Why do your hands go numb at night?

Why does it happen at night?

Tingling, numbness or a pins and needles feeling in your fingers usually means a nerve is being compressed somewhere along its route. That route is long. It begins at your neck, travels under the collarbone, through the shoulder and down the arm before it ever reaches your hand.

During the day you change position often enough to keep taking pressure off. At night you do not. A wrist curled under the pillow, an elbow bent tight, an arm overhead or a neck turned to one side can each stay that way for hours. Those are exactly the conditions that crowd a nerve.

Many people also sleep with their wrists bent without knowing it, which adds pressure inside a space that is already tight.

Where along the arm can a nerve be crowded?

There are a few common places, and more than one can be involved at once:

This is why a wrist can take all the blame for something happening further up.

• The neck, where nerve roots leave the spine
• The space between the collarbone and the first rib, especially with rounded shoulders
• The elbow, where a nerve runs through a shallow groove on the inside
• The wrist, where a nerve passes through a narrow tunnel into the hand

Which fingers are affected, and what does that tell you?

The pattern is a useful clue, though it is not a diagnosis.

Numbness in the thumb, index and middle fingers often points to the wrist, which is the pattern seen with carpal tunnel syndrome. Numbness in the ring and little fingers often points to the elbow. Symptoms that come with neck stiffness or pain running through the shoulder and arm, or that change when you move your neck, suggest the neck is involved.

Numbness in both hands, or in the hands and feet together, can also come from causes that are not mechanical. That is one reason an exam matters, and why your chiropractor may refer you to your physician.

Why hasn't a wrist brace solved it?

A brace keeps the wrist straight, which helps when the wrist is the place being crowded. If the source is the elbow, shoulder or neck, treating the wrist can mean months of effort with little change.

Nerve symptoms that are left alone can also progress, from tingling at night to numbness during the day, a weaker grip, or dropping things. Tracing the nerve along its whole path is what tells you where the compression actually is.

Do daytime habits play a part?

Yes. What happens at night often reflects what the nerve has put up with during the day. Long hours with the head forward and shoulders rounded narrow the spaces at the neck and collarbone. Resting an elbow on a desk or car door presses on the nerve there. Repetitive gripping and typing with bent wrists load the wrist.

Changing those habits will not fix every case, but it lowers the total pressure on the nerve, and that often shows up first as better nights.

What can I try at night?

Small changes to sleep position are worth trying for a couple of weeks:

• Keep your wrists straight, not curled under your head or pillow
• Avoid sleeping with your elbows bent tightly or your arms overhead
• Use a pillow that keeps your head level with your spine
• Avoid sleeping face down, which keeps the neck turned for hours
• If you wake with numb hands, change position and gently move your arms instead of shaking them hard

How does a chiropractor trace hand numbness?

The exam follows the nerve from the neck to the fingertips. Your chiropractor checks neck and shoulder movement, tests sensation, reflexes and grip strength, and uses specific tests at the neck, elbow and wrist to see which position brings the symptoms on. Imaging or nerve testing is requested only when the findings call for it.

If care is appropriate, it is directed at the place where the nerve is crowded. That can include chiropractic adjustments, hands-on work for tight muscles, nerve-friendly exercises and changes to how you sleep and work. If the findings point to something that needs medical evaluation, you are told that and referred.