The median nerve to the fingers of the hand passes through a connective tissue sheath, this sheath is called the carpal tunnel because it resembles a tunnel. This tunnel thickens due to excessive use and calcification and compresses the nerve passing through it. As a result of this compression, pain and numbness occur in the fingers. It is typical that the pain increases especially at night.
Diagnosis is made by EMG. If it is advanced, surgery is absolutely necessary.
If there is numbness in the hands? The following reasons should be considered.
1-Neck Straightening: (70%)
When the neck is straightened, two of the four vessels (vertebral arteries) going to the brain are stretched and enough blood cannot go to the brain, headache, dizziness, nausea, forgetfulness, if not treated In more advanced stages, imbalance, concentration disorder, severe irritability, and reluctance occur. Neck tension is not very advanced, but in the initial stage, it can be prevented by muscle relaxant drugs, hot application, resting in quiet and low-light places. However, if the neck tension has advanced and the pain spreads to the arms, physical therapy or complementary medicine treatment should be added to the treatment. If there is an advanced neck hernia added to the existing disease, surgical intervention may be required. If neck tension is not treated, headaches become more frequent and do not respond to pain medications, and the state of unhappiness turns into depression. Constant neck tension provides a basis for neck hernias, numbness and weakness occur in the arms. Problems such as imbalance and walking difficulties, inability to perform movements that require fine dexterity, occur.
2-Carpal Tunnel Syndrome: (10%)
A nerve and muscle ligaments coming from the arm reach the hand by passing through a narrow channel or tunnel in the wrist region at the base of the palm. This narrow canal is called the Carpal Tunnel, and the nerve that passes through the carpal tunnel is called the Median Nerve. The carpal tunnel is wide enough to accommodate only the median nerve and muscle ligaments. Any formation or swelling that takes up space in the canal causes compression of the tissues in it. This compression in the median nerve is manifested by complaints of numbness and felting in the areas stimulated by the nerve. This picture, which occurs with the compression of the median nerve in the carpal tunnel, is called Carpal Tunnel Syndrome. There are different treatment alternatives in the presence of carpal tunnel syndrome. Bandage is the most commonly used method among them. Resting the fingers, hand and wrist in their natural positions by preventing their movement is a very effective method to reduce the pressure in the carpal tunnel. In cases where the pain does not decrease with the bandage, a small dose of cortisone or local anesthetic can be injected into the wrist. Various non-steroidal anti-inflammatory and pain relievers can be used to relieve pain and inflammation. In pregnant women, these drugs should be used with the recommendation of the doctor following the pregnancy. In persistent cases, a minor surgical intervention may be required. This is an outpatient procedure that does not require hospitalization. With a small incision in the palm of the hand, close to the wrist, the connective tissue that causes compression is relieved. After the procedure, the patient returns to normal within 4-6 weeks.
3-Ulnar Groove Syndrome: (5%)
The radius-ulna, which is the hand forearm bones, and the wrist joint and small carpal bones consisting of 8 bones in 2 rows that articulate with each other, 5 comb bones, It consists of 14 finger bones. The median, radial nerve, and ulnar nerve are the main nerves in the hand. Most of the hand movements occur through the muscles in the forearm, whose tendons extend to the hand. If we feel numbness in our 4th and 5th fingers and there is a pain starting from our elbow, ulnar nerve compression should be suspected. Diagnosis is made by EMG. If it is advanced, surgical intervention is required.
4-Neck Stiffness, Muscle Spasm: (5%)
It usually occurs with excessive stretching of the muscles supporting the neck. Lifting something heavy, extreme sports, work activity, improper desk work can cause muscle spasm. In addition, falling asleep in the wrong position, high pillows and bad travel conditions can also cause stiff neck. Most of the time it is resolved with simple treatments spasms and stiffness. In long-term muscle pain, also called “Myofascial pain, Fibromyalgia, Fibrositis and Myositis”, there are points that trigger pain in the muscle and buttons that can be felt by hand.
5-Neck Hernia: (5%)
It is the protrusion of the jelly-like cartilage disc tissue, which acts as a cushion between both neck vertebrae, towards the nerves going to the spinal cord and arm. Depending on the size and effectiveness of the press, neck and arm pain, loss of strength in the arm muscles, numbness and clumsiness in the hands can be seen. If there is pressure towards the spinal cord, difficulty in walking, weakness in the legs and urinary complaints can also be seen. If the complaints do not go away despite conservative treatment, if there is severe spinal cord and nerve compression; then the treatment is surgery.
6-Hypothyroidism: (1%)
The condition of having too little thyroid hormones in the blood is called hypothyroidism or hypothyroidism. It is much more common in women than in men. Complaints and symptoms in hypothyroidism: Feeling of tiredness, Drowsiness, Sleepiness, Concentration disorder, Feeling dizzy, Depression, Dry skin, Hair loss, Dry and broken hair, Constipation, Weight gain, Difficulty in losing weight, eye swollen eyelids, Wax-colored face, Decreased sweating, Hoarse voice, Chills, Decreased appetite, Joint pain, Numbness in hands, Decreased movement, Slowed speech, Decreased heart rate, Swelling in legs, Decreased reflexes, Easy nail breakage, Muscle cramps, Goiter, High blood pressure, Elevation in cholesterol level, Disruption of menses, Miscarriage, Inability to have children, Decreased sex, Short stature in children. The most common findings in hypothyroidism are fatigue, weakness, excessive sleepiness, hair loss and feeling cold. Sometimes the patient may not be aware of the memory loss and may be warned by his friends for this reason. There is moderate weight gain and it may be difficult to lose weight. It never causes obesity.
7-Diabetes: (1%)
Diabetes, which is constantly high, can also cause numbness in the hands.
8-Other: (3%)
Rheumatic diseases, muscle diseases, multiple sclerosis, brain tumors, cerebrovascular occlusions, occlusions in arm vessels etc.
If there is numbness in the hands, first The first thing to do is to consult a neurosurgeon.
