Numbness and tingling in the hand at night

Dear Ask The Doctor: During the night I wake up because my hand goes numb and starts to tingle . This keeps me up because the sensation in my hand makes it feel like it is burning . What can I do to lessen this? I realize that sleeping on my arm causes this but I have always done that without the burning feelin.

Dear Sandy: Possibly you might be experiencing the beginning of a Carpal Tunnel Syndrome (CTS), which is an entrapment of the median nerve within the carpal tunnel at the level of the wrist. Usual symptoms include numbness, tingling, “pins and needles” and pain in the wrist and hand. The conservative treatment includes first of all a work-site ergonomic assessment may help to reduce potentially exacerbating factors, in your case you should modify all the postures or activities that reproduce the pain. The use of a wrist-hand brace that sets the wrist joint in neutral position (to be worn at nighttime for a minimum of 3-4 weeks) many off-the-shelf wrist splints seem to work well. A specific stretching/strengthening program for the hand and wrist may be useful in improving strength and dexterity. The use of anti-inflammatory medications (i.e.: “Aleve”) may be of benefit to control de pain. Lack of aerobic exercise (along with increased Body Mass Index) is a risk factor for the development of CTS and should be addressed. Overuse of legal drugs (e.g., caffeine, nicotine, alcohol) can contribute to CTS and should therefore be reduced. Most individuals with mild-to-moderate carpal tunnel syndrome (CTS) respond to conservative treatment, the local corticosteroid injection may be considered in those cases that show poor improvement with the conservative treatment (although injection rarely is used in practice).