Hands Numb? Could Be These 5 Things

To experience occasional numbness and tingling in the extremities is to be human. We’ve all felt those uncanny pins and needles before. Such sensations are normal, even welcome, from time to time. They often have pedestrian environmental causes that indicate nothing about our underlying health. More likely than not, transient numbness in the extremities is benign and, if it can be explained at all, not worth anything approaching the worry it typically engenders.

Then again, numbness in the hands isn’t always completely benign. Sometimes, it’s right to be curious about the root causes of unexplained loss or change in sensation — and, if circumstances dictate, even worried.

How can we tell the difference? In many cases, we can’t — at least, not without thorough examination by a medical expert. If you believe the numbness in your hands or other extremities is caused by an acute or emergent condition, consult a physician or visit a care facility at your earliest convenience. Otherwise, familiarize yourself with these five common causes of numbness in the extremities. If you believe your symptoms are caused by one or more of these conditions, schedule an appointment with your care provider.

  1. Peripheral Neuropathy

Peripheral neuropathy is the result of damage to the nerves in the hands and feet. One of the signature symptoms of peripheral neuropathy is tingling in the extremities; numbness is a common manifestation as well. These and other peripheral neuropathy symptoms can be treated, but reversing the progression of the condition typically isn’t possible.

Peripheral neuropathy has a number of causes, many related to chronic conditions. In some cases, the aftereffects of traumatic injuries, such as car accidents and falls, can lead to peripheral neuropathy. So can infections that affect the nervous system, including those acquired during surgery, and exposure to certain toxins that damage the nervous system.

  1. Multiple Sclerosis

Multiple sclerosis is an autoimmune disease that affects the central nervous system. Multiple sclerosis patients’ immune systems attack the myelin sheaths that surround their nerves, causing irreversible damage. Eventually, the immune system also attacks the nerves themselves. The process causes scar tissue to form in nerves’ myelin, with a host of unpredictable effects for sufferers’ sensation and mobility.

Tingling and numbness in the extremities are just two of the many symptoms of multiple sclerosis. For patients with advanced multiple sclerosis, these symptoms are largely seen as secondary to more debilitating effects, such as loss of motor control and mobility.

  1. Diabetes (Type 1 and 2)

Diabetes is a frustratingly common cause of tingling and numbness in the extremities. These symptoms can present in both Type 1 and Type 2 diabetes; gestational diabetes doesn’t typically progress to this point before the condition resolves itself after childbirth. Over time, high blood sugar levels damage body tissues and nerves, resulting in changes in extremity sensation. It’s important to note that numbness and tingling in the extremities are often accompanied by outright pain, particularly in the feet of longtime diabetes sufferers.

  1. Arthritis

Arthritis affects millions of Americans and causes untold pain and suffering. Its most common symptoms include pain, stiffness, swelling and loss of range of motion, particularly around the joints. Arthritis can be caused by cartilage loss due to age or injury, or by an autoimmune process (known as rheumatoid arthritis). All types of arthritis can cause numbness and tingling in the extremities, though it’s rare for these to be the only symptoms associated with the disease. While it’s possible to treat numbness, tingling and other arthritis symptoms (including joint pain), the condition’s progression is more difficult to halt.

  1. Cold-Weather Injuries

Not all presentations of hand numbness and tingling result from chronic conditions. Sometimes, these symptoms occur due to environmental stresses and injuries.

Cold weather is a common cause of tingling in the extremities. For starters, hands and feet bundled tightly in sturdy boots, socks and gloves tend not to move with the same freedom as unencumbered extremities. Persistent tingling and numbness may result. Left untreated, such sensations — which aren’t directly related to cold itself — can become uncomfortable or even painful.
Cold weather can also directly cause tingling and numbness in the extremities. As fingers and toes get colder, blood flow through their capillaries decreases, starving their nerves of oxygen. Left untreated, these symptoms can progress on a dangerous course, leading to frostbite and tissue necrosis.

Put Me Back In, Coach: Returning to Play After Football Concussions

The field of sports medicine has changed rapidly since the turn of the 21st century. We now know more about orthopedic and neurological sports injuries than we ever thought possible, and we’re continuing to uncover new connections and correlations.

Few sports medicine matters are more controversial than football-related head trauma — in particular, concussions sustained on the field of play. (Repeated subconcussive impacts, though related, present their own pathologies, indications and, of course, controversies.)

Until relatively recently, it was common and, frankly, expected for student and professional footballers to play on after sustaining probable concussions. Veterans of the game speak knowingly of playing past “stingers,” hits that leave stunned players unable to focus their eyes or think clearly for minutes or hours. The NFL didn’t even have a formal concussion protocol until the 2010s, and players — particularly second-stringers desperate for playing time — have long been reticent to report serious injuries for fear of losing spots in the lineup.

At this point, we know enough about the science of head trauma to know that football players shouldn’t continue to play after sustaining probable concussions. We’re a bit fuzzier on exactly when it’s safe for players to return to the field after concussive impacts. Here’s an overview of the NFL concussion protocol and the generally accepted facts around post-concussion recovery for student and professional football players.

NFL Concussion Protocol

The NFL’s concussion protocol has several game-day components for evaluating, treating and clearing players suspected of sustaining in-game concussions. These include:


  • Removal to the Locker Room: Players who sustain an obvious injury (“big hit”) on the field of play, or who exhibit symptoms of probable concussion (e.g. wooziness, blank staring, loss of coordination) after a play, must be removed from the field of play and taken to a quiet area for evaluation, generally the locker room.
  • Evaluation by Team Staff: Team medical staff subject concussion-suspected players to a full neurological evaluation using the NFL’s Sideline Concussion Assessment Tool.
  • Evaluation by Unaffiliated Neurotrauma Consultant: Unaffiliated neurotrauma consultants (not on the payroll of any team, booster organization, or other group with a potential conflict of interest) must be present at all NFL games and independently assess players for concussion signs and symptoms. The neurotrauma consultant conducts assessments in parallel with team medical staff, auditing their work to maintain process integrity.
  • Spotter Evaluation: Independent spotters review video footage of the impact and aftermath to gather more information about the injury and its potential symptoms, corroborating or contradicting medical analysis and players’ verbal feedback.
  • Recurring Examinations: If necessary, players are to be evaluated at regular intervals for the remainder of the game and beyond. These recurring examination help plot players’ return to baseline function and/or indicate if further treatment is necessary.


Clearing Players to Return

There’s a multi-step process for clearing players to return to play or practice following concussion protocol participation:

  • Players must return to prior baseline, as judged by team medical staff and the unaffiliated neurotrauma consultant (with exams conducted separately)
  • Players must successfully complete a “graduated exercise challenge” to ensure that they’re capable of performing safely on the field
  • Players must be formally cleared, and then subjected to on-field observation until team medical staff have judged that recovery is complete

Best Practices For Non-Professionals

Non-professional players typically aren’t bound by the NFL’s concussion protocol, particularly in amateur settings that don’t have concussion protocol analogues (e.g. high school football leagues). As such, it’s important for players and their parents to understand when it’s appropriate to seek evaluation and treatment for potential concussions, and when it’s okay to return to the field of play.

Parents concerned about their kids’ exposure to concussions can:

  • Obtain a preseason baseline cognitive evaluation
  • Send the child to an unaffiliated specialist to ensure that there’s no conflict of interest in return-to-play procedures and to obtain an all-important second opinion
  • Speak with coaching staff about using extra safety equipment
  • Lobby coaching staff for equal sideline treatment, e.g. not penalizing the child for voluntarily sitting out after being cleared to return to play

Everyone Is Different

Every human is different. It’s worth reiterating that adults and children have very different neurological profiles. What make sense for a highly paid NFL player might not fly for a 10-year-old child. While the medical community is more than capable of issuing recommendations around these issues, it’s ultimately up to parents and role models to set the bounds of acceptable behavior and participation for young athletes. The future of American sports quite literally depends on it.

Vacation at the Hospital? 5 Benefits of Hospital Spas

The words “hospital” and “spa” don’t often appear together in the same sentence — or paragraph, for that matter. For patients and loved ones alike, going to the hospital typically isn’t a relaxing experience. Very often, it’s just the opposite. In many layperson’s minds, hospitals are filled with stress, trauma, disease and death. No one wants to kick back, take a load off or indulge the senses in such an environment.

While some hospitals certainly remain remote and unfriendly to patients and families, increased competition for desirable patients — not to mention a growing body of evidence that suggests amenity-rich facilities produce better outcomes — has prompted many hospitals to invest in creature comforts not usually associated with medical treatment facilities. One of the biggest trends: hospital spas, either tucked into existing facilities, integrated into newly built facilities, or constructed adjacent to hospitals, often amid larger medical complexes.

Here’s a look at the what, why and how of the hospital spa movement — and five potential hospital spa benefits for you and your family.

  1. Spa Use Improves Mood

A long-period study of more than 3,000 Japanese workers recently revealed that spa treatments improve mood and morale, boosting performance and reducing the negative side effects commonly associated with career-track work. Although similar studies have yet to be undertaken on hospital patients, it’s not unreasonable to extrapolate that spa use would have similar effects for that population as well. By taking participants out of their daily routines — whether said routines involve office drudgery or medical treatments — spas serve as fertile ground for reflection and mental restoration.

  1. Spas Promote Regular, Restful Sleep

Traditional hospitals aren’t great places to get sleep. Depending on the nature of their conditions and the care plans outlined by medical staff, hospital patients may have no more than two or three consecutive hours to themselves throughout the day. For patients consigned to long stays in the hospital, such circumstances can have dramatic effects on long-term sleep patterns. Spa treatments have been shown to improve patients’ sleep cycles — helping them fall asleep more quickly and reducing their propensity to sleep and wake ceaselessly through the night. Patients who sleep better tend to recover better from illness and injury; those with chronic conditions are better able to face aggressive treatment schedules.

  1. Some Spa Treatments Have Demonstrable Skin Benefits

Spa treatments come in all manner of forms. One of the most popular classes of spa treatments is skin treatments. These vary from spa to spa, of course, but most have something unsurprising in common: They’re great for the skin. Peer-reviewed studies have shown promising spa treatment benefits for patients suffering from psoriasis, cellulitis and other common skin conditions. It’s important to note that such benefits are often transient — the dimple-reducing effects of spa treatments for cellulitis patients tend to fade after a few days or weeks.

  1. Spa Treatments Help Patients Deal with the Stress of Medical Challenges

Anyone who’s ever indulged at the spa knows a self-evident truth of spa treatments: They’re incredibly relaxing. While this is certainly useful for workaday spa visitors who look forward to massaging or treating their cares away, it’s also great for hospital patients who struggle with the stress of treatment regimens and medical challenges. While spa treatments can’t resolve primary medical problems on their own, they can certainly strengthen patients’ wills to face whatever may come.

  1. Spa Treatments Soothe Patients’ Family Members

The same stress-reducing principle applies to hospital patients’ family members — folks who often need even more support and relaxation than their brave, afflicted loved ones. Family members who avail themselves of onsite hospital treatments are better-prepared to face the travails of consulting with clinicians, supporting their patients through physical challenges, and facing emotionally painful situations with dignity, grace and ample reserves of mental strength.
If you’re looking for a relaxing, all-inclusive getaway to a destination spa or resort, your nearest hospital spa probably isn’t your best option. On the other hand, there are plenty of circumstances in which you could find yourself in need of hospital spa services. Your spa experience might not make the trip to the hospital worthwhile, but it could actively improve the quality of your experience. Who can argue with that?

Can the Polio Vaccine Really Fight Brain Tumors?

Franklin Delano Roosevelt, the United States’ longest-serving president, was known for many things: architect of his country’s World War II victory, savior of the Great Depression, last sitting president to die in office of natural causes. What many casual students of history don’t remember is that FDR was confined to a wheelchair in the later years of his life due to a childhood battle with polio, a then-common viral affliction that can cause permanent nerve and muscle damage.

Today, polio is unheard of among Americans of any age. The disease has been all but eradicated in most of the world, a microbiological victory that stands nearly alone with the eradication of smallpox as a total win for public health. The most potent weapon in the fight against polio was the polio vaccine, which empowers the immune system to rally against invading polio viruses.

Today, the urgency around polio is gone, and the polio vaccine’s original purpose has largely been fulfilled. But science may have found a new use for this cure — one that could prove just as game-changing as the near-eradication of polio itself. According to recent research, the polio vaccine shows tremendous promise in the fight against certain brain tumors, though it might be a bit premature to say that the vaccine actually cures brain tumors. Here’s what we know — and what could be coming down the road in the years to come.

Cancer’s Acquired Defenses

Malignant tumors are truly devious in their ability to evade the body’s impressive natural defenses. Over time, cancer cells develop molecular defenses — in simplified terms, complex protein coatings — that literally render them invisible to the human immune system. Cancer’s invisibility allows it to grow without facing overwhelming resistance.

Glioblastoma, a particularly deadly form of brain cancer, is no different. Until very recently, a glioblastoma diagnosis was little better than a death sentence; the condition’s five-year survival rate is truly abysmal. While glioblastoma remains one of the most difficult forms of cancer to treat, genetically engineered polio viruses may provide some hope for at least some sufferers.

How Engineered Polio Viruses Disarm Tumor Cells

These engineered polio viruses, part of the “oncolytic virus treatment” family, turn cancer cells’ natural defenses against them. First, the virus breaks through each cell’s natural defenses, causing an infection that cripples and ultimately kills them. While this process is certainly beneficial for patients, the real benefit of the oncolytic treatment is the engineered virus’s ability to recruit the body’s immune system to attack cancer cells. Initially, the immune system is spurred to action by the presence of polio viruses, but its activities over time appear to stall and even reverse the growth of tumors.

What’s Next for Brain Cancer Treatment?

Per Duke University, the concept of cancer-fighting viruses has existed for at least 100 years, but we’ve only been able to manipulate viral genomes effectively since the late 20th century. The polio virus treatment is one of the first truly promising oncolytic viruses. If its early promise pans out, it’s basically a foregone conclusion that similar treatments — possibly for glioblastoma, possibly for other tricky forms of cancer — will follow.

Oncolytic polio viruses aren’t the only promising avenue for brain cancer treatment, of course. Advances in targeted radiotherapy, such as Gamma Knife radiosurgery treatments, have made it possible to target small tumors deep within the brain without damaging surrounding tissue. Customized therapies that leverage the human immune system are gaining steam as well.

Such advances are likely to accelerate in the years to come. One day in the not too distant future, the now near-miraculous oncolytic polio virus treatment could well seem primitive and blunt.

Never a Panacea

Last century, the polio vaccine helped eliminate one of the world’s most common and devastating childhood diseases. This century, it could dramatically improve our ability to combat devastating brain tumors.
But it’s important to note that the polio vaccine isn’t a panacea. It’s proven effective at preventing one particular disease, and may soon help fight a handful of closely related cancers. Unfortunately, there’s no evidence that the polio vaccine can fight any other types of cancers or prevent other viral infections that still plague humanity. In short, it’s just one more weapon in our medical arsenal — not a weapon to end all wars, as the world’s most famous polio sufferer infamously said about another revolutionary technology developed under his watch.

TBI Patients Heal Faster When They Do This

Traumatic brain injuries are more common than most people realize. They have numerous primary causes: car crashes, slips and falls, interpersonal violence and war, sports activities, workplace accidents and more. They’re exacerbated by numerous other factors, many of which we don’t fully understand or appreciate.

Every traumatic brain injury is different, as is every recovery period. It’s difficult to generalize about dissimilar cases. That said, John Gorecki MD finds evidence that suggests that there are certain actions traumatic brain injury patients — and their caregivers, if necessary and appropriate — can take to speed and smooth the recovery period, and improve overall quality of life on a sustainable basis.

One such action: getting up and moving around. (Okay, that’s technically two actions.) Traumatic brain injury patients that ramp up and sustain physical activity as conditions allow tend to recover more quickly than patients who, though capable of light, moderate or even heavy exercise, choose to remain sedentary. Here’s a quick look at why we think activity is good for traumatic brain injury patients and what caregivers can do to encourage swift recoveries.

Why Is Physical Activity Good for TBI Recovery?

It has long been assumed that patients who’ve recently suffered head trauma need to rest and lay low. Overstimulation, this old line of thinking went, could interrupt the long process of rebuilding neural connections and repairing damaged brain tissue.

A recent NPR points to emerging evidence that bed rest is actually counterproductive, or at least not overly helpful, for patients recovering from traumatic brain injuries. Physically active patients tend to progress more quickly toward their prior baseline than sedentary patients with comparable injuries.

In a 600-patient study, scientists separated TBI patients into two cohorts. One cohort was physically active, with some patients getting out of bed as early as their first day in the hospital. The other followed a more traditional recovery program. Evidence gathered from regular progress assessments indicated increased blood flow to the injured areas of active patients’ brains, clearly demonstrating the benefits of physical activity. Patients also indicated that they felt better — both physically and emotionally — after getting up and moving about.

At Patients’ Own Pace

Investigators faced many logistical challenges during the course of this study. In particular, many TBI patients’ substantial problems with cognition and mobility made it difficult to pursue aggressive programs of physical activity, especially early in the recovery period. Patients who struggle to get out of bed on their own or control their limbs find it difficult to “exercise” in any traditional sense. For patients recovering from serious TBIs, and the family members responsible for directing their care, it’s critical to advocate for physical therapy enrollment as early as possible — even if it’s not brought up by the care team. And it’s just as important to recognize that mobility and communicative ability may return slowly.

More Tips to Speed TBI Recovery

Physical exercise isn’t a cure-all for TBI patients, and it’s also far from the only recovery tactic recommended by neurologists. Other tips and tactics to speed TBI recovery include:

  • Following Diets Rich in Protein and Beneficial Fats. Good nutrition is critically important for recovering TBI patients. In particular, diets rich in omega fatty acids and brain-building proteins promote faster neurological recovery. They’re also great complements to active lifestyles.
  • Eating Regular, Small Meals. It’s common for TBI patients, particularly early in the recovery process, to fall out of eating rhythm. To ensure that they’re eating the right amount at the right time, patients or care providers should set aside small, pre-prepared meals for consumption at regular intervals — every 3 to 4 hours, ideally — and set alarms or pair meals with other predictable activities to stay on schedule.
  • Avoiding High-Impact Activity. Some exercise is good for recovering TBI patients, but too much, too soon is likely counterproductive. Patients should avoid activities that can aggravate their existing injuries or cause new ones.

Limits to Recovery
Recovering from a traumatic brain injury is a frustrating, often lengthy process that depends heavily on the severity and morbidity of the initial injury. While the patient’s attitudes and actions play a critical role in the progression and ultimate outcome of his or her recovery, the blunt truth is that recovery is very often destined to be incomplete or unsatisfying, both for the patient and his or her family. It’s important to launch into the rehabilitation process with open-minded optimism — and, by the same token, to be realistic about the prospects.