Is hand numbness a cervical spondylosis? Auntie Zhang is an accountant, just retired at the age of 50 this year. Recently, she has been feeling numbness in her right hand, and recently found that she wakes up with numbness when she sleeps and her hand muscles have atrophied. The doctor suspected that it was “cervical spondylosis” and suggested that she have a cervical MRI, but the test results were not abnormal. So what exactly is the cause? Auntie Zhang came to the hospital, after doing an electromyogram, the diagnosis was immediately clear. It turned out to be “carpal tunnel syndrome”, which means that the median nerve in the wrist is stuck. The clinical manifestations are often numbness of the thumb, index and middle finger, with a history of nighttime numbness and hand muscle atrophy in severe cases. The doctor made a small incision of 1cm in her wrist, and after the surgery, Zhang’s hand numbness was soon relieved. In fact, there is another kind of “hand numbness” is mainly numbness of the ring and little finger, severe cases are accompanied by atrophy of the interosseous muscles of the hand, affecting fine activities, which is due to the ulnar nerve in the elbow by the compression, the so-called “elbow canal syndrome”, which requires surgical release. Carpal tunnel syndrome Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome. It is caused by compression of the median nerve at the wrist, resulting in pain, numbness, and progressive atrophy of the greater interosseous muscle on the radial side of the hand. Late atrophy of the greater interphalangeal muscle and dysfunction of the thumb to the palm. Electromyography suggests slowed sensory and motor conduction of the median nerve at the wrist. For patients with short duration and mild symptoms, conservative treatment such as rest, local seal, physical therapy and neurotrophic drugs can be taken first; for those with obvious symptoms and ineffective conservative treatment, surgery is recommended, and the current method is mainly open transverse carpal ligamentotomy and endoscopic transverse carpal ligamentotomy. Elbow canal syndrome Elbow canal syndrome is a series of symptoms and signs caused by the compression of the ulnar nerve in the ulnar nerve sulcus of the elbow, and is the second most common peripheral nerve entrapment syndrome after carpal tunnel syndrome. Patients often have a history of trauma or dislocation of the elbow joint. Typical clinical manifestations include decreased or abnormal sensation in the dorsal ulnar side of the hand and one and a half fingers of the ulnar side of the palm, and normal sensation in the medial forearm. Interosseous muscle atrophy, with claw-shaped hand deformity in long-standing cases. Electromyography may also suggest a series of electrophysiological manifestations of the ulnar nerve at the elbow due to entrapment. Elbow canal syndrome is usually treated surgically, depending on the degree of ulnar nerve compression and elbow entrapment factors, simple elbow canal dissection and decompression, medial humeral epicondyle resection, or ulnar nerve anterior surgery can be chosen. Finger flexor tendon stenosis tenosynovitis, also known as “trigger finger”, is caused by repeated abrasion and thickening of the finger flexor tendon at the beginning of the fibrous sheath, resulting in difficulty or limitation of finger flexion and extension activities, mostly in the thumb, middle and ring fingers. The clinical manifestations of the disease include the occurrence of popping sounds during finger flexion and extension activities, palpable stiff nodules and pressure pain on the palmar side of the metacarpophalangeal joint, and limitation of finger flexion and extension activities. For patients with mild symptoms in the early stage, conservative treatment such as physiotherapy and closure can be considered; for recurrent episodes of stenosing tenosynovitis where local closure and other conservative treatments are ineffective, the discomfort can be relieved by surgical excision of the slide and partial removal of the tendon sheath. Hand masses Hand masses are very common, but rarely malignant, mainly benign tumors and some non-tumor masses, the latter of which accounts for the major part, such as tendon sheath cysts, sebaceous cysts, epidermoid cysts, etc.. There are also inflammatory masses, such as tuberculous metacarpophalangeal tuberculosis and purulent granuloma. Common benign tumors of the hand include hemangiomas, endophytic chondromas, hemangioblastomas, nerve sheath tumors, and giant cell tumors. Small benign masses can be surgically removed if they affect the aesthetics and function of the hand, but they have a certain recurrence rate. The proportion of malignant tumors is very small, mainly melanoma, synovial sarcoma, epithelioid sarcoma, etc. In addition to surgical excision, radiotherapy, chemotherapy and immunotherapy are also required.