Q. I have pain and numbness in my hands that wakes me from sleep at night. I can shake them, and they feel better. They don’t go numb during the day. Should I be concerned?
A. The symptoms you describe are classic for carpal tunnel syndrome. Carpal tunnel syndrome is caused by compression of the median nerve as it courses through the carpal tunnel and enters the palm of the hand. It usually affects the thumb, index, middle and ring fingers by producing numbness and tingling. The underlying cause is variable, but it is commonly associated with tendon inflammation or sustained positions—such as wrist flexion in deep sleep—that increase the pressure in the carpal tunnel. Some patients say that occupational activities produce symptoms, while other patients notice that daily activities such as driving and holding the newspaper are aggravating. Women who are pregnant or have recently had a baby may experience these kinds of symptoms as well. Symptoms of carpal tunnel during the early phase usually come and go as the offending activity is either modified or discontinued. However, constant numbness or weakness may be signs of more severe compression with potential damage to the nerve. If you experience symptoms that concern you, I recommend evaluation by your health care provider who can begin a treatment plan that includes further diagnostic workup.
Justin Arnold, M.D.
Center for Sports Medicine & Orthopaedics
2415 McCallie Avenue
Chattanooga, Tn. 37404