands upon waking, changing the position to relieve the pressure should help resolve this symptom. Avoiding sleeping on the hands or with the arms above or under the head may also help prevent hand numbness upon waking.

Carpal tunnel syndrome

Carpal tunnel syndrome may also cause numbness or tingling in the hands and wrists. Carpal tunnel syndrome occurs when the median nerve in the hand becomes compressed, generally due to inflammation from overuse.

Carpal tunnel syndrome can lead to symptoms such as pain, tingling sensations, and decreased strength in the hands. People who do more repetitive movements, such as using a cash register or typing on a keyboard for long periods, may be more likely to develop or experience carpal tunnel syndrome.

Learn more about carpal tunnel syndrome here.

Diabetes

Diabetes is a chronic disease that occurs when the body cannot make or use insulin properly. It causes high blood sugar levels, which may lead to other complications.

Nerve issues are common among people with diabetes. The American Diabetes Association note that “about half of all people with diabetes have some form of nerve damage.”

These nerve issues are more common in people who have had the disease for years. Controlling blood sugar levels carefully may help prevent or delay nerve damage.

Peripheral neuropathy

The peripheral nervous system sends nerve signals between the central nervous system and the rest of the body. There are different types of peripheral neuropathy, many of which cause similar symptoms, such as numbness, tingling, or painful sensations in the nerves.

Doctors may use imaging tests to check whether anything inside the body is putting pressure on the nerves. Nerve tests, such as electromyography and nerve conduction studies, may help doctors identify faulty nerve signals in the muscles, which could allow them to confirm a diagnosis.

Learn more about peripheral neuropathy here.

Pinched nerve

Sometimes, numb hands could be a sign of a pinched nerve.

If inflammation or trauma causes the tissues in the body to put pressure on a nerve, the nerve may send faulty signals. These faulty signals could cause various symptoms, such as pain, weakness, and numbness, in the muscles of the affected area.

Cervical spondylosis

Cervical spondylosis, or arthritis in the neck, is a condition that occurs as the disks in the spine wear down. This degeneration may occur due to trauma in the area, but it typically happens with age and general wear and tear.

Spondylosis can lead to the space between the vertebrae in the neck becoming thinner, which could place pressure on the nerves. If this occurs, it may cause symptoms such as numbness and tingling in the hands and arms. These symptoms can also affect other areas of the body, including the legs and feet.

Imaging tests of the neck can help doctors identify signs of osteoarthritis or cervical spondylosis.

Alcohol use disorder

Drinking too much alcohol over longer periods may also cause some symptoms of nerve damage, as excessive amounts of alcohol can damage nerve tissue. People who use alcohol very heavily may also have other issues, such as nutrient deficiencies due to a poor diet.

With a combination of these factors, it is not uncommon for people with severe alcohol use disorder to experience numbness, pain, or tingling in their limbs.

Neurological conditions

Some neurological conditions, such as multiple sclerosis (MS), can lead to numbness in the arms and hands. A person with a neurological condition may notice other symptoms, such as difficulty walking, changes in vision, or numbness or pain in other areas, such as the legs and feet.

Blood tests can help eliminate other possible conditions and check for markers of MS. Imaging tests, such as an MRI scan, can reveal any damaged areas in the brain that are causing symptoms.

Other conditions

Various other issues may lead to similar symptoms in the nerves. Other possible causes include:

• Sjogren’s syndrome
• syphilis
• lupus
• rheumatoid arthritis
• Raynaud’s syndrome
• hyperthyroidism
• Guillain-Barré syndrome
• encephalitis
• tumors in the brain or neck

Similar symptoms may also appear as a side effect of some medications, such as chemotherapy drugs or cardiovascular drugs.

Diagnosis and treatment

If a person wakes up with numb hands, they should spend a few minutes trying to wake the hand up before seeking medical treatment. In doing so, they can be certain that the issue is not simply due to pressure after having slept in a strange position or on the hand.

To wake up the hand, a person should try:

• shaking the hand
• flexing the hand
• massaging the hand

If the numbness goes away, this is likely an indicator that the numbness was simply due to pressure rather than to an underlying condition.

Anyone who suspects that an underlying condition is causing their symptoms should see a doctor for a diagnosis. Most diagnoses will involve imaging tests, such as X-rays, CT scans, or MRI scans, to look for signs within the body or brain.

Nerve tests will also help doctors evaluate nerve function and confirm a diagnosis.

In many cases, doctors will refer a person to a neurologist, who can make a more specific diagnosis and put an appropriate treatment plan in place.

Exercise

For some issues, such as carpal tunnel syndrome or arthritis, exercise may help strengthen the muscles around the wrists, potentially improving symptoms.

Hand and wrist exercises may help stretch and strengthen the muscles in the area to relieve pressure on the joints. People with cervical spondylosis may also benefit from some posture exercises.

Topical creams

Some topical medications may help reduce symptoms such as pain or tingling in affected areas. The following drugs and ingredients may be effective:

• lidocaine
• benzocaine
• menthol
• capsaicin

Doctors may recommend topical creams to help manage symptoms of nerve pain in people with peripheral neuropathy or diabetic neuropathy.

Wrist guards

Splints or wrist guards help protect the wrist and relieve pressure in this area of the body.

People with carpal tunnel syndrome may find relief by wearing wrist guards when performing repetitive tasks or during times when symptoms usually show up. Some people may also benefit from wearing them while they sleep.

Medications

Treatments will vary depending on the severity of the symptoms and the person’s health status. Some possible treatments include:

• tricyclic antidepressants
• calcium channel blockers
• serotonin-norepinephrine reuptake inhibitors (SNRIs)
• opioid drugs

When to see a doctor

Anyone who is waking up with numb hands and also experiencing troubling symptoms should see a doctor immediately. Examples of these symptoms are:

• weakness in the muscles or sudden loss of grip strength
• numbness that travels into the arms, shoulders, or back
• pain or numbness that lasts longer than the first few minutes after waking up

Sometimes, numbness may be a sign of a medical emergency, such as a stroke or heart attack. In this situation, the person will require emergency care, and they may have other symptoms.

In the case of a stroke, these may include:

• confusion or trouble concentrating
• difficulty speaking or forming words
• sudden migraines
• weakness or paralysis on one side of the body
• loss of balance or dizziness

If a person experiences numbness in the left arm and jaw due to a heart attack, they might also experience:

• chest pain or discomfort
• shortness of breath
• lightheadedness
• cold sweat

Anyone experiencing numbness in their hands alongside any of these other concerning symptoms should seek emergency medical care.

Summary

Numbness in the hands indicates that something is compressing the nerves in the hand or wrist.

This compression may occur due to simple issues, such as sleeping on the hand. However, it can be a sign of an underlying illness, either short-term or chronic.

Doctors may order several tests to check the nerves and confirm a diagnosis.

Treatment will vary depending on the underlying issue or condition. Some conditions may require long-term treatment to manage the symptoms.

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