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Numbness or Weakness in Your Hands? Check Your Neck · Neck & Back Surgery Answers with Dr. Leonard Kibuule

• 0:00
  SPEAKER_00: If your fingers keep going numb, your hand is tingling, or your grip is suddenly doesn't feel as strong as it used to, it's very easy to brush it off.
• 0:06
  SPEAKER_00: Maybe you slept on it wrong, maybe it's carpal tunnel, maybe you've been typing a little bit too much.
• 0:11
  SPEAKER_00: But there is a point where numbness and weakness in your hand can be telling you something very important is happening.
• 0:16
  SPEAKER_00: Especially if you're starting to drop things, struggling with buttons, losing grip strength, or noticing that one hand simply isn't working the way that it used to.
• 0:24
  SPEAKER_00: And if you keep ignoring it, the damage may actually get much harder to reverse.
• 0:29
  SPEAKER_00: I'm Dr.
• 0:29
  SPEAKER_00: Leonard Kabule.
• 0:30
  SPEAKER_00: I'm an orthopedic spine surgeon here in Houston, Texas.
• 0:32
  SPEAKER_00: And in this video, I'll show you the clues that make me look beyond the hand itself, the symptoms I take much more seriously, and what I do next if those symptoms are happening to me.
• 0:42
  SPEAKER_00: Most people do not start by thinking they have a nerve problem.
• 0:45
  SPEAKER_00: They just notice little things.
• 0:46
  SPEAKER_00: Maybe one hand falls asleep more than the other.
• 0:49
  SPEAKER_00: You shake it out, it gets better, you move on.
• 0:51
  SPEAKER_00: Then it starts happening more often.
• 0:53
  SPEAKER_00: Maybe your grip feels a little off, you're dropping your phone, you're opening a jar, and that's becoming more difficult and takes more effort.
• 1:00
  SPEAKER_00: Buttons or a zipper may feel a little bit harder than it used to to open and close.
• 1:04
  SPEAKER_00: Nothing seems dramatic enough on its own, so you adjust around it.
• 1:09
  SPEAKER_00: You switch hands, you stop carrying things a certain way, you tell yourself it's probably in your wrist, the way you slept, or maybe you're just getting older.
• 1:17
  SPEAKER_00: And that is why these problems can sneak up on people.
• 1:20
  SPEAKER_00: What gets my attention is when the pattern starts changing.
• 1:24
  SPEAKER_00: The numbness lasts longer, the tingling keeps coming back, one hand clearly feels weaker, or something you used to do without thinking suddenly it takes more effort.
• 1:33
  SPEAKER_00: That is when I start asking whether the problem is actually coming from somewhere further up the line.
• 1:39
  SPEAKER_00: The nerves that give your hands feeling and strength start much higher up in the neck area.
• 1:44
  SPEAKER_00: They travel from the neck through the shoulders and arms all the way into the hands.
• 1:48
  SPEAKER_00: Think about a garden hose with a kink in it.
• 1:50
  SPEAKER_00: The kink may be several feet away from the nozzle, but the weak flow shows up at the end of the nozzle.
• 1:57
  SPEAKER_00: A compressed nerve can be a similar phenomenon.
• 1:59
  SPEAKER_00: If that nerve gets squeezed in your neck, you feel tingling in the fingers, numbness in parts of the hand, pain through the shoulder or arms, or weakness in grip, and sometimes your neck itself barely hurts at all.
• 2:11
  SPEAKER_00: But this is one of the reasons these problems can be confusing.
• 2:14
  SPEAKER_00: You feel the symptom in your hand, but the pressure on the nerve may be happening much further upstream.
• 2:21
  SPEAKER_00: Once I start suspecting that the problem is in the neck, the next question is much more important.
• 2:25
  SPEAKER_00: Is the nerve simply irritated or is it starting to lose function?
• 2:29
  SPEAKER_00: Pain and tingling can be miserable, but weakness gets my attention in a very different way.
• 2:34
  SPEAKER_00: If your hand tingles occasionally or your strength is normal and things are improving, I may have plenty of time to let that settle down.
• 2:40
  SPEAKER_00: But if you tell me your grip has gotten weaker, you're dropping things, or your hand can't do what it used to about a month ago, now I'm thinking very differently.
• 2:49
  SPEAKER_00: Because now we're not just talking about what the nerve feels like.
• 2:52
  SPEAKER_00: What we're talking about is what the nerve can still do.
• 2:56
  SPEAKER_00: Go back to the hose analogy.
• 2:58
  SPEAKER_00: If the hose is bent a little, plenty of water can still flow through.
• 3:01
  SPEAKER_00: But if you take that kink and it gets tighter and that stays that way long enough, the flow starts dropping.
• 3:08
  SPEAKER_00: A nerve that stays significantly compressed can behave in a very similar way.
