Clinically reviewed by What is numbness in hands and feet
Numbness and tingling is a symptom, not a diagnosis. A nerve somewhere along its path is compressed, irritated or damaged. The useful question is not what tablet stops it, it is which nerve, and where.
In Urdu people say haath pair sun ho jate hain. The pattern matters more than the feeling: which fingers or toes, one side or both, and whether anything is weak.
Four causes account for most cases. A trapped nerve at the wrist, a nerve root pinched in the neck or lower back, diabetes, and vitamin B12 deficiency. They are treated very differently, so working out which one you have is the point of the first appointment.
Symptoms you might have
- Thumb, index and middle finger, worse at night, eased by shaking the hand: carpal tunnel
- Little and ring finger, worse with the elbow bent or leaned on: a trapped nerve at the elbow
- A stripe down one arm, changing with neck position: a nerve root in the neck
- Down the back of one leg with low back pain, worse on sitting: a nerve root in the lower back, like sciatica
- Both feet evenly, starting in the toes, burning at night: diabetic neuropathy
- Both hands and both feet, with tiredness or unsteady walking: possible B12 deficiency
- Numbness with muscle wasting or a dragging foot: needs medical assessment
Why it happens
- Carpal tunnel syndrome, from repeated gripping, wrist work or long hours on a phone
- A disc or wear and tear in the neck pressing on a nerve root, common in motorbike riders
- A disc in the lower back pressing on a nerve root
- Diabetes, often undiagnosed or poorly controlled for years
- Vitamin B12 deficiency, more likely with a diet low in meat, eggs and dairy, after long use of acid-reducing medicine or metformin, and in older adults
- Thyroid problems and kidney disease
- Long periods squatting or sitting cross-legged, which compresses nerves at the knee
- Pregnancy, where fluid retention squeezes the nerve at the wrist
When you should see a physiotherapist
Come in when numbness is happening regularly, when it wakes you, or when you have started dropping things. Mapping where the numbness is, testing strength and reflexes, and finding which movements reproduce it is what separates a wrist problem from a neck problem.
Some causes are not physiotherapy problems. If the pattern points to diabetes, B12 deficiency, thyroid or kidney disease, you need blood tests and a doctor.
Go to a hospital immediately if numbness comes on suddenly down one side of the body, or with a drooping face, a weak arm or slurred speech. That is a stroke.
Go the same day if there is numbness around the groin or back passage, loss of bladder or bowel control, or numbness and weakness spreading up both legs over hours.
Al-Shama Physiotherapy Clinic
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اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
What treatment you get depends entirely on what the assessment finds, because the same numb hand can come from three different places and the wrong treatment wastes months.
- Assessment first: sensation mapping, strength and reflex testing, and specific tests at the wrist, elbow, neck and lower back
- Nerve gliding techniques, restoring the nerve's ability to move within its tunnel rather than stretching it
- Manual therapy to the neck, wrist or lower back to take pressure off the nerve
- Exercise therapy to strengthen the muscles that hold the problem area in a better position
- Splinting, mainly a night wrist splint where the wrist is the source
- Ultrasound and TENS for pain and swelling around an irritated nerve
- Dry needling for muscles in protective spasm around the neck or buttock
- Referral when the pattern is metabolic rather than mechanical. Blood tests and nerve conduction studies are arranged through a doctor
Surgery is rarely the first answer. It is considered for a trapped nerve that has already caused muscle wasting, or for a nerve root compression with weakness that keeps getting worse.
Exercises, and what to avoid
What helps
- Nerve glides for the nerve involved, done gently and stopped before the numbness increases
- Neck and shoulder blade strengthening where the source is the neck
- Walking and general activity, which is also the best thing for nerve health if you have diabetes
- Changing position every 30 minutes, whatever work you do
What to avoid
- Sleeping with the wrist curled, or with the arm under your head
- Sitting cross-legged or squatting for long stretches, and leaning the elbow on a hard surface
- Hard stretching of a numb limb. An irritated nerve gets worse with stretch, not better
- Carrying on as before and hoping it passes. A nerve left compressed for a year can be permanently damaged
What you can do at home
Write down the pattern before your appointment: which fingers or toes, one side or both, what time of day, what makes it worse.
If you have diabetes, check your feet daily. Numb feet get injured without you knowing.
For a wrist pattern, a simple night splint from a pharmacy often reduces night numbness within a week or two.
Heat helps tight muscles around the neck and back. Ice suits a swollen wrist better. Neither fixes the nerve itself.
Avoid positions that press on a nerve: a phone held with the wrist bent, an elbow on a car window, legs crossed for an hour.
How long it takes
Carpal tunnel caught early usually improves within two to four weeks of splinting and nerve work, and settles over six to eight weeks.
Numbness from a nerve root in the neck or lower back usually improves over six to twelve weeks, following the same pattern as the pain.
Diabetic neuropathy is slower and partly permanent. Burning often improves within four to eight weeks of good sugar control, but lost feeling usually does not return.
B12 deficiency improves once a doctor treats it, often over three to six months, and the longer it was left the less complete the recovery. Nerves regrow at roughly a millimetre a day, so no cause of numbness settles in days.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
ہاتھ یا پیروں کا سن ہونا خود بیماری نہیں۔ یہ نشانی ہے کہ کہیں نس دب رہی ہے یا خراب ہو رہی ہے۔
اگر انگوٹھا اور پہلی دو انگلیاں سن ہوں اور رات کو تکلیف ہو، تو کلائی کی نس کا مسئلہ ہے۔ اگر گردن کے درد کے ساتھ پورا بازو سن ہو، تو گردن کی نس۔ اگر دونوں پیر برابر سن ہوں اور جلن ہو، تو شوگر کی وجہ سے۔
بی12 کی کمی، تھائیرائڈ یا گردے کا مسئلہ ہو تو ڈاکٹر سے خون کا ٹیسٹ کرانا ضروری ہے، فزیوتھراپی سے یہ ٹھیک نہیں ہوتا۔
فوراً ہسپتال جائیں اگر جسم کی ایک طرف اچانک سن ہو جائے، منہ ٹیڑھا ہو، یا بولنے میں لگن آ جائے۔
Roman Urdu
Haath ya pairon ka sun hona khud bimari nahi. Ye nishani hai ke kahin nas dab rahi hai ya kharab ho rahi hai.
Agar angootha aur pehli do ungliyan sun hon aur raat ko takleef ho, to kalai ki nas ka masla hai. Agar gardan ke dard ke sath pura bazu sun ho, to gardan ki nas. Agar dono pair barabar sun hon aur jalan ho, to sugar ki wajah se.
B12 ki kami, thyroid ya gurday ka masla ho to doctor se khoon ka test karana zaroori hai, physiotherapy se ye theek nahi hota.
Foran hospital jayen agar jism ki ek taraf achanak sun ho jaye, muh tedha ho, ya bolne mein lagnat aa jaye.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
Why do my hands go numb at night?
Is numbness in the hands and feet a sign of diabetes?
Which doctor should I see for numbness?
Can vitamin B12 deficiency cause numbness?
Does numbness go away on its own?
Related conditions
- Carpal tunnel syndrome treatment
- Bell's palsy treatment and exercises
- Sciatica treatment and exercises
- Diabetic neuropathy treatment
- Foot drop treatment