"If Numb Hands Wake You Up Every Night"—Know Whether It's Your Wrist or Elbow [Health Talk]

[Financial News] Carpal tunnel syndrome, in which the median nerve is compressed in a narrow passage inside the wrist and causes hand numbness, is common among long-term smartphone and PC users as well as long-distance drivers.
Ko Young-yoon, a professor of orthopedic surgery at Soonchunhyang University Seoul Hospital, said, "Not all hand numbness is caused by the same condition. It is important to check which fingers are numb, when the symptoms worsen, and whether the hand is losing strength."
Carpal tunnel syndrome occurs when the median nerve is compressed in the carpal tunnel, a narrow passage inside the wrist. The median nerve is responsible for sensation from the thumb through part of the ring finger and for movement of the thumb muscles. By contrast, cubital tunnel syndrome occurs when the ulnar nerve, which runs along the inside of the elbow, is compressed. It is the same nerve that causes an electric-shock-like tingling sensation extending to the little finger when you hit your elbow.
Carpal tunnel syndrome develops when pressure increases inside the carpal tunnel. Although it often has no specific cause, risk factors include periods when the body tends to swell, such as pregnancy or menopause, as well as diabetes, thyroid disease, rheumatoid arthritis, and obesity. Wrist fractures, arthritis, and lumps such as ganglion cysts can also cause the condition. Repeatedly bending the wrist, performing tasks that require force, and using vibrating tools may worsen the symptoms.

The two conditions cause numbness in different areas. Carpal tunnel syndrome mainly affects the thumb, index finger, middle finger, and the thumb-side half of the ring finger, while the little finger is generally unaffected. As symptoms worsen, weakness in the thumb can make it difficult to button clothes or pick up coins. Cubital tunnel syndrome, on the other hand, causes numbness in the little-finger-side half of the ring finger and the little finger. Some people also experience pain along the inside of the elbow or forearm. As the condition progresses, weakness in spreading and bringing the fingers together can make delicate tasks such as using chopsticks or writing difficult.
The conditions also differ in when symptoms appear. Carpal tunnel syndrome is characterized by hand numbness at night or in the early morning that can wake people from sleep. Shaking or rubbing the hand often provides temporary relief. Symptoms may also worsen while driving or using a smartphone or computer for long periods with the wrist held in one position.

Diagnosis begins with a medical history focused on which fingers are numb, whether symptoms occur at night, and which positions make them worse. Doctors may then press or tap the nerve to assess sensation, muscle strength, and muscle atrophy. X-rays may also be performed to check for fracture-related deformities or osteophyte formation.
In the early stages, treatment typically begins with wearing a splint at night to keep the wrist straight. Maintaining the wrist in a neutral position without bending it is important. When symptoms are severe, an ultrasound-guided steroid injection may be administered.
Ko advised, "Because nerve conditions can become more difficult to recover from the longer they are left untreated, people who experience recurring mild numbness should not put off seeking care. They should visit a nearby hospital for an examination." 

[email protected] Jeong Myeong-jin, medical correspondent Reporter