Numbness Of Fingers : Causes, Symptoms, Diagnosis & Treatment

• Why Do Fingers Go Numb
• Physiological Causes
• Neuropathy
• Polyneuropathies
• Diabetes
• Other Neurological Pathologies
• Raynaud's Syndrome
• Traumatic Injuries
• Other Reasons
• Diagnostics
• Treatment
• Help At The Prehospital Stage
• Conservative Therapy
• Surgery

Numbness of the fingers occurs with neurological pathologies, angiotrophoneurosis. Rarely provoked by injuries, neurotic disorders, beriberi, some somatic diseases. In healthy people, it is caused by an uncomfortable position of the limb. May be associated with pain, paresthesia. The cause of the symptom is established according to the data of the survey, physical examination, neurological examination, the results of electrophysiological, imaging and laboratory techniques. Treatment may include NSAIDs, vitamins, antiplatelet agents, calcium antagonists.

Why do fingers go numb

Physiological causes

In a healthy person, numbness of the fingers occurs due to a long stay in an uncomfortable position, it is caused by compression of blood vessels, disorders of local blood circulation. The symptom appears at the moment of awakening from sleep with a hand placed under the pillow or under the head. It can be noted when resting on the back with arms thrown over the head. It is combined with tingling, a feeling of "disobedience" of the hand. It goes away on its own within 5-1 minutes.

Another cause of finger numbness is prolonged exposure to the cold. Decreased sensitivity due to vasospasm, may be accompanied by aching pains. It is considered a sign indicating the possibility of developing frostbite in the absence of warming measures.

Neuropathy

Numbness is one of the first symptoms of neuropathy. At the initial stages, it appears periodically, complemented by a sensation of tingling, "crawling crawling". Subsequently, hypesthesia becomes permanent, pain, muscle weakness, changes in the skin and soft tissues join. The area of ​​numbness is determined by the affected nerve:

• Neuropathy of the radial nerve. When the nerve trunk is involved in the upper third of the shoulder, sensitivity is disturbed in the area of ​​1, 2, and partially 3 fingers. With a lesion at the level of the forearm, hypesthesia occurs only on the back of the fingers.
• Neuropathy of the ulnar nerve. On the palmar surface, the little finger and half of the ring finger go numb, on the back - half of the 3rd finger, completely 4-5 fingers.
• Neuropathy of the median nerve. On the palmar side, numbness appears in 1-3 and half of the 4th fingers, on the back, sensitivity decreases in the region of the nail phalanges of 2-5 fingers.
• carpal tunnel syndrome. Damage to the median nerve during compression in a narrow bone canal is manifested by numbness of 1-3 fingers.

Polyneuropathies

Multiple neuropathies occur in some rheumatic and oncological diseases, severe diseases of the kidneys and liver. They can be provoked by severe infectious processes, occupational hazards, exogenous intoxications. There is symmetrical involvement of the limbs. Numbness is caused by:

• chronic inflammatory demyelinating polyneuropathy;
• neural amyotrophy of Charcot-Marie-Tooth;
• Russi-Levi syndrome;
• Refsum's disease;
• alcoholic polyneuropathy;
• polyneuropathy of pregnant women;
• neuroacancetosis;
• neuroAIDS;
• polyneuropathy in systemic vasculitis.

Numbness of fingers

Diabetes

Diabetic neuropathy is a special case of polyneuropathy. It can be diagnosed in patients with any form of diabetes mellitus. The likelihood of developing neuropathy depends on the duration and severity of the underlying disease. Pathology is manifested by numbness, burning, tingling, pain, short-term convulsions, distorted perception of temperature and tactile stimuli, muscle weakness. The hands suffer less than the feet.

Other neurological pathologies

Numbness of the fingers is included in the clinical picture, but, as a rule, is not a leading symptom in the following diseases:

• Neck plexitis. It develops with osteochondrosis of the spine, intervertebral hernia. It becomes the result of birth trauma, fractures, bruises and subluxations of the cervical spine, some infectious diseases (tonsillitis, influenza, tuberculosis). It is formed due to compression of the nerve plexus by the cervical rib or enlarged lymph nodes.
• Shoulder plexitis. The cause of damage to the brachial plexus is trauma to the clavicle and shoulder joint, compression by lymph nodes, aneurysm or tumor, compression in bedridden patients and people using crutches, infectious, dysmetabolic diseases.
• Horner's syndrome. The defeat of sympathetic nerve fibers is formed against the background of blockade of the brachial plexus, improper drainage, Pancoast cancer, aortic aneurysm, multiple sclerosis, otitis, thyroid diseases.

Permanent numbness of the fingers can be the result of damage to the spinal cord and brain in spinal cord injury, TBI, or hemorrhage. Other possible provoking factors are malignant and benign brain tumors, neurorheumatism. Short-term hypoesthesia occurs in the pre-syncope period in patients with neurocardiogenic syncope.

Raynaud's syndrome

Paroxysmal ischemia of the hands in typical cases is most pronounced in the region of the 2nd and 4th fingers. First, there is numbness, coldness and blanching of the fingers, then - bursting, burning, aching pain. The attack ends with a feeling of heat, a sharp reddening of the fingers. Raynaud's syndrome is detected in the following cases:

• Rheumatic diseases : SLE, scleroderma, rheumatoid arthritis, systemic vasculitis.
• Neurological pathologies : diencephalic disorders, damage to the sympathetic ganglia, compression of the neurovascular bundles.
• Other conditions : hematological and endocrine diseases, systematic hypothermia, vibration disease.

