Can Hand Numbness Come from the Wrist or from the Neck?

Key points in 30 seconds

1. Hand numbness can come from the wrist or from the neck.
2. Wrist-related numbness is worse at night and gets better when you shake your hand.
3. Neck-related numbness runs down the arm like a line and changes with the direction of your head.
4. If both are present, treating only one gives you only half the improvement.
5. If your hand is losing strength or the flesh at the base of your thumb has shrunk, get checked soon.

What we often hear

• "My hands are numb, but I don't know if it's from my wrist or my neck."
• "I wake up at night because my hands are numb."
• "I keep dropping things."

Can hand numbness come from the wrist or from the neck?

Both are possible. When a nerve is pinched at the wrist, it's carpal tunnel syndrome; when it's pinched at the neck, it's a herniated disc in the neck. Where and when the numbness happens differ.

When people come in with numb hands, most think of the wrist first. But if numbness that started in the neck is treated only at the wrist, it stays the same no matter what. First we need to find where the nerve is pinched.

How do you tell by where it's numb?

Carpal tunnel syndrome affects the thumb, index, and middle fingers, while the little finger tends to be fine. Numbness from the neck isn't just in the fingers; it runs down the arm like a line.

Wrist-related numbness typically gets worse at night. People say they wake up with numb hands and it gets a bit better when they shake them. This is because they sleep for a long time with their wrists bent.

With the neck, numbness changes when you turn your head or tilt it back. If your arm gets more numb when you move your neck in a certain direction, we suspect the neck.

Type	Where it's numb	When it gets worse	What comes with it
Pinched at the wrist	Thumb, index, and middle fingers
Less in the little finger	At night · enough to wake you
When the wrist is bent	Better when you shake your hand
Flesh at the base of the thumb shrinks
Pinched at the neck	Runs down the arm like a line
Up to the shoulder and forearm	When turning or tilting the head back
When sitting for a long time	Stiff neck and shoulders
Sometimes arm weakness

Can both be present at the same time?

Yes. A nerve already pinched at the neck can easily cause symptoms when pinched just a little more at the wrist. That's why treating only one side sometimes brings only half the improvement.

People who say they only got about half better after treating just the wrist are often in this situation. That's why we check the neck and wrist together in the clinic.

What are the limits of this judgment?

Where and when it's numb can't confirm it on their own. To tell for sure, you need a test that shows where the nerve is actually pinched.

Something important to add. If your hand is losing strength and you often drop things, the fleshy area at the base of the thumb has noticeably shrunk, or both hands are numb, get checked soon. When a nerve stays pinched for a long time, there comes a point where it's hard to reverse.

If you have diabetes, the cause of the numbness may be the diabetes itself rather than a pinched nerve. That needs to be checked first.

We look at the wrist and neck together. Even with the same numbness, treatment differs for a nerve pinched at the wrist and numbness coming down from the neck.

If your hands are numb and you don't know where it's coming from, come see us. It doesn't take long to tell which it is.

How much you recover differs from person to person, depending on where the nerve is pinched and for how long.