• 3:12
  SPEAKER_00: At first, you may get pain, tingling, or numbness, but as the compression gets worse or goes on for longer, strength can start to go and may become much, much worse.
• 3:22
  SPEAKER_00: And once function is declining, I become much less comfortable simply watching it for months and hoping that it turns around on its own.
• 3:29
  SPEAKER_00: There is another kind of hand problem that raises my concern even more.
• 3:34
  SPEAKER_00: Sometimes the pressure is not just one nerve leaving the neck.
• 3:37
  SPEAKER_00: It can be the spinal cord itself.
• 3:39
  SPEAKER_00: And when that happens, the symptoms can start looking very, very little bit differently.
• 3:44
  SPEAKER_00: People may tell their hands are feeling a bit clumsy, their handwriting may have changed a little bit, they're fumbling with keys, coins, utensils, buttons, or even zippers.
• 3:54
  SPEAKER_00: Sometimes they don't describe the hand as dramatically being weak.
• 3:58
  SPEAKER_00: They just know it just doesn't cooperate the way that it used to.
• 4:01
  SPEAKER_00: And if those hand changes are happening along with changes in walking or balance, now I'm paying very close attention.
• 4:08
  SPEAKER_00: Not because every balance problem comes from the neck, but when the loss of hand dexterity and walking changes start showing up together, that can mean that the spinal cord itself is being compressed.
• 4:19
  SPEAKER_00: That is a situation I do not want somebody treating indefinitely as a tight neck problem or a sore shoulder problem or a wrist problem without figuring out exactly what's going on.
• 4:30
  SPEAKER_00: And if weakness comes on suddenly, especially with facial drooping, trouble speaking, or sudden weakness somewhere else in the body, that needs urgent medical attention.
• 4:41
  SPEAKER_00: That is not something to do or something to soothe is coming specifically from the neck.
• 4:46
  SPEAKER_00: Most of the neck problems I see develop more gradually.
• 4:50
  SPEAKER_00: And that is exactly why they can be very easily ignored.
• 4:54
  SPEAKER_00: If this is helpful, subscribe to the channel.
• 4:57
  SPEAKER_00: I'll keep breaking down these spine problems, the warning signs I pay attention to, and the treatment decisions that matter so you can understand what is happening before you have to make a very big decision.
• 5:08
  SPEAKER_00: How do I figure out where the problem is coming from?
• 5:11
  SPEAKER_00: This is where I start putting the whole picture together.
• 5:14
  SPEAKER_00: I want to know which fingers are numb, whether the tingling stays in the hands or travels through the shoulders and arms, whether moving the neck changes anything, and whether one side is clearly weaker than the other.
• 5:25
  SPEAKER_00: I also want to know what has changed in your daily life.
• 5:28
  SPEAKER_00: Are you dropping things?
• 5:30
  SPEAKER_00: Are buttoning buttons harder?
• 5:32
  SPEAKER_00: Has your handwriting changed?
• 5:33
  SPEAKER_00: Can you still grip and lift things the way you could a few months ago?
• 5:38
  SPEAKER_00: Then I examine your strength, your sensation, your reflexes, and coordination.
• 5:42
  SPEAKER_00: If I'm worried about the spinal cord, I'm looking for signs of that as well.
• 5:47
  SPEAKER_00: Only then does the MRI become very useful and very significant because plenty of people have wear and tear in the neck on an MRI and may feel perfectly fine.
• 5:57
  SPEAKER_00: I am not looking for the ugliest picture.
• 6:00
  SPEAKER_00: I am looking for something that explains what your hand is actually doing.
• 6:04
  SPEAKER_00: Could it be something else?
• 6:05
  SPEAKER_00: Absolutely.
• 6:06
  SPEAKER_00: Hand numbness or weakness can come from carpal tunnel, another pinch nerve further down the arm, arthritis, neuropathy, tremor disorders, or other neurologic problems.
• 6:17
  SPEAKER_00: So I am not assuming every numb hand is coming from the neck.
• 6:21
  SPEAKER_00: What makes me look harder at the neck is the pattern, symptoms that travel through the shoulder or the arm, numbness in a particular part of the hand, weakness that is progressing, or loss of dexterity that is happening along with other neurologic changes.
• 6:35
  SPEAKER_00: That is why the exam matters.
• 6:37
  SPEAKER_00: I'm trying to figure out where along the nerve path the problem is actually happening before I decide to treat.
• 6:44
  SPEAKER_00: If symptoms, examination, and imaging all point to the same nerve or the same area of spinal cord being compressed, now we have something we can make a decision about.
• 6:54
  SPEAKER_00: And the next question is usually the one most people really want answered.
• 6:58
  SPEAKER_00: Can this get better without surgery?
• 7:01
  SPEAKER_00: Very often, yes.
• 7:02
  SPEAKER_00: If you have some neck or arm pain, tingling or numbness, your strength is intact and the symptoms are improving.
