Peripheral Neuropathy: A Common Cause of Hand and Foot Numbness

Hand and foot numbness can occur for various reasons. It may be due to issues with lumbar or cervical discs, or it could be a result of peripheral neuropathy. In this session, we will explore peripheral neuropathy.

 

As winter brings chilly winds, many people report experiencing numbness and tingling in their hands and feet. Most often, they attribute these symptoms to poor circulation caused by the cold weather. However, the underlying causes of hand and foot numbness can include circulatory disorders, lower back nerve compression, peripheral neuropathy, spinal disorders, strokes, and even psychological issues.

 

Peripheral Neuropathy: Tingling Symptoms on Both Sides.

One of the most representative and common causes of hand and foot numbness is peripheral neuropathy. The central nervous system includes the brain and spinal cord, while the thin nerves that branch out from the spinal cord are called peripheral nerves. These peripheral nerves pass through small openings between the vertebrae, known as "nerve foramina," and spread widely throughout the body, including the arms, legs, and torso. They can be categorized into three types based on their function: motor, sensory, and autonomic nerves, with different symptoms arising from damage to each type. Peripheral neuropathy is a condition caused by damage to the sensory nerves of the peripheral nervous system, which spreads throughout the body like electrical wires. If the motor nerves are damaged, weakness and muscle wasting may occur. If the autonomic nerves are affected, it can lead to abnormal sweating, disturbances in bowel and bladder functions, and dizziness. There are various causes of peripheral neuropathy, but damage to the peripheral nerves in the neck and lower back is particularly common. The neck and lower back are areas that experience frequent movement, as the cervical and lumbar vertebrae are continuously moved through connected joints. This movement can lead to chronic compression of the nerve roots passing through the openings between the vertebrae, resulting in damage. This is referred to as "radiculopathy," which is one of the most common causes of hand and foot numbness.

 

The causes of peripheral neuropathy include:

1. Diabetes: Diabetic neuropathy, resulting from high blood sugar levels, is the most common cause of nerve damage.
2. Infections: Viral or bacterial infections, such as shingles, HIV, or Lyme disease, can damage nerves.
3. Injury: Physical trauma or repetitive stress can lead to nerve damage.
4. Toxins: Exposure to alcohol, heavy metals, or certain chemicals can negatively impact nerve health.
5. Autoimmune Diseases: Conditions like rheumatoid arthritis and lupus can affect nerve function.
6. Nutritional Deficiencies: A deficiency in essential nutrients, particularly vitamin B12, can lead to problems with nerve function.

 

 

 

In the case of polyneuropathy, where multiple peripheral nerves are damaged simultaneously, tingling symptoms typically first appear in the soles of the feet or fingertips. These symptoms gradually progress symmetrically to the entire limbs, often leading to significant pain that can hinder daily activities. This can result in discomfort while walking, running, using chopsticks, or writing.

 

The symptoms of peripheral neuropathy include:

1. A burning pain often starting in the hands or feet.
2. A tingling sensation in specific areas, resulting from nerve damage.
3. Numbness, particularly commonly felt in the fingertips or toes.
4. Increased numbness when adopting certain positions.
5. A loss of sensation, leading to decreased or absent feeling in affected areas.
6. Muscle weakness, making it difficult to lift objects.
7. Easy fatigue during daily activities and a lack of energy.
8. A loss of balance, resulting in instability when walking or standing.
9. An increased risk of falling or injury.
10. Changes in temperature sensation, leading to dulled or heightened responses to normal temperatures.
11. Skin color changes, which may appear red or pale.
12. Altered sweating, resulting in either reduced sweating or excessive sweating.
13. Difficulty performing fine motor tasks, such as writing or buttoning clothes.
14. Symptoms may appear symmetrically on both sides or may affect only one side.
15. Symptoms often worsen at night, potentially disrupting sleep.
16. Variability in symptoms throughout the day, with increased fatigue.
17. Discomfort in daily life, which can lead to mental stress.
18. As symptoms progress, muscle atrophy or abnormal reactions may occur.
19. A decreased sensitivity to various stimuli, which may result in unrecognized minor injuries or wounds.

"Neglecting peripheral neuropathy can lead to the progression of numbness throughout the body and may even result in paralysis," he stated. "If you experience new-onset numbness in the soles of your feet or the tips of your fingers that gradually worsens, along with difficulties in walking or using chopsticks, it's important to confirm the presence of peripheral neuropathy through tests such as electromyography (EMG), nerve conduction studies, and evoked potentials."

If Your Fingers Are Numb, Suspect Carpal Tunnel Syndrome

In peripheral neuropathy, mononeuropathy occurs when peripheral nerves are compressed by surrounding structures such as bones, joints, ligaments, and muscles. This type of neuropathy typically presents with numbness limited to one arm or one leg, with carpal tunnel syndrome being the most representative condition.

Carpal tunnel syndrome results from compression of the nerve in the wrist due to the wrist ligaments and joint. It primarily manifests as numbness in the thumb, index, and middle fingers, often worsening after extensive use, but symptoms may improve when shaking the hand.

"If symptoms such as pain and numbness occur when the wrist is fully flexed, or if light tapping over the middle area of the wrist elicits numbness, carpal tunnel syndrome should be suspected," he stated.

Cervical Disc Herniation: Causes Shoulder Pain and Arm Numbness

If you experience numbness in your hands accompanied by a tingling sensation in your fingers, shoulder pain, headaches, or stiffness in the back of your neck, there is a high possibility that it could be due to a cervical disc herniation (cervical intervertebral disc herniation). In this condition, the nucleus inside the disc between the cervical vertebrae protrudes and compresses the nerve roots or spinal cord, leading to symptoms such as stiffness and aching in the neck, as well as numbness and pain in the shoulders, arms, and hands. Additionally, if you experience numbness on the sides or back of your legs, it may indicate a lumbar disc herniation, and if you have numbness in the ankles, calves, thighs, or buttocks accompanied by lower back pain, spinal canal stenosis should be considered.

"Even if numbness is felt in the hands or feet, the actual cause is often related to spinal disorders in the cervical or lumbar regions," he noted. "Especially in cases where a patient has undergone spinal surgery or has chronic neck and back pain, the cause of numbness in the hands and feet is likely to be a spinal condition."

 

Q1. If peripheral neuropathy is suspected, which department should I visit at the hospital?

For detailed diagnostic tests and appropriate treatment, it is recommended to consult a neurologist. However, if extensive testing is unnecessary or if you only need symptom management, it is also acceptable to see a physician with relevant experience or consult in the departments of orthopedics, neurosurgery, pain medicine, or rehabilitation medicine.

 

 

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