Hand Pain & Numbness

The causes can be anywhere from brain to cervical cord to thoracic outlet, arm, elbow , wrist and hand.

1. Compressive neuropathy
   • Carpal tunnel syndrome (median Nerve) – compression is at the level of the wrist. Patient present with numbness in the thumb and index finger followed by pain. The symptoms are more common at night and then it becomes constant.
   •  Cubital tunnel Syndrome(Ulnar Nerve)   – Compression is at the level of the elbow. The symptoms are more in little and ring finger and more at night Nocturnal awakenings

Diagnosis EMG AND NCV – It tests the functions of nerve and able to detect any pathology along their path.
Treatment Consult pain physician –USG guided median nerve release or Ulnar nerve release is very effective. The release is done under ultrasound  guidance and hence it is very safe and give quick results.

2. Cervical Spine disc herniation – If there is disc herniating and compressing the nerve, you will feel paresthesia and tingling in the nerve distribution. If the nerve compression is been for long time, there could be muscle weakness leading to loss of grip.

Diagnosis – cervical MRI scan

3. Cervical spondylosis – It is arthritis in cervical or neck bones. This can also lead to compression of cervical nerves. Patient present with pain in arm, forearm or hand along with numbness.

Diagnosis – Cervical MRI scan
Treatment – Medication and Neck injection by a pain physician.

4. Thoracic Outlet Syndrome – Either compression of Nerve arises from Bony compression due to cervical rib  or compression of venous or arterial system or  soft tissue compression due to scalene muscles or fibrotic bands

Diagnosis – MRI of thoracic inlet.
Treatment – Physical therapy and botulinum toxin injection. In some cases surgery will be needed.

5. Raynaud’s Phenomenon – It is a disease in which the blood supply to your hands is reduced. Hand become cold, numb and at times blue. Can happen in various diseases like  SLE, Rheumatoid arthritis., Sjogren’s Syndrome.

Treatment needs  to be treated by Rheumatologist.

6. Herpetic infection – it is a skin infection. Nerve root affected will have pain along with rash.

Consult your dermatologist and for pain

7. Peripheral Neuropathy – Diabetes, Chemotherapy and Other medications , Alcohol , Vitamin B12 deficiency , hypothyroidism,

Test – Serum Vit B12 test (160 to 950 pg/mL), Blood Sugar, thyroid profile,  NCV for neuropathy.
Treatment – Correction of the cause. Control the Blood Sugar level, Vit B12 supplements either orally or in injectable forms, reduce alcohol intake.

For Video description, please follow the link    https://youtu.be/vWfci9siZKo