Hand numbness Assessment Questionnaire

Why: to establish if acute or chronic.

Why: can help determine which nerves are affected e.g. carpal tunnel syndrome causes numbness of the pulps of the thumb, index, middle and half of the ring finger; peripheral neuropathy typically causes a glove and stocking sensory loss to hands and feet; C8 spinal cord or nerve root lesion causes numbness of the little finger; C7 spinal cord or nerve root lesion cause numbness of the middle finger; C6 spinal cord or nerve root lesion causes numbness of the outer side of the forearm and thumb.

Why: helps to determine which nerves may be affected.

Why: can help determine the cause of hand numbness e.g. carpal tunnel syndrome is usually worse at night.

Why: helps to determine the cause of arm numbness e.g. carpal tunnel syndrome symptoms may be relieved by dangling the arm over the side of the bed.

Why: e.g. whiplash injury, Brachial plexus injury, finger injury, hand injury.

Why: diabetes, chronic renal failure, leukemia, lymphoma, lupus and amyloidosis can be a cause of peripheral neuropathy; causes of carpal tunnel syndrome include hand trauma, rheumatoid arthritis, Acromegaly, amyloidosis, pregnancy, hypothyroidism, Paget's disease, diabetes mellitus and tophaceous gout.

Why: e.g. Vitamin B12 deficiency can be a cause of peripheral neuropathy.

Why: some medications can cause peripheral neuropathy e.g. amiodarone, phenytoin, nitrofurantoin, isoniazid, heavy metals.

Why: certain occupations requiring repetitive motions are at risk of causing work-induced overuse disorders e.g. process and meat workers are at risk of carpal tunnel syndrome due to rapid finger and wrist movement.

Why: Tabes dorsalis of syphilis may be a cause of peripheral neuropathy.

Why: alcohol abuse (with or without vitamin B1 deficiency) can be a cause of peripheral neuropathy.

Why: if also pain in the involved extremity this usually suggests herniated cervical disc , spinal cord tumor or cervical spondylosis. Other conditions to consider are brachial plexus neuropathy, thoracic outlet syndrome, cervical rib, Pancoast's tumor, Raynaud's disease, sympathetic dystrophy or various entrapment syndromes such as carpal tunnel syndrome and ulnar nerve entrapment at the elbow.

Why: may suggest a type of brachial plexus; compression of the C8 segment by cervical spondylosis or a disc herniation, median or ulnar nerve lesions; diabetes mellitus causing a peripheral neuropathy.

Why: may suggest a cervical spinal cord or nerve root lesion due to cervical spondylosis (degeneration) or herniated cervical disc.

Why: e.g. numbness of the face may suggest a diagnosis of cerebrovascular disease, a mass in the brain, migraine or multiple sclerosis.

Why: may suggest migraine or mass in brain.

Why: e.g. weakness of upper limb, increased muscular tone, increased reflexes, occasionally sensory loss.

Why: e.g. blurry vision, double vision, dizziness, weakness, numbness or tingling in any limbs.

Why: e.g. numbness or "pins and needles" affecting the pulps of the thumb, index , middle and half of the ring finger. These symptoms are usually noticed after, rather than during, rapid use of the hands. There may also be pain, which may radiate up as far as the shoulder, from the inside of the wrist.

Why: e.g. distal loss of sensation and/or muscle power loss in the hands and feet. A typical sensory loss is a symmetrical glove and stocking loss to all sensation.

Why: usually associated with anxiety e.g. lightheadedness, faintness, dizziness, breathlessness, palpitations, sweating, dry mouth, agitation, fatigue, numbness of the hands, feet or mouth.