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Bilateral hand weakness and discomfort
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Bilateral hand weakness and discomfort

I am a 33 year old female and woke up two days ago with bilateral hand weakness and discomfort to both hands and wrists.  The discomfort is hard to describe, it is an "achy" feeling.  My hands feel really weak, but I am able to still function.  I have had a dull headache in the occipital lobes to the base of my skull for several months, but thought it was just possible allergies.  I am not sure if the two are related, but find it odd that both of my hands feel the same.  No numbness or tingling noted and the "pain" is localized to the posterior wrists down to the fingers with tightness of the hands and weakness.  I do not have a family history of MS, ALS, or Parkinsons diseases.  Any advice would be appreciated.

handerson
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Did the numbness occur upon awakening? Have you ever had numbness like this before?

A cause of numbness of the hand/fingers is carpal tunnel syndrome. It usually also has sensory changes of the palm at the thumb, index and middle fingers, and the ring finger on the side near the middle finger. I am not sure if you have these other features or not, but I will elaborate on carpal tunnel syndrome.

Carpal tunnel syndrome is a compression/entrapment syndrome of the median nerve at the wrist. It usually results from excessive use of hands and occupational “microtrauma”.  Other causes include hypothyroidism, amylodosis, and arthritis to name a few. It may also arise during pregnancy and resolve after delivery of the child. The sensory changes usually are worse at night. Patients may complain of having to shake their hand to wake it up. Over time, you may develop atrophy of muscles of the thumb supplied by the median nerve. This syndrome can be bilateral.

I would recommend that you follow up with your primary care physician. You may need to be referred to a local neurologist. He/she will perform a specific neurological examination focused on the median nerve. The neurologist may also elect to perform an EMG/NCS to evaluate the motor and sensory components of the median nerve as it crosses the wrist. I would have this evaluated and not wait. (If there are other features on neurological examination, you may need neuroimaging of the brain/spine).

Treatment options for carpal tunnel syndrome include surgical release of the carpal ligament at the wrist. However, less invasive procedure such as splinting of the wrist, which can be purchased at local drug stores, should be tried first. Medications are usually directed at the underlying cause and include NSAIDs such as ibuprofen.

Again, I would recommend you get this evaluated by your primary care physician sooner than later to ensure that there are no other features to suggest a more worrisome diagnosis.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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