What is the treatment for nocturnal paresthesia (numbness) of the hand?

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From the Guidelines

To treat hand numbness at night, it is essential to prioritize non-pharmacological approaches, such as wearing a wrist brace and performing simple stretching exercises, to reduce pressure on the median nerve and improve circulation. The primary goal of managing hand numbness is to control symptoms and optimize hand function, which is in line with the overarching principles of managing hand osteoarthritis, as stated in the 2018 update of the EULAR recommendations 1.

Some key considerations for managing hand numbness at night include:

  • Wearing a wrist brace while sleeping to keep the wrist in a neutral position
  • Performing simple stretching exercises before bed, such as gently extending and flexing the wrists for 30 seconds each
  • Shaking hands or hanging them over the side of the bed to improve circulation
  • Elevating arms on pillows while sleeping and avoiding sleeping with arms under the head or body to prevent compression

It is also important to note that over-the-counter anti-inflammatory medications like ibuprofen (400-600mg every 6-8 hours with food) can reduce inflammation and associated numbness, as recommended in the 2018 update of the EULAR recommendations for the management of hand osteoarthritis 1. However, these should be used with caution and under the guidance of a healthcare provider.

If symptoms persist beyond two weeks despite these measures, it is crucial to consult a healthcare provider, as the numbness could indicate an underlying condition requiring specific treatment, such as carpal tunnel syndrome, which is a common cause of nighttime hand numbness due to compression of the median nerve in the wrist 1.

From the Research

Hand Numbness at Night Treatment

  • Hand numbness at night can be caused by various factors, including nerve compression or entrapment neuropathies 2
  • Treatment for hand numbness at night may involve addressing the underlying cause, such as modifying activities that may be causing nerve compression 2
  • In some cases, treatment may include systemic steroid prescriptions to reduce inflammation and relieve pressure on the affected nerve 2
  • Diagnostic tools such as peripheral nerve ultrasound may be used to confirm the diagnosis of nerve compression or entrapment neuropathies 2
  • Early diagnosis and management of nerve compression is necessary to maintain limb function and improve the patient's quality of life 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Acute compressive radial neuropathy and wrist drop due to the repetitive overuse of the arm.

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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