Expert advice: Numb fingers and toes after a Brevet - Numbness in your fingers and toes when riding a road bike?

Question from TOUR reader Eckart E.: I've been riding Brevets for four years, and in 2015 I rode Paris-Brest-Paris for the first time. But two months after finishing in Paris, three fingers on my right hand (thumb, index finger, middle finger) and two toes on my left foot were still permanently numb. On the recommendation of my GP, I initially took vitamin B tablets. Without success. There is plenty of advice from friends and on the internet: alternative practitioner, osteopath, orthopaedist, sports surgeon, wait and see, cold-warm treatment. Which direction should I take? The condition is becoming increasingly unpleasant due to the lack of sensitivity and grip. Apart from that, I have no pain or restrictions as a result, I can also move my fingers normally.

Answer from Dr Christian Merkl: Malfunctions in the extremities often trigger fears that central causes are responsible for the disorders. In principle, disorders of the cervical spine can become clinically relevant for the first time after a long bike ride in an aerodynamic position if constrictions of the nerve exit point at the cervical spine due to herniated discs, but also due to degenerative changes such as vertebral joint arthrosis or bony growths, cause irritation at the nerve root. In your case, however, a peripheral nerve (median nerve = carpal tunnel syndrome) appears to be so severely damaged by mechanical pressure that it causes sensory disturbances. In another variant, the ulnar nerve is damaged by pressure on the outer wrist, causing the outer fingers (4 and 5) to drop out. This can be prevented by wrapping the handlebars with a soft leather strap and gripping them as often as possible while riding to prevent constant pressure on one region of the wrist.

If the nerve is already damaged, such a long journey is often just the last straw that breaks the camel's back. In this case, I recommend having the nerve conduction velocity measured by a neurologist. If this is significantly impaired, surgery is often necessary: This involves splitting the carpal tunnel ligament, which should relieve the nerve.