Differential Diagnosis for Hand Numbness at Night
- Single most likely diagnosis
- Carpal Tunnel Syndrome: This condition is the most common cause of hand numbness, especially at night. It occurs when the median nerve is compressed in the wrist, leading to numbness, tingling, and pain in the hand, particularly in the thumb, index, and middle fingers.
- Other Likely diagnoses
- Ulnar Nerve Compression: Compression of the ulnar nerve at the elbow or wrist can cause numbness and tingling in the hand, especially in the little and ring fingers.
- Radiculopathy: Nerve root compression in the neck (cervical radiculopathy) can cause numbness, tingling, and pain in the hand, depending on which nerve root is affected.
- Thoracic Outlet Syndrome: Compression of the nerves and blood vessels that pass through the thoracic outlet (the space between the collarbone and first rib) can cause numbness, tingling, and pain in the hand.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Acute Stroke or Transient Ischemic Attack (TIA): Although less common, hand numbness can be a symptom of a stroke or TIA, especially if accompanied by other symptoms such as facial weakness, speech difficulties, or vision changes.
- Multiple Sclerosis: This chronic autoimmune disease can cause numbness, tingling, and weakness in various parts of the body, including the hands.
- Spinal Cord Compression: Compression of the spinal cord can cause numbness, tingling, and weakness in the hands, as well as other symptoms such as back pain, leg weakness, and bladder or bowel dysfunction.
- Rare diagnoses
- Peripheral Neuropathy: Certain types of peripheral neuropathy, such as diabetic neuropathy or vitamin deficiency-related neuropathy, can cause numbness and tingling in the hands.
- Tumors: Rarely, hand numbness can be caused by a tumor compressing a nerve, such as a schwannoma or a ganglion cyst.
- Inflammatory Conditions: Conditions such as rheumatoid arthritis or lupus can cause hand numbness and tingling due to inflammation and nerve compression.