Why Are My Hands Going Numb

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Hand Numbness

A common complaint patients share is occasional numbness in one or both hands. The most serious causes of numbness in the arm or hand would typically be associated with other symptoms such as chest pain, sweating, shortness of breath, severe headache, visual changes, confusion or changes in speech. These could indicate heart attack or stroke and need to be evaluated by a medical professional immediately.

Hand Numbness Overview

However, the vast majority of hand/arm numbness complaints are not medical emergencies. A typical cause of numbness is nerve irritation. Nerve related symptoms include numbness, tingling, “pins and needles” and sometimes burning sensations. Nerves can be irritated by inflammation, compression, stretching or direct trauma.

Hand Numbness & Carpal Tunnel Syndrome

The most common cause of hand numbness is carpal tunnel syndrome, which is an irritation of the median nerve as it crosses the wrist. This will usually cause numbness in the thumb, index and middle fingers. Patients will complain of numbness at night or when they wake up in the morning. They may also experience numbness with driving.
Another common source of numbness is cubital tunnel syndrome, which is an irritation of the ulnar nerve at the elbow. The distribution of numbness for this problem is the pinky finger and ring finger. This is frequently associated with holding your elbow flexed for prolonged periods (like talking on the phone) or resting the inside of the elbow on an armrest or table.

Hand Numbness & Nerve Irritation In The Neck

Other reasons for hand numbness include nerve irritation from the neck. In this case, the hand symptoms are typically combined with neck complaints, but not always.
Hand numbness, tingling or burning is usually a self-limited problem and will resolve on its own. If the symptoms are not resolving, they should be evaluated by a physician. The most concerning problem that is sometimes associated with hand numbness is weakness or atrophy (shrinking) of muscles. This usually indicates that the nerve has partially lost its connection to the muscle it is supplying. Again, any development of weakness or atrophy needs to evaluated by a physician.

Diagnosing Hand Numbness

If you are having any of the above complaints, your doctor may refer you for an EMG and NCS (Electromyography and Nerve Conduction Studies). This diagnostic test is excellent for evaluating entrapment neuropathies such as carpal tunnel syndrome or cubital tunnel syndrome as well as cervical radiculopathies, which are nerve problems radiating from the neck.
We provide electrodiagnostic testing (EMG/NCS) here at Sierra Regional Spine Institute and frequently use this to help diagnose the source of patients hand numbness and to help develop a comprehensive treatment program. Let us know if we can help you with any of these problems.

Article written for “We’ve Got Your Back Magazine”

By Dr. Chris Twombly

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Artificial Disc Replacement

At Sierra Regional Spine Institute, we believe that the future is restoration of anatomy and function through motion. The artificial disc replacement is the answer to that problem. Sierra Regional Spine Institute continues to be a leader in Nevada when disc replacement surgery is needed.
It is a surgical procedure in which degenerated intervertebral discs in the spinal column are replaced with artificial disc implants in the lumbar or cervical spine.

The procedure is used to treat chronic, severe low back pain and cervical pain resulting from degenerative disc disease.

Artificial disc replacement has been developed as an alternative to spinal fusion, with the goal of pain reduction or elimination, while still allowing motion throughout the spine. Another possible benefit is the prevention of premature breakdown in adjacent levels of the spine, a potential risk in fusion surgeries.

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Revision Spine Surgery

Revision spine surgery is a surgery procedure performed in certain patients to correct the problems of earlier spine surgery. Revision surgery is only when working with patients who experience chronic pain or any worsening symptoms even after the initial surgery.
Other factors that can indicate the need for revision spine surgery include:

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At Sierra Regional Spine Institute we use Decompression in a few ways to treat and make the process of recovery smoother for people with fractures: Microdiscectomy, Microendoscopic Laminectomy, Minimally Invasive Cervical Foraminotomy (MICF), Vertebroplasty and Kyphoplasty.


Microdiscectomy, also called microlumbar discectomy (MLD), is a very common MIS decompression procedure performed in patients with a symptomatic lumbar herniated disc. The operation consists of removing the portion of the intervertebral disc that is herniated and compressing a spinal nerve root.