• 7:09
  SPEAKER_00: I usually have room to treat this conservatively.
• 7:12
  SPEAKER_00: That might mean medication for a period of time, physical therapy, changing some activities that are aggravating the nerve.
• 7:19
  SPEAKER_00: Sometimes an injection can be useful as well.
• 7:21
  SPEAKER_00: What I care about most is the direction that things are going.
• 7:25
  SPEAKER_00: If you're hurting less, sleeping better, using your arm more normally, and your strength remains good, I do not need to rush into surgery just because I have an MRI that shows a herniated disc.
• 7:36
  SPEAKER_00: But if the hand is getting weaker, your grip is deteriorating, or your dexterity is getting worse, now I am not just wanting the pain to improve.
• 7:43
  SPEAKER_00: I am thinking about protecting function.
• 7:46
  SPEAKER_00: And that changes how long I am willing to wait.
• 7:48
  SPEAKER_00: Because once we know that the problem is coming from the neck, there is still one big question that's left.
• 7:54
  SPEAKER_00: What do we actually do about it?
• 7:55
  SPEAKER_00: Many neck problems do not require surgery.
• 7:58
  SPEAKER_00: But if symptoms are not improving despite appropriate treatment, weakness is significant or getting worse, or the spinal cord is being compressed and function is starting to change, surgery may become the better option.
• 8:10
  SPEAKER_00: The goal is to take pressure off the nerve or spinal cord before the loss of function becomes harder to recover.
• 8:16
  SPEAKER_00: How do we do that depends on the anatomy.
• 8:19
  SPEAKER_00: Sometimes a cervical fusion is the right choice.
• 8:21
  SPEAKER_00: In the right patient, an artificial disc may allow us to remove the damaged disc, decompress the nerve, and preserve motion at that level.
• 8:29
  SPEAKER_00: I like motion preservation when the anatomy supports it, but I do not choose an artificial disc simply because it's the newest thing.
• 8:37
  SPEAKER_00: Some levels need stability.
• 8:40
  SPEAKER_00: Some patients are better served with a fusion.
• 8:42
  SPEAKER_00: The treatment has to match the problem.
• 8:44
  SPEAKER_00: And that is why figuring out why your hand is going numb or getting weak comes before talking about any operation.
• 8:52
  SPEAKER_00: So let me make this practical.
• 8:54
  SPEAKER_00: Your hand occasionally tingles, then goes completely back to normal.
• 8:59
  SPEAKER_00: That by itself does not mean you need to have a surgery.
• 9:03
  SPEAKER_00: And it does not tell me that the problem is in your neck.
• 9:06
  SPEAKER_00: But if the numbness keeps coming back, lasts longer, traveling through the shoulders into the arms, or one hand clearly feels weaker than the other, I would want to figure out if the nerve is being compressed.
• 9:17
  SPEAKER_00: If you are dropping things, losing grip strength, struggling with buttons, keys, handwriting issues, or other fine movements that used to be easy, I would take that more seriously.
• 9:29
  SPEAKER_00: And if those hand changes are happening along with worsening balance or changes in the way you walk, I would want to know is the cervical cord being evaluated and is it being possibly compressed?
• 9:42
  SPEAKER_00: You do not need to diagnose yourself.
• 9:44
  SPEAKER_00: You just need to recognize that when this has moved beyond a random numb hand, you may need to seek intervention.
• 9:51
  SPEAKER_00: If this were happening to me, I would start by paying attention to these three things.
• 9:56
  SPEAKER_00: Is this happening more often?
• 9:58
  SPEAKER_00: Am I losing strength or dexterity?
• 10:01
  SPEAKER_00: Is it spreading beyond the hand into the arm or showing up with changes like walking or balance problems?
• 10:07
  SPEAKER_00: If the answer to any of these questions is yes, especially if weakness is getting worse, I would get it evaluated rather than continuing to wait and see.
• 10:15
  SPEAKER_00: The first step is not automatically surgery.
• 10:18
  SPEAKER_00: It is figuring out where the nerve is being affected and whether it is simply irritated or actually starting to lose function.
• 10:25
  SPEAKER_00: Because if the problem is coming from your neck, repeatedly treating the hand is not going to remove the pressure from the nerve higher up.
• 10:33
  SPEAKER_00: If you're dealing with persistent numbness, weakness, or loss of hand function, and you're not sure whether your neck may be involved, my team at Premio Orthopedics and Spine Health can help you work through it.
• 10:45
  SPEAKER_00: You can find out more information to schedule an evaluation or second opinion in the description below.
• 10:52
  SPEAKER_00: And if your symptoms are coming from a herniated disc and you're already wondering whether surgery is necessary, watch my video on when you actually need surgery for herniated disc and sciatica.
• 11:02
  SPEAKER_00: I'll show you what makes me comfortable continuing to wait and the signs that make the decision much more urgent.