Hi, folks i'm Bob Schrupp physical therapist, Brad Heineck physical therapist
Together we are the most famous physical therapist on the internet. In our opinion of course, Bob. How to tell
What is causing the numbness in your hands. We're gonna go over five common causes
I'm sure this has happened to most people at sometime. You get this, numbness, tingling
Pricking, burning sensation. Yeah feels like little
Electrical feeling kind of some people describe it. Yeah sometimes you
Wake up with it when you're sleeping on your arms funny
And usually it goes away right away but if you get some that numbness that's persisting and not going away, we'll show
You, some tests you can, do on yourself to try to help determine. Right, right.
We try to keep it simple right Brad? Yeah ,keep it simple exactly and you got a neat diagram here i really like
This diagram. Yeah, we'll show this diagram
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Back and forth that's way it goes. That's how life works.Alright, let's go talk
About the first most common source of numbness which is carpal tunnel. Right. And maybe this is a good time to show
this Brad. It is.
So you've got three main nerves that are going to innervate your hand
We got the median nerve, which is the carpal tunnel nerve. Show which fingers that affects Brad.
So the median is the orange here and if you got your palm facing you it's part of the thumb
The pointer finger the middle finger and half of the ring finger.. Yeah and on the backside it's just
The upper half of those, the pointer finger , the distal part
yeah
distal or toward the finger nails of the pointer, middle, and ring finger. the radial nerve
Is just part of the thumb here and really the backside of the hand. Right, so i'm looking at it
like. It's like you're wearing a glove without fingertips in it. Yeah
I always wondered why they made those gloves that way. There you go. And then the final one is the ulnar nerve
Which is more tends to be the pinky. Right.
And half of the ring finger, half of the ring finger. So this is the one where if you bump
Your funny bone right in the elbow
You, may, feel that up into the pinky and that's what there's a real common thing or i hit my funny
Bone and you feel it in your pinky that's
Why. It's really an ulnar nerve is what you hit. Precisely. As it goes around through the elbow
There's no funny bone no, we learned that at school
You're, a funny guy, though
Again, carpal tunnel so that's that median nerve. Going to be affecting here
Let's just show, you a couple easy tests you can. You can do Phalen's test. You want to show
That one Brad? Sure. So yep all you do is you're saying your prayers you're keeping
your elbows up and as you do this you
Want to see if that recreates the symptoms. Typically for 30 seconds right Bob? Sure. So palms together, when you go up
Like this don't let this happen
Keep the palms together and then this as far as you can go. Matter of fact, I've got a person with
Carpal tunnel right now and we've done both of these and he's positive on both. Okay positive means that it actually
occurred right
And then there's reverse Phalen's. Same thing kind of keeping a sharp angle
At the wrist. Yeah don't let this happen right glue the hands together in the back and let the elbows down. And then sometimes
We just go ahead and we tap right on that about where that nerve would
Be right in the middle between the two fleshy parts here. Right. You're right over the carpal tunnel that's
Why and now you're gonna tap for about 30 seconds and you start feeling
Tingling and burning or numbness you know being recreated. Right.
Typically the same symptoms that bother you whenever you're having the problem that you're questioning
So let's say it's not that let's say
You're getting pain in different parts of the hand maybe it might be median, nerve, maybe it's radial, ulnar, we don't know which one?
Maybe it's coming from your neck
Sure. So a real simple way to test that is we're actually just gonna have you move your
Neck in different directions and does that change the numbness and the tingling does it bring it on, does it take it off?
So brad's gonna show from the side. I'm gonna show from the frontal view
So we're gonna go ahead and just the first one we typically have people do we start in good posture and
And and sometimes we just do a chin tuck. Yep and see if that changes things
And i think both Bob and I've had will do a few chin tucks here
Oh, my hands feel a little different or better. Right. That's not uncommon so that's how we start with as strange
As that may seem
Okay, next one is you're
Gonna go ahead straight flexion. A lot of times this might recreate. It might make it a bit worse this might
Make the numbness worse. If this is happening when you do this it probably
There's definitely the neck that's playing a role. Right. It's not always all of it Sometimes you might have a little bit of both.
