By the way, Doctor: What causes tingling hands at night?

By the way, Doctor

What causes tingling hands at night?

Q. I wake up at night with pins and needles in one or both of my hands. I've tried chiropractic, physical therapy, and a special pillow, with no success. What's causing this, and what can I do to stop it?

A. The likeliest cause of your symptoms is compression of one or both of the main nerves that supply feeling and function to your hands. These nerves — the median and ulnar nerves — run from the spinal cord at the neck all the way down to the hands. They pass through the vertebrae of the neck, across the armpit, down to the bony elbow joints, and between the ligaments and bones of the wrist. If they come under pressure at any point along the way, the arm or hand may feel as if it has "fallen asleep."

This is most likely to occur if you sit or lie with your hands in one position for a long of time. That doesn't usually happen during the day, but it's common at night. Typical pressure points during sleep are the neck, elbows, and wrists. Your head may be in a position that causes the vertebral bones or discs or the muscles in your neck to press on the median and ulnar nerves. Lying on your back with elbows at your sides may create pressure on them at the elbow joints. And sleeping with both wrists bent forward can put pressure on the nerves at the wrists.

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