Traumatic injuries

Short-term numbness of the hand is possible with any injury, accompanied by significant swelling of the limb, develops against the background of vascular compression. Loss of sensation, combined with intense pain that is not eliminated by non-narcotic analgesics, indicates the development of a formidable complication - myofascial compartment syndrome, which requires urgent medical care to preserve the viability of the limb.

A special case of compression due to trauma is the increase in edema in the first days after fixing the arm in a plaster cast. The fingers become numb, turn blue, and become sausage-shaped due to swelling. The patient complains about the strong pressure of the plaster. The symptom disappears after loosening the bandage, which should be carried out in a trauma room.

In wounds with a violation of the integrity of the nerve trunks, numbness of the fingers develops immediately after injury, combined with movement disorders. The zone of loss of sensitivity corresponds to the area of ​​hypesthesia in case of neuropathy of the corresponding nerve.

Other reasons

Among the diseases and pathological conditions, accompanied by numbness of the fingers, include:

• Hypertonic disease. The symptom appears with a persistent increase in systolic pressure above 140-16 mm Hg. Art., combined with swelling of the hands, redness of the face, sweating, prolonged pain in the heart.
• anemia. Hypesthesia of the fingers is complemented by malaise, weakness, fatigue, shortness of breath, palpitations, headache, impaired concentration. Possible dizziness, fainting.
• Lack of vitamins. Vitamin B1 deficiency in the peripheral form of beriberi is manifested by weakness, numbness of the feet and hands, difficulties in minor operations that require fine finger movements. Lack of B12 provokes peripheral neuropathy.
• Takayasu's disease. Numbness of the fingers in nonspecific aortoarteritis is potentiated by ischemia of the upper extremities. Sensitivity disorders are supplemented by coldness, absence or weakening of the pulse in the arteries of the limb.
• Derkum disease. Multiple lipomas compress the skin branches of the peripheral nerves, resulting in pain, numbness of the fingers, impaired fine motor skills.
• Mental disorders . Temporary numbness of the fingers (more often - paroxysmal) is observed with panic attacks, phobic disorders, hysterical neurosis. Sometimes it is combined with tremor, coldness, crawling sensation.

Diagnostics

Determination of the cause of numbness of the fingers is carried out by neurologists. The initial stage of the examination includes a survey, general and neurological examination. The specialist evaluates the appearance of the hand, determines the pulsation of the arteries, examines reflexes, asks the patient to perform various movements to identify movement disorders. As part of the further examination, the following are appointed:

• Electrophysiological Methods . Electroneurography and electromyography help to confirm the damage to the nerve trunks, to determine its level, prevalence and severity of the pathological process.
• Radiography . X-ray examination of various parts of the upper limb is prescribed taking into account the nature of neurological disorders, ENG and EMG data indicating the level of damage. On the pictures, bone deformities, tumors originating from cartilage and bone tissue, degenerative changes are determined.
• Angiography. A contrast study of the vessels is recommended for signs of Raynaud's syndrome. The method confirms the violation of the uniformity of the lumen of the arteries, the absence of collaterals, the insufficient number of capillaries.
• CT and MRI. Performed in cases of suspected diseases and injuries of the spinal cord or brain. They help to clarify the localization, size and nature of the pathological focus.
• Laboratory tests . In the course of laboratory diagnostics, specific markers of rheumatic diseases, signs of anemia and hypovitaminosis are determined.

Electroneuromyography

Treatment

Help at the prehospital stage

Patients with non-traumatic numbness of the fingers are advised to limit the load on the hands, take regular breaks when performing minor operations or working at the computer. With hypoesthesia caused by occupational hazards, a change in specialty may be required. Victims with injuries of the upper limbs after immobilization with plaster are recommended to maintain an elevated position of the hand. With an increase in edema, you should immediately contact a traumatologist.

Conservative therapy

Drug treatment is carried out using drugs of the following groups:

• NSAIDs . They are prescribed during the period of exacerbation of neuropathy, reduce swelling, reduce the severity of pain. In severe pathology, systemic corticosteroids are added to the treatment regimen.
• Vitamins . With a deficiency of B12, the introduction of cyanocobalamin is indicated, with a lack of B1, neuropathies, and other neurological pathologies, pyridoxine, thiamine are recommended.
• calcium antagonists . Required by patients with Raynaud's syndrome. Increase the lumen of blood vessels. May be combined with selective serotonin receptor blockers, ACE inhibitors.
• Antiplatelet agents . They are used for angiotrophoneurosis, improve peripheral circulation, eliminate arterial spasm, reduce the frequency and severity of ischemia attacks.
• Sedative drugs . Patients with neurotic disorders are prescribed mild herbal remedies. According to indications, antidepressants, tranquilizers are used.

With the ineffectiveness of the treatment of certain pathologies, drug blockades are indicated. Drug therapy is supplemented with phonophoresis, drug electrophoresis, electromyostimulation. At the recovery stage, massage, manual therapy, physiotherapy exercises are used.

Surgery

The tactics of surgical intervention for numbness against the background of injuries and diseases of the peripheral nerves is determined by the nature of the process:

• Neuropathy : removal of a neoplasm of the nerve trunk, neurolysis, decompression.
• Traumatic injuries : plastic or nerve suture.
• Plexitis : removal of cervical ribs, tumors, aneurysms.

The list of surgical techniques for lesions of the brain and spinal structures is very extensive. Open or minimally invasive removal of a herniated disc, stabilizing operations for spinal cord injuries, removal of hematomas and tumors, interventions on blood vessels are possible.