But all three of those nerves
Originate back here and the low neck. Okay you can try turning. Turn one to the right
Then turn to the left and again is it recreating your symptoms or is it making your symptoms worse and
Then side bending
Try to put me one ear on to your shoulder your right here onto
Your right shoulder your left ear off your left shoulder. And you may want to do you know
Repetitions of this just to the right you know i'm not more than 10
But up to 10 and see if the
Repetition will help reproduce. Sometimes it reproduces it sometimes it takes it away. Right. If there's any change at all that
Means that it probably is again the neck is involved and the last one is we work on is going back like
this, again, good posture
Extending back does that recreate your symptoms? Right.
Now if any of these create any unusual pain, you're just gonna stop it. Right. So, we're just looking for.. That's often
What you might see to is pain
Along with that Brad. I mean because usually once it gets to numbness and tingling there's usually some pain involved
Also. Right. All right the third most common you know
Possibility would be diabetes and there's really not a test that
We would do that you would do at home. Right, but generally as a rule of thumb it starts in your feet first
Yeah, so they call it's a neuropathy often described as where your feet
Globally or i call a stocking, like, the area that when you pull up a stock in that whole areas
Nummy and tingly and those people when it gets
Bad they have a hard time with walking and balance because you can't feel their feet very
Well that's more the that's in a later stage but
Starting off it just might be a mild numbness going in but if you're getting numbness in your feet and your hands
That's one thing we're gonna suspect is diabetes. Sure.
Get that checked out then. Then there's all the ulnar nerve entrapment. Remember the ulnar nerve
Was the one that affected the little pinky and a little half of the ring finger
That you can
Have actually you can the nerve can get trapped underneath here. Right. Under underneath the tunnel here and one of the tests for this
Very simple is is to actually just turn your your hand out like this and then flex it
flex the elbow
And that's really putting a lot of stretch on that nerve.Sure, yep. And you can see if that that
Recreates your symptoms. You actually can go right under this bone to and tap under there. Where the funny
Bone is and see if that recreates your symptoms. I've seen people that
Just sometimes sit in an armchair too much, a hard one.
we have people on wheelchairs and that the pressure on there actually causes the numbness down there. I have that in the car i had
Rest my arm driving and it would hit right in that spot and i didn't stay there very long
Because it's not very comfortable. Right. Or you know i'd put a different pad there you know
You could have thoracic outlet syndrome too, you know the nerves come out from the upper thoracic
Level here. A simple test for that one is just is it Roo's?
Roo's. Right, where you go like this
People that work over a head often times, like a mechanic working into their car or working if someone's working on a ceiling a lot
you know. They may feel that those symptoms. So you know
Yeah, you're bringing your arms up to a straight across level here and you can even bring them
Back a little bit and then you're getting just gonna you know squeeze your hands open your hands and
If it starts recreating the symptoms there's a chance you have thoracic outlet syndrome. Right. That's a
Whole different animal that you have to have treated. And we have video just on that with
Some exercises to address that. So the final thing that as a possibility and you're probably, going to know
What if you have this is a Raynaud's syndrome
I don't know if that's the way to say it. I think you got it right, Raynaud's. So you're getting a spasm of arteries
It causes reduced blood flow. And that the typical sign is the fingers first turn white
Then they turn blue. It's the the colors of the flag and then eventually they end up red and burning sure now
You said your daughter has a mild case of this. Right hers just turns white. Hers just turn white.
And she's sensitive to being in the cold
You know if we go skiing she got the warmest gloves we can get and even then
You know she pulls her gloves off and they're just all white and she's not very comfortable
But you know hers never gets to that severe case. Sure
It's often triggered by cold or emotional
Events. Right, right. So that's really it that's probably some of the five most common reasons why you're gonna have
Some numbness or tingling. Obviously if you're concerned
Go and see your doctor. Right and get a get a diagnosed. Bob that was very
Well done. I have to admit you really put that out
Well i think you get an a+. Wow, I haven't gotten an a+ since I cheated in Algebra
All right thanks everybody for watching