“Why do my hands go numb at night?” is a very common question I hear in my practice.

In this post, I will explain the common causes for this symptom, tests to decide which of those likely affects you, and some basic treatments to try to make you feel better.

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First, it is important to figure out which part of your hand is affected. Sometimes, it may feel like the whole hand, but the brain can play tricks on you, particularly if you are still half asleep. So… Try to scratch the affected fingers, once they are numb, and see which ones are affected. The major distinction is to see if the thumb and index are numb, the middle finger is numb, or the ring and little finger are numb.

Next, figure out if anything else brings on the numbness, apart from sleep. Do the hands go numb when you use your hands in the day, such as gripping or holding things? Do they go numb mainly when you lean on your elbow? Finally, do they go numb when you hold your neck a certain way?

Putting these together will help figure out which one of the following is the likely problem…

Next Steps

To help figure out what is wrong, we can put symptoms into different groups or categories, that help figure out what the problem is.

If the thumb side of the hand is affected, mainly at night, it gets better with shaking or hanging the hand down and worse with gripping or bending of the wrist, it is more likely to be carpal tunnel syndrome. Try using a splint to keep your wrist straight at night and you need to get a nerve conduction test to prove the diagnosis accurate. You can book one with us here.

If the little finger side goes numb, it gets worse with leaning on the elbow and better with holding the elbow straight, then it is likely pressure on your ulnar nerve at the elbow. Try sleeping with the elbow straight, not leaning on you elbow and get a nerve conduction study to prove the diagnosis. You can book one with us here.

The area of the skin supplied by the median nerve (causing carpal tunnel) and ulnar nerve (funny bone nerve) are shown above.

The other reasons hands can go numb are to do with the neck, spinal cord or rarely the brain. Pinched nerves in the neck can cause your thumb side to get numb or tingly (C6 nerve), middle finger and ring finger (C7 nerve) or other parts of the hand and arm (could be brain and spinal cord). A review with a neurologist can explore these options, and further scanning, such as a CT or MRI, may be needed. You can book an appointment with a neurologist at East Neurology here.

The C6, C7 and C8 nerves in the neck supply the above skin areas, which are a clue as to which nerve could be affected.
The area of the brain that deals with the hand is arrowed, above.