Minimally Invasive Cervical Foraminotomy

This is a MIS cervical foraminotomy decompression procedure that enlarges the space in which a spinal nerve root exits the cervical spinal canal (intervertebral foramen). This narrowing can be caused by a herniated disc, bone spurs, thickened ligaments or joints, which may result in pinched nerves.


Vertebroplasty for the treatment of vertebral compression fractures (VCFs) was introduced in the United States in the early 1990s. The procedure is usually done on an outpatient basis, although some patients stay in the hospital overnight. The procedure may be performed with a local anesthetic and intravenous sedation or general anesthesia.

Using x-ray guidance, a small needle containing specially formulated acrylic bone cement is injected into the collapsed vertebra. The cement hardens within minutes, strengthening and stabilizing the fractured vertebra. Most experts believe that pain relief is achieved through mechanical support and stability provided by the bone cement.
Kyphoplasty involves an added procedure performed before the cement is injected into the vertebra. First, two small incisions are made and a probe is placed into the vertebral space where the fracture is located.

The bone is drilled and one balloon (called a bone tamp) is inserted on each side. The two balloons are then inflated with contrast medium (which are visualized using image guidance x-rays) until they expand to the desired height and removed. The spaces created by the balloons are then filled with the cement. Kyphoplasty has the added benefit of restoring height to the spine.

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Cervical Fusion

Cervical Fusion is an operation that creates a solid union between two or more vertebrae in the upper spine (neck) area. This procedure may assist in strengthening and stabilizing the spine and may thereby help to alleviate severe and chronic back pain.
The best clinical results are generally achieved in single-level fusion, although fusion at two levels may be performed in properly selected patients.

Bone grafts may be taken from the hip or from another bone in the same patient (autograft) or from a bone bank (allograft). Bone graft extenders and bone morphogenetic proteins (hormones that cause bone to grow inside the body) can also be used to reduce or eliminate the need for bone grafts.

Fusion sometimes involves the use of supplemental hardware (instrumentation) such as plates, screws, and cages. This fusing of the bone graft with the bones of the spine will provide a permanent union between those bones. Once that occurs, the hardware is no longer needed, but most patients prefer to leave the hardware in place rather than go through another surgery to remove it.

Fusion can sometimes be performed via smaller incisions through MIS techniques. The use of advanced fluoroscopy and endoscopy has improved the accuracy of incisions and hardware placement, minimizing tissue trauma while enabling an MIS approach.

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Lumbar Fusion

This is a MIS technique that is performed in patients with refractory mechanical low back and radicular pain associated with spondylolisthesis, degenerative disc disease, and recurrent disc herniation. The procedure is performed from the back (posterior) with the patient on his or her stomach.

Using x-ray guidance, two 2.5-cm incisions are made on either side of the lower back. The muscles are gradually dilated and tubular retractors inserted to allow access to the affected area of the lumbar spine.

The lamina is removed to allow visualization of the nerve roots. The disc material is removed from the spine and replaced with a bone graft and structural support from a cage made of bone, titanium, carbon-fiber, or a polymer, followed by rod and screw placement.

The tubular retractors are removed, allowing the dilated muscles to come back together, and the incisions are closed. This procedure typically takes about 3 to 3 1/2 hours to perform.

Outcome & Benefits

Pioneers of both surgical and non-surgical techniques


Minimally Invasive Spine Surgery

MIS was first performed in the 80s but has recently seen rapid advances. Technological advances have enabled surgeons to expand patient selection and treat an array of spinal disorders, such as degenerative disc disease, herniated disc, fractures, tumors, infections, instability, and deformity.
This can result in quicker recovery, decreased operative blood loss, and speedier patient return to normal function. In some MIS approaches, also called, “keyhole surgeries,” surgeons use a tiny endoscope with a camera on the end, which is inserted through a small incision in the skin. The camera provides surgeons with an inside view, enabling surgical access to the affected area of the spine.

Benefits of Minimally Invasive Surgery

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