Bilateral Hand Numbness and Weakness

Anatomy

Numbness in one or both hands describes a loss of sensation or feeling in your hand or fingers. Often, hand numbness may be accompanied by other changes, such as a pins-and-needles sensation, burning or tingling. Your arm, hand or fingers may feel clumsy or weak.

Numbness can occur along a single nerve in one hand, or it may occur symmetrically in both hands.

  • Description—Although carpal tunnel syndrome is a common condition associated with numb hands, it is not the only cause. Other potential causes are listed below.
  • Causes—COMPRESSION NEUROPATHY

    In addition to numbness, compression neuropathy can cause weak or twitchy muscles. Compression neuropathy is pressure on a nerve (Figure 1). The pressure may come from an injury, thickened muscles, enlarged blood vessels, ganglion cysts, etc. Types include:

    Ulnar nerve compression at the wrist: This causes numbness and tingling of the little finger, part of the ring finger, and in the palm on the little finger side.
    Ulnar nerve compression at the elbow: This causes not only the numbness noted above but also numbness on the back of the hand on the pinky side.
    Pressure on the radial nerve in the forearm or above the wrist: This can cause numbness over the back of the thumb, the index finger, and the web between these two fingers.
    Median nerve compression at the elbow: This can cause numbness not only in the same area as in carpal tunnel syndrome but also in the palm at the base of the thumb.
    Pressure on nerves in the neck (Figures 2-3): This can be caused by arthritis, diseases, infections, tumors, blood vessel abnormalities and other conditions of the spinal cord. In addition to numbness, symptoms include weak muscles and decreased reflexes in the arm and forearm, and even the legs.
    Sometimes, a nerve may suffer from pressure at more than one area. This is called “double crush.” Pressure on a nerve may require surgery to get relief.

  • Treatment—The pattern and distribution of symptoms can help determine if the cause is pressure on a nerve, a disease, medications, nutritional or another condition. Depending on the suspected cause, further tests such as an x-ray, an MRI, nerve tests (such as EMG), blood tests, or a spinal tap may be used to help confirm a diagnosis. Specific treatment recommendations can then be made by your specialist. You may also be referred to other specialists such as a neurologist, rheumatologist, pain management specialist, or other.

    Figure 1: Sensory distribution of nerves
    Figure 2: Cervical root distribution
    Figure 3: Interconnections of nerves originating in the neck