Numbness in my hands and feet, is it a cerebral infarction?

Author: Wang Baojun, Chief Physician, Baotou Central Hospital, Inner Mongolia

Reviewer: Fan Dongsheng, Chief Physician, Peking University Third Hospital

In daily life, middle-aged and elderly people often experience numbness in their hands and feet. Some people habitually believe that numbness in their hands and feet means that there is something wrong with their brain blood vessels, which makes them panic and even have various questions, such as, "Am I having a cerebral infarction? What should I do now?"

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(1) Causes of numbness in hands and feet

So, does numbness in the hands and feet mean cerebral infarction? What are the specific causes? From the analysis of the causes, numbness in the hands and feet can be roughly divided into the following situations.

1) Some middle-aged and elderly people may suffer from numbness in their hands and feet due to nutritional deficiencies, such as vitamin B deficiency, due to long-term consumption of a single food or poor gastrointestinal absorption capacity, or suffering from underlying gastrointestinal diseases.

2) Peripheral neuropathy caused by diabetes is manifested as decreased sensation and numbness in the extremities.

3) If numbness occurs in the upper limbs, it is likely cervical spondylosis.

4) If unilateral numbness of the hands and feet occurs, you should be alert to cerebral infarction, but cerebral infarction is usually accompanied by symptoms such as blackouts, slurred speech and limb weakness.

5) Local bone hyperplasia in the lumbar spine can compress local nerves and cause symptoms such as numbness, weakness and atrophy of the lower limbs.

6) If symptoms such as numbness, weakness and atrophy of the hands occur, it is necessary to determine whether it is due to compression of the hand nerves, such as cubital tunnel syndrome, carpal tunnel syndrome, etc.

(2) Diagnosis and treatment of numbness in hands and feet

So, how should we make basic judgments and treat numbness in hands and feet?

1) It manifests as unilateral upper limb numbness and often occurs after waking up. The most common cause is cervical spondylosis. X-ray examinations of the cervical spine in the anteroposterior and bilateral oblique positions can be performed in time to determine whether it is cervical spondylosis. Once diagnosed, physical therapy, exercise therapy, and drugs should be used for treatment; unilateral upper limb numbness may also be caused by carpal tunnel syndrome and thoracic outlet syndrome. In this case, immobilization, anti-inflammatory, physical therapy, etc. can be used for treatment.

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2) Symptoms include unilateral numbness of the lower limbs. The most common cause is lumbar disc herniation, which compresses the sciatic nerve. In this case, imaging examinations such as lumbar CT and MRI should be performed first. After the diagnosis is confirmed, traction, acupuncture, massage, and exercise therapy should be performed under the guidance of a doctor.

3) If the patient has a history of underlying diseases such as hypertension and hyperlipidemia, and experiences numbness in one hand or foot, he or she should go to the hospital immediately for examinations such as cranial CT and MRI to determine whether it is an intracranial lesion, such as cerebral infarction, intracranial tumor compression, etc., and then take active treatment.

4) If the limbs are numb, such as "glove-like" or "sock-like" numbness, to confirm whether it is peripheral neuropathy caused by diabetes, the patient should measure blood sugar after meals and blood sugar 2 hours after meals under the guidance of a doctor, and perform a glucose tolerance test. If diagnosed with diabetes, hypoglycemic treatment should be performed and B vitamins should be supplemented. In addition, alcohol poisoning caused by long-term heavy drinking can also cause the same symptoms. After quitting drinking and receiving treatment, the symptoms will gradually improve.

5) Improper sleeping posture and mechanical pressure can also cause numbness in the hands. Don't panic at this time. It will not last too long. Move your upper limbs and wrists and the symptoms will soon be relieved.

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In summary, numbness in the hands and feet is often not caused by cerebral infarction. Patients should remain calm and explain the location and nature of the disease clearly so that doctors can make a correct diagnosis and provide appropriate treatment.