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Numbness in the hands: causes, diagnosis and when to seek medical advice

Numbness in the hands is a common neurological symptom, often described as tingling, burning or reduced sensation affecting the fingers or the entire hand.

In most cases it is transient and benign; however, in some situations it may indicate an underlying medical condition that requires evaluation.

Common causes

The most frequent cause is carpal tunnel syndrome, typically affecting the thumb, index and middle fingers and often worsening at night.

Other common causes include:
Cervical spine disorders with nerve root compression
Poor posture or prolonged nerve pressure
Diabetes and diabetic neuropathy
Vitamin deficiencies, especially vitamin B12
Anxiety and hyperventilation
Circulatory disorders of the upper limbs

Night-time numbness

Numbness during sleep is common and usually related to carpal tunnel syndrome or an inappropriate sleeping position causing nerve compression.

When to seek medical attention

Medical evaluation is recommended if numbness:
persists for an extended period
is associated with weakness or pain
progressively worsens
appears suddenly and severely

In rare cases, it may be associated with vascular or serious neurological conditions.

Diagnosis and treatment

Diagnosis is based on medical history and neurological examination.

Depending on the clinical findings, investigations may include:
nerve conduction studies (EMG)
cervical spine imaging
blood tests

Treatment depends on the underlying cause and may involve ergonomic measures, physiotherapy, medication or, in selected cases, surgical intervention.