Numb Hands When Sleeping

“I get numb hands when sleeping, but thought it wasn’t worth mentioning.”

A surprising pattern I’ve noticed in practice is that a significant number of my new patients suffer from nightly hand numbness, and most think it’s not fixable!

Once they mention that their hands go numb when sleeping, it takes a few simple orthopedic tests to narrow down what may be causing their numbness.

In many cases, we’re able to resolve it through conservative muscle and joint care, without medication or surgery.

Read on about eight possible causes of hand numbness when sleeping. I’ll note which issues chiropractors (or other musculoskeletal practitioners like physical therapists) can effectively treat, and which should be referred to other health care professionals.

Conditions that may cause Numb Hands When Sleeping:

• Upper Cross Syndrome
• Cervical Radiculopathy
• Neuropraxis Injury
• Stenosis
• Diabetic Neuropathy
• Carpal Tunnel Syndrome
• Cardiovascular Issues
• Autoimmune Diseases or Other Illnesses
• What should I do if I have numb hands when sleeping?

Upper Cross Syndrome

The most common cause of hand numbness in my opinion is also the one most often misdiagnosed as carpal tunnel by medical doctors.

Upper cross syndrome (UCS) consists of postural imbalances throughout the neck, chest, and upper back that cause numbness and tingling in the hands, especially when sleeping or at rest.

The posture responsible for UCS is:

• Pushed forward head posture
• Extension of the upper neck
• Slumped, internally rotated, and rounded shoulders

Picture someone slumping at a computer desk, or a teenager hunched over a phone.

(It might even be you reading this right now!)

This posture tightens the muscles in the top and side of the neck as well as the chest, while muscles in the front of the neck and between the shoulder blades become overstretched and weak.

All this muscle tension pinches the nerves in the neck, then in the chest, and then yet again in the elbow or wrist.

Nerves are very sensitive to pressure, and tension at each site stacks, exponentially increasing the numbing all the way downstream in the hands and wrists.

So even though each affected area may only add a 5-10% compression or irritation to the nerve, by the time that nerve makes it to the hands it is only 60-80% effective.

Further adding fuel to the fire, the tense muscles tend to get tighter at your maximum and minimum activity levels. In other words, most symptoms show up either during strenuous work or when resting.

This may seem daunting but UCS can usually be resolved quickly and simply by loosening the tight muscles, strengthening the loose weak ones, and correcting the problematic posture.

These four steps can be done at home or with the help of a chiropractor, PT, LMT, or other muscle-specific practitioner:

• Trigger point work
• Massage
• Stretching the side neck and chest muscles
• Reactivating the muscles in the front of the neck and between the shoulder blades

Daily attention to stretching and retraining your muscles can quickly reverse the UCS posture, eliminating the numb hands when sleeping.

Cervical Radiculopathy

Another common cause of hand numbness at night is cervical radiculopathy. Or, more simply put, a disc herniation in the neck that pushes on the nerves leaving the neck.

This pressure on the nerve root can cause numbness, tingling, weakness, or pain in the arm and hand of the affected side.

When the spine is loaded, like when standing or lifting, the symptoms worsen. Because of this, the pressure actually lessens while sleeping, and the beginning and end of the day tend to be the most intense.

Conservative treatments for cervical radiculopathy aim to help reduce the pressure and decrease symptoms long enough for healing to take place.

Options include:

• Traction therapy
• Rehab exercises
• Gentle Chiropractic adjustments to the neck and upper back

Any combination of these treatments should help.

If the hand numbness is accompanied by significant loss of grip strength and isn’t improving quickly with conservative treatment, surgery may be necessary to ensure that there aren’t permanent nerve problems down the road.

Neuropraxis Injury

Often called a stinger or burner in sports, a neuropraxis injury is an injury to a nerve when it is overstretched.

A few common causes of this type of injury include a fall on the head or shoulder, getting headbutted in the outstretched arm, or having a limb wrenched in an awkward position when sparring in martial arts.

The good news is that neuropraxis injuries usually heal on their own as long as the nerve doesn’t continue to stretch.

Avoiding the sport or activity for a few weeks is usually indicated. A chiropractor or athletic trainer can tape the area to further stabilize the area until it finishes healing.

Stenosis

Stenosis is the narrowing of the space that a nerve or the spinal cord runs through.

There is a certain amount of narrowing that happens due to normal aging, but it becomes problematic when it starts to put pressure on the nerve root or spinal cord.

