Somebody’s arms may go numb during the night while they sleep due to the posture they assume while sleeping. This is the conventional reason most commonly attributed to the development of this condition and although many people have come to associate its occurrence correctly with their sleeping posture, there are other instances where it may be due to certain health conditions. In this week’s essay, we shall try to understand what those associated conditions may be and why it is important to remember them.
An arm that becomes numb in the morning after someone wakes up from sleep may be due to nerve damage. Other conditions may be responsible for the development of this problem known medically as paraesthesia. Some of the issues responsible for this are referred to as benign, while others need active treatment to be administered. Therefore, this is a prickling or burning sensation, which is most commonly felt in the hands and feet. Among the Yoruba, it is described as ‘paja paja’; it is ‘tamu tagana’ in the Igbo language, while among the Esan people, it is described as ‘e khe khe’. As in many other languages spoken across the country, the noun often bears repetition.
People describe this condition as a feeling of pins and needles or that it seems as though there is no blood flowing through the area. In this way, patients will often come to the hospital alarmed that they have become paralysed or are about to suffer that fate. Others attribute it to an impending stroke.
While it is important to seek the possible reasons why this may be happening, it is often necessary to acknowledge that it is a very uncomfortable feeling that is usually without pain. It can attack an individual rather suddenly with no prior warning. The sleeping position that one assumes can put pressure on the nerves, especially at pressure points around the affected parts of the body where they are close to the bone. Common positions that can cause this are as follows:
1) When the forearms are positioned in such a way that the hands face upwards while sleeping
2) When the arms are lifted away from the sides of the body
3) If you sleep with your elbows extended such that the entire arm and forearm are straight
4) If you sleep with the wrists flexed
5) When you sleep on your stomach and place your hands above your head.
The cases arise mostly in the course of sleeping and will become relieved as soon as the person changes their sleeping posture or soon after waking up. The general implication of this event is that the nerve involved has been under sustained pressure as the person slept. On the whole, this sort of nerve damage is medically referred to as peripheral neuropathy. This is in contradistinction to nerve damage that can occur within the central nervous system made up of the brain and spinal cord. However, contrary to the factors described above about the sleeping posture, it is important to know that nerves can suffer damage from so many other problems that will manifest their presence with numbness in the arms, hands, legs, or feet.
Nerve damage is often caused by direct injury to the affected nerve. Similar effects are caused by the presence of certain bone marrow disorders, which can involve the nerves. The same is true for some autoimmune conditions like systemic lupus erythematosus (SLE), which we described on this page about two years ago. This may also become a manifestation of chronic alcohol intake over many years, and this can resemble the sort of damage that is often associated with the effect of certain agents used in cancer chemotherapy.
Tumours, whether they are benign or malignant, can also affect some nerves in such a way that they cause progressively worsening numbness in those parts of the body either by compressing the affected nerve as a part of an increase in size or by invading the nerve as a direct result of tissue invasion, which is characteristic of cancers as a whole. This kind of picture is also seen in people who have diabetes. It is a risk that gets worse as the disease lingers in the body, especially if the blood sugar control has not been optimum. It is known as diabetic neuropathy and is recognised as a complication of that disease. It usually causes numbness in the feet and legs and is associated also with a tingling sensation due to the combined effects of a sustained elevation of blood glucose in the blood and elevated levels of fat. It can also affect the hands and arms. When the hands and feet are affected at the same time, it is known as the glove and stocking effect.
Furthermore, numbness and tingling sensation are some of the most common features of a disease known as multiple sclerosis. Also known as MS, this disease is the result of the body’s immune system mounting a sustained attack on the nerve fibres of the brain and spinal cord. It is also an autoimmune disorder much like SLE described in the chapter above. In MS, the face is also found to be numb with a tingling sensation in addition to the hands, arms, feet and legs. Certain lifestyles can contribute to a person’s liability to developing nerve compression with associated tingling and numbness. Therefore, when you do a job that involves repetitive arm and hand motions, such as among teachers and secretarial staff, this becomes a significant risk. The same is true of factory hands and those who work in certain industries where the manual component is repetitive and constant.
When a person repeatedly sleeps on one side of the body frequently, this complication can result. As we have seen before now, this is also a problem for people living with diabetes. Lastly, certain vitamin deficiencies, especially among the B-complex group of vitamins, can lead to this disturbing condition. The persons involved can suffer from a range of problems, which can include anaemia of the megaloblastic type and tingling sensation in the extremities. There are certain people who are at an increased risk for suffering from this kind of anaemia and they are generally people over 50 years of age and among vegetarians.
People who lost their caecum earlier in life due to injury or an operation are also prone to developing such a problem. The caecum is where the small intestine meets the colon. Then there are those people who underwent gastric bypass surgery due to tumour or obesity and those who suffer from digestive disorders such as celiac disease and Crohn’s disease. Fortunately, neither of these disease conditions is common in our country. Megaloblastic anaemia is seen in people in whom the size of their red blood cells is bigger than normal, while at the same time having a reduced number of red cells. That effectively reduces their overall packed cell volume (PCV).
The prevention of such numbness in the arm or tingling sensation will depend on the cause. So also, will the treatment be dependent on the cause. There are those people who develop such problems because they suffer from a fairly common problem known as carpal tunnel syndrome. Such people will need to learn how to sleep in a position that limits the pressure exerted on their wrists. This is a nerve disorder in which there is increased pressure exerted on the median nerve and the tendons passing through that channel in the wrist joint. When these supportive measures fail, there is often a resort to medications, which can also fail. When that happens, there is no option but to pursue a surgical solution.
