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As a physician, I’ve heard patients for 25 years tell me that their hands go numb when lying down. Should this be something that worries you, or is it no big deal? After all, if you ask around, consistently waking up with numb hands isn’t a particularly common complaint of healthy people. And that is why you should be concerned about this problem and what may be causing it.

What Can Cause Numbness in Hands While Sleeping?

When any body part goes numb, it means that the nerve supply to that area has been cut off. So your hands going numb while you sleep means that, likely, a nerve that goes from your neck to the hand is being compressed. 

Nerves have their own blood supply around the outside, so pressure on a nerve cuts off that blood supply and the nerve is eventually starved for oxygen and nutrients, making it shut down.

If this happens for a short period of time, the nerve just wakes up again once the pressure is removed. However, continued insult on the nerve can mean that it gets a little damaged with each episode. So months or years of numb hands at night can mean damaged nerves

Why Do My Hands Go Numb When I Lay Down?

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Cervical Stenosis or Disc Bulge

What usually causes this to happen? The biggest and most significant cause is neck (cervical) stenosis, a disc bulge, or when there’s little room in either the neck bones due to arthritis or the disc for the nerves to travel through or exit (1). You don’t have to have constant neck pain with stenosis or a disc bulge, and some patients just notice that their hands are numb.

When the neck gets into a weird position at night and the muscles that protect it during the day relax, the nerves get crunched and the hands go numb. Many times a cervical collar worn only at night will reduce the numbness. You may need to experiment with different collars or varying amounts of tightness (usually wearing it loosely while sitting on the side of the bed is enough, as the shoulders come up when you sleep and this makes the collar tighter). If this helps your hands, you likely need a cervical MRI to check this out.

Thoracic Outlet Syndrome

The second biggest cause is thoracic outlet syndrome, or TOS. This means that the nerves are getting crunched in the shoulder area (2). This is a common problem for modern computer users, as the shoulder and head come forward, leading to nerve compression. There are some stretches for this issue in our e-book Orthopedics 2.0.

Carpal Tunnel Syndrome

Other causes can include carpal tunnel syndrome in the wrists. This is when the main nerve of the hand (median nerve) gets pinched in the tunnel that it traverses in the wrist. If this is the cause, simple wrist splints worn at night can be a huge help. However, both of these issues may require your doctor to take a closer look at the overarching cause of this problem.

What Are Other Possible Issues?

Another reason to be vigilant about getting this figured out is that these nerves being “offline” can cause other problems, like issues in the upper extremities that are caused by the nightly nerve compression.

These include tennis and golfer’s elbow (lateral and medial epicondylitis) as well as arthritis in the hands and shoulder (3). 

Numbness in your hands when you lay down can be a big deal but it’s often ignored by physicians who aren’t experts in the area of musculoskeletal treatment. If you are wondering why your nerves are getting slowly less sensitive (changes in overall sensation) or why your shoulders, elbows, and hands ache all the time, take it seriously and look for a medical professional with true musculoskeletal expertise.

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References

(1) Raja A, Hoang S, Patel P, et al. Spinal Stenosis. [Updated 2021 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441989/

(2) Jones MR, Prabhakar A, Viswanath O, et al. Thoracic Outlet Syndrome: A Comprehensive Review of Pathophysiology, Diagnosis, and Treatment. Pain Ther. 2019;8(1):5-18. doi:10.1007/s40122-019-0124-2

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile