Tingling in my arms and hands with a large reduction of hand strength. Hands cannot make a fist without large amount of pain. Feels like a cramped muscle.

by John
(Indiana)

I was taking some equipment apart for work this week and was using a battery drill and a sawzall. I have done this over the years many times and have not had anything more severe than just a low back ache when done. However, this time was really different. I awoke throughout the night with both of my arms "asleep". Normally this is when I had been laying on an arm or some odd position. But in this case, I was flat on my back. My hands are now constantly numb with a tingling sensation and I cannot make a fist without intense pain in my hands and forearms. My concern is do you think that i did some major nerve damage or would this be normal and should pass over time?

HELLO JOHN,
What's different here is that making a fist is painful. Is there swelling of any of the fingers. If you use your other hand to bend the fingers, does it hurt.

I take there was a lot of vibration. I suspect this is a fairly complex syndrome, with strain of muscles, irritation of nerves and perhaps some local injury to the joints in your fingers.

Using the Search this site function at C-H, type in "pronator teres muscle". The nerve to the fingers 1-4 passes between the bellies of this muscle - it's a muscle you would use to hold a vibrating drill. Is it tender in the forearm?

If it affects the pinkie too then we would be looking at the first rib and the neck for a thoracic outlet problem.

Use your common sense. Massage your fingers and arms for a few days, use ice if there's swelling, but if things aren't improving within a week then get professional help.

Let me know how you get on. Happy NY, may it be better than the end of 2011!

Dr B