Possible symptoms of stenosis include:

• Numbness and weakness in both the hands and/or feet
• Loss of grip strength
• Reduced coordination
• Poor balance

Some of these symptoms lead to increased fall risk in a patient population that can least afford the fall.

For mild stenosis, posture correction and improving coordination through chiropractic adjustments, muscle activation, and rehab exercises may be enough to eliminate the nerve symptoms.

However a moderate or severe case will likely need surgical intervention to open up the constricted space and allow the nerve enough room to function correctly.

Carpal Tunnel Syndrome (CTS)

When inflammation or swelling narrows the space in the wrist that houses the median nerve, carpal tunnel syndrome (CTS) ensues.

CTS causes numbness or tingling in the affected hand only where the median nerve innervates. This means the numbness is limited to the palm, thumb, pointer, and middle fingers.

If the ring finger or pinkie are involved, you likely have upper cross syndrome or a nerve issue higher up the chain, but not carpal tunnel syndrome.

Interestingly, I have had several patients who, before we met, went through with carpal tunnel release surgery that ended up not helping their hand symptoms at all. Once we worked through the upper cross treatment protocol, their symptoms completely resolved.

When the symptoms are due to true carpal tunnel syndrome, taping or splinting the wrist can help in the initial stages. Subsequent strengthening of the muscles surrounding the wrist and forearm can then help keep the area from getting overworked and inflamed again. 

Identifying and correcting poor wrist posture, repetitive stress movements, or aberrant movement patterns may also help prevent future flare ups.

A chiropractor can assist with the preventative measures noted above. A medical doctor may suggest eliminating the most stressful movements, and in severe cases opt for decompression surgery to hopefully stop the patient’s CTS altogether.

Diabetic Neuropathy

Diabetes is a metabolic disease that is rapidly growing in prevalence in western countries and the United States in particular. Almost 40 million Americans have been diagnosed with diabetes, and almost 80% of Americans 65 years or older are diabetic or prediabetic.

Some of the side effects of long term diabetes are nerve and blood vessel issues, because elevated blood sugar levels over time essentially caramelize those structures. As you can imagine, this leads to decreased circulation, poor nerve conduction, and very slow healing.

Diabetic neuropathy first presents as numbness in the hands and feet, then works up the legs and arms over time. 

A chiropractor can help patients implement lifestyle changes such as improving diet or increasing exercise, but a medical doctor will need to be a major part of the care team as well to help regulate insulin and provide any other supportive medication.

The nerve and blood vessel issues caused by diabetes are slow to reverse, and if they have been going on long enough, may become irreversible and eventually lead to amputation and death.

“An ounce of prevention is worth a pound of cure”, so consulting a chiropractor or holistic medical doctor now to start with prevention or early treatment is essential to a long, healthy life.

Cardiovascular Issues

Heart or blood vessel problems can cause decreased blood flow to the extremities, which often leads to numbness or coldness in the hands and feet.

Initial workup and diagnostic tests should be performed by a medical doctor or specialist with access to all the labs and imaging equipment required for an accurate and complete diagnosis.

Depending on the specific diagnoses, a chiropractor can be part of the care team working with the patient towards overall better health, but the MD or specialist would quarterback the overall care plan.

Autoimmune Diseases or Other Illnesses

There are many other rarer causes of numbness in the hands that can come from bacterial, viral or parasitic infections, or autoimmune conditions that attack the nerves, blood vessels, or brain.

A chiropractor would not likely be heavily involved in management of those issues, other than to continue to educate and support the patient to make overall better health decisions, reduce systemic inflammation, and stay active.

What should I do if I have Numb Hands When Sleeping?

There are myriad causes of numbness in the hands and feet, but when specifically talking about numb hands when sleeping, the top causes are:

• Upper cross syndrome
• Neck disc herniations
• Nerve stretch injuries
• Carpal tunnel syndrome

All four of these can be effectively diagnosed and treated by a chiropractor. Not all chiropractors use the same methods, but a combination of the following treatments should be able to resolve nightly hand numbness without medication or surgery:

• Spinal and extremity adjustments
• Muscle strengthening
• Trigger point therapy and stretching
• Postural coaching 
• Rehab exercises

If you have been experiencing numb hands when sleeping, drop us a line!

As mentioned earlier, I’ve had several patients seek care and eventually surgery for what their care team thought was carpal tunnel syndrome, when it ended up being something else like upper cross syndrome.

Save yourself the expense and long recovery of an unnecessary surgery and try chiropractic or physical therapy first!

The green button below will take you to our online booking site Jane to schedule a free Discovery Call when it works with your schedule. We’re happy to help you try a conservative approach to resolving the issue.