Ring and pinky finger numb while sleeping

“Why do my hands go numb at night?” is a very common question I hear in my practice.

In this post, I will explain the common causes for this symptom, tests to decide which of those likely affects you, and some basic treatments to try to make you feel better.

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First, it is important to figure out which part of your hand is affected. Sometimes, it may feel like the whole hand, but the brain can play tricks on you, particularly if you are still half asleep. So… Try to scratch the affected fingers, once they are numb, and see which ones are affected. The major distinction is to see if the thumb and index are numb, the middle finger is numb, or the ring and little finger are numb.

Next, figure out if anything else brings on the numbness, apart from sleep. Do the hands go numb when you use your hands in the day, such as gripping or holding things? Do they go numb mainly when you lean on your elbow? Finally, do they go numb when you hold your neck a certain way?

Putting these together will help figure out which one of the following is the likely problem…

Next Steps

To help figure out what is wrong, we can put symptoms into different groups or categories, that help figure out what the problem is.

If the thumb side of the hand is affected, mainly at night, it gets better with shaking or hanging the hand down and worse with gripping or bending of the wrist, it is more likely to be carpal tunnel syndrome. Try using a splint to keep your wrist straight at night and you need to get a nerve conduction test to prove the diagnosis accurate. You can book one with us here.

If the little finger side goes numb, it gets worse with leaning on the elbow and better with holding the elbow straight, then it is likely pressure on your ulnar nerve at the elbow. Try sleeping with the elbow straight, not leaning on you elbow and get a nerve conduction study to prove the diagnosis. You can book one with us here.

The other reasons hands can go numb are to do with the neck, spinal cord or rarely the brain. Pinched nerves in the neck can cause your thumb side to get numb or tingly (C6 nerve), middle finger and ring finger (C7 nerve) or other parts of the hand and arm (could be brain and spinal cord). A review with a neurologist can explore these options, and further scanning, such as a CT or MRI, may be needed. You can book an appointment with a neurologist at East Neurology here.

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Pain and numbness in hands while sleeping

Numbness and pins and needles are common symptoms affecting the hands and fingers, particularly at night. Generally, these symptoms suggest nerve compression somewhere. Sometimes, however, the cause can be different and potentially severe. For example, heart attacks and multiple sclerosis can also cause hand numbness. So, what causes pain and numbness in arms and hands while sleeping, and how do we manage it?

Symptoms

Firstly, you need to define what numbness means. Does it mean a total lack of feeling or altered sensations such as pins and needles? Also, we need to ask exactly where and when these symptoms occur. For example, carpal tunnel syndrome causes symptoms mostly at night or while sleeping and with repeated hand movements. Generally, the thumb and three fingers are affected, while the pinky finger is fine.

Also, we need to ask about other symptoms, such as pain or weakness in the hands or fingers. For example, does the pain or weakness move to the upper arm or neck?

In addition, we need to rule out other medical conditions that would make nerve pressure more likely. For example, diabetes or underactive thyroid can cause stress on the median nerve or inflammation of the small nerves in the fingers.

Common causes of pain and numbness in arms and hands while sleeping

Carpal tunnel syndrome  

Carpal tunnel syndrome is the most common cause of pain and numbness in hands while sleeping. The median nerve pinching in the carpal tunnel often causes numbness and pins and needles in the thumb and 2-3 fingers, usually sparing the little finger. However, in more severe cases, pain and muscle weakness occurs.

Damage to the  superficial branch of the radial nerve  

This branch supplies sensation to the base of the thumb and two fingers on the dorsum of the hand. Pressure on the nerve usually occurs after an injury – either a wrist fracture or an injection that has hit the nerve.

Usually, as the superficial branch supplies only skin, there is often no muscle weakness or wasting.

Cubital tunnel syndrome

Generally, pinching the ulnar nerve at the inside of the elbow causes cubital tunnel syndrome. Symptoms include numbness and pins and needle affecting the ring and pinky fingers. Also, wasting and weakness occur in the small muscles between the fingers.

Peripheral neuropathy

In addition to pinching or trapping of the nerves, the sheath surrounding the nerves (myelin) can become inflamed, leading to a condition called peripheral neuropathy. There are many causes of inflamed nerves, including diabetes, underactive thyroid, specific medication, vitamin deficiencies, and high alcohol intake.

Spinal cord and brachial plexus cause of numbness in hands while sleeping

Nerves supplying the hand run up the arm to the spinal cord and brain. Before the nerves reach the spinal cord, they form a complex array of nerve groups called the brachial plexus.

Nerve problems in the brachial plexus or the spinal cord can cause numbness in the hands. However, as both structures contain many grouped nerves, the damage will likely generate more than just numbness in the hand. Instead, we would expect numbness over a larger area or associated weakness and wasting in the hand, arm, or shoulder parts.

How to sort out numbness in your hands while sleeping?

Generally, we order these tests to determine the cause of the numbness and treat it appropriately.

Nerve conduction studies and EMG test the speed of messages through the nerves and the muscle contraction at the end of the nerves. In addition, it often tells us where and why the nerve messages are abnormal.

An ultrasound can see the path and thickness of the nerves that supply the arm and hand. The peripheral nerves examined under ultrasound include median, ulnar and radial nerves. Pinching the nerves leads to the thickening of the nerve just before the entrapment zone.

If numbness is thought to be coming from the spinal cord or brain, an MRI might be needed to rule out a tumour, inflammation, or a stroke.

Finally, blood tests help exclude nerve inflammation.

Final word from Sportdoctorlondon about numbness in hands while sleeping

Most numbness in hands while sleeping is due to a pinched nerve in the hand or arm, such as carpal tunnel syndrome or cubital tunnel syndrome. However, it is essential to see an experienced doctor to confirm a pinched nerve and rule out more severe conditions.

Related condition:

• Pinched nerve: what does it mean?
• Carpal tunnel syndrome
• Cubital tunnel syndrome
• Burning pain in the thigh: is it meralgia paraesthetica?
• Baxter’s nerve entrapment

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