Head and hand numbness

Hi.  I am a 41 year old woman, healthy but have lots of stress.  During the night I woke up with my right hand and right side of my head extremely numb and tingling, ("pins and needles").  It took about 20 minutes for the hand numbness to go away but after 4 hours, I still have numbness in my fingertips.  The right side of my head is better but not completely and I have a headache with pressure.  I just don't feel right.  What could be the cause of this and should I be worried.  It only happened one other time approximately 1 month ago.  

[DrNavneetMD]

Hello Dear,

What is the exact side of the pain in the hand? Is it the wrist which is affected? Did you sleep on the dependant position which pressure on your hand?
If your wrist is involved then probably you might be having symptoms of carpal tunnel syndrome.
Carpal tunnel syndrome (CTS) or median neuropathy at the wrist is a medical condition in which the median nerve is compressed at the wrist, leading to pain, paresthesias, and muscle weakness in the forearm and hand.
Most cases of CTS are idiopathic (without known cause). Repetitive activities are often blamed for the development of CTS along with several other possible causes.
(Refer: Michelsen H, Posner M (2002). "Medical history of carpal tunnel syndrome". Hand Clin 18 (2): 257-68)
The first symptoms of CTS may appear when sleeping and typically include numbness and paresthesia (a burning and tingling sensation) in the fingers, especially the thumb, index, and middle fingers.
These symptoms appear at night because many people sleep with bent wrists which further compresses the carpal tunnel. If the median nerve is already under stress, the increased compression of the bent wrist results in numbness and tingling. Difficulty gripping and making a fist, dropping objects, and weakness are symptoms of progression. In early stages of CTS individuals often mistakenly blame the tingling and numbness on restricted blood circulation and they believe their hands are simply “falling asleep”.
(Refer: http://www.emedicine.com/EMERG/topic83.htm)
Studies have also related carpal tunnel and other upper extremity complaints with psychological and social factors. A large amount of psychological distress showed doubled risk of the report of pain, while job demands, poor support from colleagues, and work dissatisfaction also showed an increase in the report of pain, even after short term exposure.
(Refer: Nahit ES, Pritchard CM, Cherry NM, Silman AJ, Macfarlane GJ (2001). "The influence of work related psychosocial factors and psychological distress on regional musculoskeletal pain: a study of newly employed workers". J Rheumatol 28 (6): 1378-84)
Physiotherapy offers several ways to treat and control carpal tunnel syndrome. As such, it may include a range of modalities ranging from soft tissue massage, conservative stretches and exercises and techniques to directly mobilize the nerve tissue
treating any possible underlying disease or condition, immobilizing braces, physiotherapy, chiropractic, massage therapy, medication, prioritizing hand activities, ergonomics.
Also, you can take acetaminophen for your headache.
Consult your neurologist if it still persists.
Best

[mrsdollar]

Dear Dr. Navneet:

Thank you for that information.

I do a LOT of typing for my profession.  To answer your questions: (1) The exact side of the numbness ("pins & needles") I experienced to my head was the right side; (2) my wrist was not affected; and (3) I was sleeping on the side that my right hand and head was affected.

I do have difficulty gripping and making a fist, dropping objects, and weakness.  I am constantly dropping things because I don't have a good grip.

Maureen M. Barber