I touched on Carpal Tunnel syndrome a few years ago in this blog post. There are many things that can cause numbness and tingling in the hands or feet; both WebMD and Spine-Health discuss and share these similar details and findings. Falling asleep on your arm or pinching the nerve in your leg from sitting too long cause temporary compression of the nerves, however the way most people live cause can cause a more permanent compression leading to serious nerve related conditions. If you drive more than half an hour a day, sit at a computer, have old sporting injuries, car accidents or spend lots of time texting on the phone then you are susceptible to developing nerve compression issues (sometimes called neuropathy)
What could it feel like?
Sometimes symptoms feel like electrical shocks; other times it’s a sense of weakness, a hand that can’t squeeze, an arm that won’t open a heavy door, or a leg that feels like it will “give out” at any moment. Maybe it feels like weakness or heaviness in the arms or legs, as if they’re locked in place. Maybe it feels like odd sensations, as if wearing tight gloves or stockings, or simply just feeling clumsier in the hands, or dropping things more often for no apparent reason. There are worse situations where there’s a chronic throbbing that occurs leaving people in intense pain and discomfort, and dependent on medication for basic and temporary pain relief.
How many people are affected?
While I’d love to provide some Canadian statistics (however you can expect that the numbers would be comparable for us as well), at most recent, approximately 20 million Americans suffer some form of peripheral neuropathy (https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet – 2017 update), and various causes are discussed. But in my 14 years of clinical experience, what causes numbness or tingling usually comes down to one of three things: a problem in the wrist, a problem in the elbow, or a problem in the neck.
The most probable causes
Most numbness and tingling is felt due to irritation of the nerves that come from the base of the neck, travel through the shoulder, past the elbow, past the wrist and into the fingers. Before you can treat this condition, you need to first find out where the cause of the tingling is coming from. It usually comes from one of three places:
- Wrist – if you have a collapse of the carpal tunnel, you can get numbness and tingling in the fingers along with severe pain in the wrist and hand. This is typically caused by repetitive strain injury, especially for those that work at keyboards or use motorized equipment that sends a vibration through the arms. Diagnosis can be made through a thorough history and testing, along with nerve conduction testing.
- Elbow – this is the least common of the three. Chronic aggravation of the tendons at the base of the forearm (just below the elbow) can irritate the nerves as they pass through. You may have heard the terms “Golfer’s Elbow” and “Tennis Elbow” describe flare ups of these tendons. You certainly don’t have to play golf or tennis to strain these tendons; in fact, most people that I’ve seen with this problem rarely do play these sports. Diagnosis can be made through a thorough evaluation of your day to day habits, palpation and orthopedic testing.
- Neck – this is the most common of the three. Every peripheral nerve in the body attaches to the spinal cord at some point. To reach it, it travels through small holes in the sides of the spine. These holes can become closed by localized inflammation, bone spurs, spinal disc degeneration and spinal misalignment. This can be caused by prior accidents, or poor posture over time. If they’re close enough, they can irritate the nerve that goes down to the hand. Diagnosis can be made through a thorough history, nerve scan, xray and orthopedic testing.
How can I try and help myself?
I’ve heard multiple examples and attempts at treating this issue. People will take anti-inflammatories, OTC medications and pain killers, they have “rubbed this cream” or “applied that gel”, used heating pads, hot showers, Epsom salt baths, massage therapy and constant stretching (both of which are useful and positive modalities, but not always able to address the dominant cause). I have met people who have had 1 or multiple surgeries – whether on their wrists, to their spine, and while in many cases the symptoms and severity were improved, they were not resolved long-term.
When someone merely treats the symptoms with pain killers or anti-inflammatories, they get short term relief with a greater incidence of reoccurrence. That means it comes back. And, this problem becomes more difficult to treat the more often you’ve had it.
Want to help yourself? Good! I’ve often found that these 3 habits always make things worse, so here’s what you can do about them:
- Texting ! Watch your posture. When your head is flexed forward for long periods of time (like when scrolling through social media apps or playing a video game) the spinal cord gets stretched and the nerves in your lower neck are under tension. This is especially the case while doing this in bed, with your head propped forward on a pillow. Not OK! As your mom always said – sit up straight! This same position with a book is no better either. If you’re slouching as you do this – that same neck tension will pull on your spinal cord and nerves all the way into your lower back – and can trigger/influence legs/feet tingling sensations as well!
- Not taking breaks! The muscles in your forearms fatigue over time when doing activities that use them. Typing at a keyboard, digging holes in the garden, trimming the grass and other activities with your hands will tire out the forearm and wrist, leading to inflammation and pressure on the nerves. So, take breaks. Stretch your forearms, neck, shoulders and hands regularly! If you’re dealing more with tingling in your legs or feet – your lower spine was not meant to be in a chair all day long – sitting decreases the natural and normal arc of the spine, and puts more pressure on the nerves for as long as you sit.
- Get the right pillow. If your pillow is too high, or too low, it creates tension at the base of your neck. The nerves that travel all the way down into your hands get stretched and irritated – not OK! Once irritated, the body creates inflammation, and the numbness cycle can begin. When lying on your side, your pillow should be the right size to keep your neck straight, not tipped down or up. This will limit the stress on the nerves that cause numbness and tingling in the hands. Again, for legs/feet, sometimes a pillow between the knees is required/useful to minimize the tilting of your knees together – more common with women because of their “Q” angle – wider hips meant for child bearing (in most cases)
Exploring a different approach…
If you’re finding yourself at an impasse or not getting the relief you want, proper evaluation should include at least a nerve scan to evaluate any stress on the nerves, an x-ray to evaluate the alignment of the lower neck, and possibly orthopedic testing of the neck, shoulder, elbow and wrist areas. Many people receive the orthopedic testing with other professionals – but the nervous system tests are not performed.
This is where we are different – We utilize postural analysis, 3 nervous system scans to evaluate stress, and standing x-rays of all relevant spinal regions to confirm if the cause is structural and neurological in nature. Don’t just take my word for it either – a JMPT 1994 published paper found, “Significant increase in grip strength and normalization of motor and sensory latencies were noted. Orthopedic tests were negative. Symptoms dissipated.” A few years later in another JMPT publication (1998), ‘With chiropractic care, patients had “significant improvement in perceived comfort and function, nerve conduction and finger sensation overall.”’ And most recently, The Journal of Chiropractic Medicine 2008 found “Patients showed an 85.5% resolution of the nerve symptoms after only 9 chiropractic treatments.”
Want to know more?