Expert: Dr. J. Shawn Leatherman - 3/18/2007

Question
I have had about 3 instances over the past month or so where I wake up with a slight feeling of numbness on a portion of the back of my head and a little in my arm on the same side. All 3 times occurred when waking up, and the numbness went away within seconds of adjusting my head or sitting upright. I've never had the sensation during the day. I have a history of TMJ that causes jaw and neck pain/tension. Do you think this numbness is something to worry about?  

Answer
Dear Mike,

Sorry it has taken me a few days to get back in touch with you, hope you haven't been too worried about this.

Transient numbness that occurs from sleeping that quickly resolves from changing the position of the head or body is a common experience.  There are a few likely causes to think about, but most are not serious.  Moreover the fact that this has only happened on a few occasions is a good sign that the problem is minor.

The sensation of numbness is called by the peripheral nerves to the brain for interpretation.  Therefore irritation to the nerve supply is the reason.  This irritation could be caused by a lack of blood flow to the area due to compression, arterial compromise from plaques in the cardiovascular system, metabolic causes such as diabetes, mineral and electrolyte deficiencies, vitamin B12 deficiency, or actual nerve compression in the upper neck or back of the head.

In your case I do not expect metabolic or systemic cause due to the fact that the numbness is only being experienced in one specific area, and the fact that it resolves quickly.  It is likely that your sleeping position is placing pressure on the upper neck complex and causing a local irritation to the superficial nerve supply that sends and receives information from the back of the head.

What to do:  First analyze your sleeping position and the support of your neck.  The best position to keep the spine in a neutral position is flat on your back with an orthopedic cervical pillow that allows support of the neck without flexing the head forward.  This position eliminates excessive stress on the neck, spinal cord and the nerve roots.  You can mimic this position by rolling up a towel and placing it directly under the neck and sleeping on a very flat pillow.  Never use more than one pillow as this places increased stress on the neck.

Try this for a few days to see if it reduces your symptoms.  In addition I do think that it would be a good idea to have the neck examined by a chiropractic physician as well to verify the exact cause of the problem. You may also have some degenerative changes in the neck, or fixation of the normal movement which is contributory to the issue. It is good to address these issues before they become a worse problem down the road.  In addition the chiropractor can recommend a good cervical pillow for your home use and the appropriate way to utilize it.

In relation to the TMJ, yes it can definitely cause some neck pain/tension/discomfort, but neck problems can contribute to ongoing TMJ problems as well because the anatomy specifically the nerve innervation has a very close relationship.  In this case though, I do not believe that the TMJ is the problem.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net