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Dr. Abby
Dr. Abby, Board Certified MD
Category: Health
Satisfied Customers: 10330
Experience:  Family Physician, practicing medicine for over 10 years, United States
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My hand hurt a great deal at night, but gets better during

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my hand hurt a great deal at night, but gets better during the day. It seems like it gets better when I stand up and get moving. The pain is centered in the palm and fingers. I do have some niumbness and tingling in the hand during the day.
Hello,

Are there certain fingers that seem to be more affected?
Any pain in the wrist?
Do you work a lot with your hands? (typing, etc)
Any neck pain?

Dr Abby
Customer: replied 7 years ago.
I don't type a lot. I do take notes by hand with clients during the day. I think I might have injured myself a lttle bit at the gym last August and did not go back. I did not get this pain until recently; probably in the past three weeks. My thumb feels tinglind. My middle and ring fingers ache. It is usually tnigling, but at night the pams and past of the hand feels preety painful. It wakes me up. If I drape my hand over the side of the bed and get some circulation going it seems to remit a bit. When I get going for the day, it becomes increasing less of a problem. I am not noticing neck pain. I saw a chiropractor for one session two weeks ago. She did not feel that I had much misalignment. She thought that I probably had a Sprain in the muscles around the breast and that this is radiating down my arm to my hand. It feels like my hand is getting worse and not better.
Thank you for the additional information,

It sounds like you have some type of nerve irritation. Nerve irritation is what causes the tingling and numbness and can often cause a burning type of pain in the hand as well.

One of the most common causes of tingling in the hand is carpal tunnel syndrome. This develops when the nerve that supplies the thumb, pointer and middle finger becomes irritated or compressed as it passes through a tunnel/band of tissue in the wrist. Usually, people have numbness mainly in these fingers, but some people describe tingling of the entire hand. It can also cause pain in the hand as well.

For many people, the symptoms are worse at night, as you are describing.

People at risk for the development of this syndrome include pregnant women (wrist swells during pregnancy) and people who work on computers/typewriters or do a lot of repetitive work with their hands. (writing...)

The nerve that supplies the hands/forearm can also be irritated anywhere along its course. It does not have to be the wrist, it can occur at the elbow or at the level of the neck.

A nerve conduction test/EMG test is performed in order to determine exactly where the problem is occuring. Your doctor may be able to tell by physical exam where the likely area is, but the EMG is the test of choice.

Until you can see your doctor for an exam and testing, you can try wearing a wrist splint that keeps your wrist in neutral position at night.
Also try taking an anti-inflammatory such as ibuprofen or aleve (as long as you do not have any contraindications).

The treatment depends on where the irritation is occuring. Steroid injections in the wrist and physical therapy are often the first steps if the splints do not work.

It does not sound to me like a muscle strain at all, to be honest.

Here is more information for you if you would like to read about it:

http://familydoctor.org/online/famdocen/home/common/pain/disorders/023.html


Let me know if you have any follow up questions and I will be happy to answer them for you,

Dr Abby

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Customer: replied 7 years ago.
I am hoping to finish with Dr. Abby. Is it possible that this could be created by a virus. Evidently last August, I had a viral infection that affected my inner ear and affected my hearing. Although the symptoms are gone, I am wondering if you have any sense that the nerve problem could be affected by the virus. It's interesting that the ear is on the right side and the hand challenge is also on the right side.
It is possible, but there are more common causes.

The ear problem that you had is commonly caused by viruses.

It would be unusual for a virus to cause the symptoms you are having though.

Herpes viruses and the Epstein barr virus can affect the nerves of the arms, but the resultant effects are usually weakness and loss of sensation.

Dr Abby
Customer: replied 7 years ago.
First I want to thank you so much! I am a psychotherapist and it is the holidays and I now think I can wait to see my doctor in January instead of trying to cancel my patients this week! That all makes sense.. When you say use a splint, what do you mean? Does it improve potentially if I try to stop writing and using it during the day, or is it a function of something not related to use at this point? Again thank you and I hope that you are having great holidays.
Here is a link to a wrist splint that you can get at Walgreens.

What the splint needs to do is to prevent you from being able to bend the wrist when you are sleeping.
You can also wear it during the day (if you can write with it on)...it may make a difference.

http://www.walgreens.com/store/catalog/Braces-and-Supports/Carpal-Tunnel-Wrist-Brace---Maximum-Support/ID=prod3227158&navCount=1&navAction=push-product

You are very welcome and I hope that you enjoy your holidays as well!

Dr Abby