Hand Numbness With Rheumatoid Arthritis
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You might say it feels like pins and needles, a tingling, or as if a hand has gone to sleep.
While people with rheumatoid arthritis (RA) often experience these signs of numbness, especially in their hands, the sensations are not directly related to rheumatoid arthritis. The most likely cause is carpal tunnel syndrome, a painful condition caused by compression of the median nerve, which runs from the wrist to the fingers.
Carpal Tunnel Syndrome Can Be a Complication of RA
Carpal tunnel syndrome is a common RA complication. Research published in Archives of Rheumatology found that about 5.5 to 6.8 percent of people with RA will develop carpal tunnel.
When you have RA in your wrist, inflammation develops, which can lead to swelling in the lower arm or hand; the inflammation and swelling increase pressure on the median nerve. Over time, the median nerve is compressed to the point that it partially or completely blocks the nerve and the impulses traveling through it. This can result in a mild to severe tingling, burning, or a numb feeling, as well as weakness, a loss of sensation, or even — in extreme cases — a loss of function.
Ask your rheumatologist about any numbness as soon as possible, and be prepared to answer questions, says Eric Ruderman, MD, a professor of rheumatology at Northwestern University’s Feinberg School of Medicine in Chicago. Your rheumatologist will want to know about:
- Location Where do you feel numbness, specifically? In your wrist, palm, or certain fingers?
- Timing How frequently do you feel it? Is it sustained, or does sensation come and go?
- Duration How long do numbness episodes last?
- Typical Circumstances Do you feel it more when you do certain activities, such as driving, typing, texting, or using a blow-dryer?
Your rheumatologist might diagnose and treat you, or send you to a neurologist or orthopedic surgeon who specializes in treating such issues in the hands.
Other Possible Causes of Numbness With RA
Rheumatoid vasculitis, a serious complication of RA, which may occur in people with a history of severe disease, can cause numbness. Evidence suggests, however, that with improvements in RA treatment, this complication is much less common now, notes the Cleveland Clinic. When vasculitis happens, blood vessels become inflamed, limiting blood flow. Vasculitis that affects nerves can cause loss of sensation, tingling, and numbness.
Some biologic medications used to treat RA may cause numbness, although this isn’t a common side effect, according to Johns Hopkins Arthritis Center.
Diagnosing Carpal Tunnel Syndrome
Carpal tunnel syndrome diagnostic tools may include:
- An ultrasound, which will identify other causes of wrist pain but does not diagnose carpal tunnel itself
- An electromyogram, which measures the electrical activity of your muscles during contraction and relaxation. This shows where muscle damage exists and can rule out other problems; it also does not identify carpal tunnel.
- A nerve conduction study, which Dr. Ruderman calls the gold standard test to diagnose carpal tunnel syndrome, is a shock test that uses electrodes to find out whether electrical impulses slow down when they’re in the carpal tunnel.
RELATED: Rheumatoid Arthritis Symptoms You Shouldn’t Ignore
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