For people experiencing hand pain accompanied by tingling, numbness, and/or difficulty with typing or grasping objects, it’s common to first suspect carpal tunnel syndrome or perhaps rheumatoid arthritis.
Here are a few ways to differentiate those conditions from cervical radiculopathy:
Carpal tunnel syndrome
This condition involves the median nerve becoming irritated or compressed in the carpal tunnel, which is a bundle of ligaments running through the wrist and into the hand. Carpal tunnel syndrome can be similar to C6 radiculopathy because both are typically felt on the thumb side of the hand and wrist. However, C6 radiculopathy is likely to be accompanied by other symptoms higher up the arm, such as weakness in the bicep. In contrast, carpal tunnel syndrome might involve weakness in the thumb.
While rheumatoid arthritis is an autoimmune disease that can cause pain, tingling, and/or numbness in the hands, it usually is felt symmetrically. So if a certain joint in the left hand is affected, then that same joint in the right hand is also probably affected. Cervical radiculopathy, however, is typically only felt on one side of the body.
If rheumatoid arthritis progresses long enough, the swelling in the wrist can actually cause carpal tunnel syndrome.
Other Problems That Can Cause Hand Numbness
Nerve dysfunction—either due to damage or disease—is known as neuropathy. Typically, neuropathy involves numbness or weakness in one or more parts of the body.
Many problems can potentially cause neuropathy to be experienced in the hand. A few examples include:
- Diabetes. If diabetes progresses or isn’t managed well with diet and/or medications, various complications can develop. One of the more serious complications of diabetes is neuropathy. For people who have diabetes, these symptoms of tingling and numbness usually start in the feet, but they can also occur in the hands.
- Vitamin B12 deficiency. Some people don’t get enough vitamin B12, whether through gaps in their diet, inability to naturally absorb enough of it, or as a side effect of a medical condition or treatment. Vitamin B12 is critical for nerve health, so low levels can harm the nerves and result in numbness and/or weakness. If a blood test confirms vitamin B12 deficiency, a doctor might recommend dietary changes or B12 supplements. (Beef, fish, eggs, and fortified cereals tend to be good sources of vitamin B12. Vegetarians and vegans can get enough B12 with careful planning.)
- Alcohol abuse. Excessive amounts of alcohol can harm nerves. The manner in which the nerves are damaged by alcohol isn’t always known, but experts suspect that multiple factors could be at work, including increased difficulties with nutrient absorption and associated poor diet. Someone with a long-term alcohol problem could also be at increased risk for a vitamin B12 deficiency as mentioned above.
In addition, various diseases or a traumatic injury to the hand, such as a broken bone or deep cut, could lead to nerve damage that leaves part of the hand painful, numb, tingling, and/or weak.
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Diagnosing the Cause of Hand Numbness
In order to most effectively treat hand numbness and associated symptoms, a correct diagnosis is needed. The doctor will likely use some combination of the following to achieve this goal:
- Patient history. A thorough understanding of the patient’s medical background, previous illness, and injuries can bring context to the current situation. If a family history for a certain disease is present, then that could be a clue for what to check for first.
- Physical exam. The doctor might perform physical tests in the office for strength, range of motion, and reflexes. In addition, a clinician can perform Spurling’s test (by pushing down on the head) to see if radicular pain can be reproduced. If Spurling’s test causes radicular pain, then the problem likely originates in the neck as opposed to the carpal tunnel or elsewhere.
- Blood test. This test can check for diseases or nutritional deficiencies.
- Nerve conduction test. This test can check nerve function—including speed of message conduction—to determine which areas of a nerve might be damaged. This type of test can confirm a condition such as carpal tunnel syndrome.
- Imaging test. A computed tomography (CT) scan or magnetic resonance imaging (MRI) scan can be used to study images of inside the body. These scans can help spot many potential problems, such as if bone spurs, a herniated disc, or a tumor is pressing against a nerve root in the cervical spine, which could cause pain, weakness, and/or numbness symptoms in the shoulder, arm, hand, and/or fingers.
Many other methods could also be used to help diagnose the cause of hand numbness. For instance, sometimes a doctor might need to do a biopsy where a tiny piece of nerve or skin is taken for further examination to determine what might be wrong.