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. Sometimes these symptoms are related to an RA complication: carpal tunnel syndrome, a painful condition caused by compression of the median nerve, which runs from the wrist to the fingers.
Why Is Carpal Tunnel Syndrome Considered an RA Complication?
Carpal tunnel syndrome is somewhat common among those with RA; as many as 5 percent of people with RA will develop it. So what’s the connection? Think of it as a cascade or domino effect: A person has RA in her wrist and inflammation develops, which can lead to swelling in the lower arm or hand. Together, 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. RELATED: 10 Essential Facts About Inflammation From Rheumatoid Arthritis Ask your rheumatologist about any numbness as soon as possible, and be prepared to answer questions, says Eric Ruderman, MD, professor of medicine-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 hair 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. Carpal tunnel syndrome diagnostic tools may include:
X-rays or an ultrasound, which will identify other causes of wrist pain, but do 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, but 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: Are Muscle Cramps in Hands a Symptom of Rheumatoid Arthritis? A doctor might have you wear a wrist splint at night, for example, or get a steroid injection, or change the dosage or type of RA medication you’re on (if your RA disease activity isn’t well-controlled). In rare, severe cases, surgery may be necessary: A surgeon could cut the ligament that runs over the top of the carpal tunnel, giving the swelling a place to go and relieving some of the constant nerve pressure. Anecdotally, painting, crafting, and other art-based hobbies that use the hands may help people with rheumatoid arthritis, according to research published in the Indian Journal of Rheumatology. There are also different hand exercises you can do at home to help strengthen the hands and relieve pain and stiffness.
Switch Up Your Hand Use Habits and Routines
To help you function better when experiencing numb hands, consider how common household items can help you grip things easier. For example, use a pair of cuticle scissors to cut open condiment packets, or fit a tennis ball over your toothbrush to make it easier to grip. There are to make it easier to do every day tasks such as wash and dry your hands with hand pain and stiffness, too. RELATED: Natural Remedies for Carpal Tunnel Syndrome
Good Treatment Options for Carpal Tunnel Syndrome Are Available
It’s best to treat carpal tunnel syndrome early, whether you have rheumatoid arthritis or not. There’s no reason to live with the pain. Untreated, carpal tunnel problems may lead to muscle atrophy and weakness in your hand, and less dexterity in your fingers. In rare cases, the median nerve can become permanently damaged. Treatment for carpal tunnel syndrome includes nonsurgical options as a first step, and surgery if pain, weakness, or swelling persist. According to the American Association of Neurological Surgeons, most people find relief from carpal tunnel symptoms with nonsurgical options. These can include:
Braces or splints for the wrists, which hold them in a neutral position. These are worn either at night during sleep or during the day while participating in activities that make the issue worse.Pain medication, such as ibuprofen, naproxen, or aspirin, can help with pain and swelling, though they won’t fix the problem itself.Steroid injections can also provide relief from pain and swelling.
If necessary, surgery can help treat pain and swelling by making an incision that helps to relieve the pressure and inflammation on the wrist’s median nerve. After healing, the problem typically relieves itself by providing more room for the nerve to function without swelling, which resolves the issue.
