What causes bilateral arm numbness?

From the Guidelines

Bilateral arm numbness is most likely caused by conditions affecting the nervous system, with the most recent and highest quality evidence suggesting that cervical spine problems, peripheral neuropathy, and other neurological conditions are the primary causes. The most common causes of bilateral arm numbness include:

• Cervical spine problems like herniated discs or spinal stenosis, which compress nerves traveling to both arms 1
• Peripheral neuropathy, often associated with diabetes, vitamin B12 deficiency, or alcohol abuse, can cause symmetrical numbness in both arms
• Carpal tunnel syndrome, when present in both wrists, can cause numbness in both hands and arms
• Multiple sclerosis, thoracic outlet syndrome, and certain medications can also lead to bilateral arm numbness
• In some cases, anxiety and panic attacks may cause temporary numbness in both arms due to hyperventilation
• Serious conditions like stroke, though less common, can occasionally present with bilateral symptoms

It's essential to note that the evidence from 1 and 1 primarily discusses lower extremity peripheral artery disease and acute limb ischemia, which, although relevant to limb numbness, does not directly address bilateral arm numbness. Therefore, these studies are not directly applicable to the question at hand. In contrast, the evidence from 1 provides more relevant information on the diagnosis and management of neurological conditions that can cause bilateral arm numbness. If you experience persistent bilateral arm numbness, especially if accompanied by weakness, difficulty breathing, chest pain, or speech problems, seek immediate medical attention as these could indicate a medical emergency. Treatment depends on the underlying cause and may include physical therapy, medication, lifestyle changes, or in some cases, surgical intervention.

From the Research

Causes of Bilateral Arm Numbness

• Bilateral arm numbness can be caused by various factors, including trauma and compression along the course of the median, ulnar, or radial nerve from the brachial plexus to the fingers 2
• Diabetes, smoking, alcohol consumption, rheumatoid arthritis, and hypothyroidism are risk factors for nerve entrapment, which can produce bilateral symptoms 2
• Carpal tunnel syndrome, the most common nerve entrapment condition, results from median nerve compression at the wrist and can cause numbness in the thumb and index and middle fingers 2
• Cervical radiculopathy, thoracic outlet syndrome, or compression of the ulnar nerve above the elbow (cubital tunnel syndrome) or at the wrist (ulnar tunnel syndrome) can also cause decreased sensation and numbness in the arms 2
• Neuropathic pain, which can be caused by a lesion or disease of the somatosensory nervous system, can also lead to bilateral arm numbness 3
• Other conditions, such as central post-stroke pain, can also cause bilateral arm numbness, and gabapentin has been shown to be effective in reducing pain severity in these patients 4

Risk Factors and Associated Conditions

• Risk factors for bilateral arm numbness include diabetes, smoking, alcohol consumption, rheumatoid arthritis, and hypothyroidism 2
• Associated conditions include carpal tunnel syndrome, cervical radiculopathy, thoracic outlet syndrome, and neuropathic pain 2, 3
• Gabapentin has been shown to be effective in reducing pain severity in patients with neuropathic pain, including those with central post-stroke pain 5, 4

Diagnosis and Treatment

• Diagnosis of bilateral arm numbness typically involves a physical examination, medical history, and diagnostic tests such as electromyography and radiography 2
• Treatment options for bilateral arm numbness depend on the underlying cause and may include medications such as gabapentin, physical therapy, and lifestyle modifications 2, 5, 6