半夜手麻醒來？先分清楚：手腕、頸部，還是胸口那條通道

简单回答：半夜被手麻醒，最常见的是手腕的腕管受压（腕管综合症），但不少人其实是从颈部、或从锁骨和第一肋骨之间那条通道开始被压到的。麻在哪几根手指、什么动作会加重，可以帮你初步分辨。醫道閣看手麻，不只看手腕，会一路看到颈部、胸口和肩膀那条横向的线：通道被谁挤窄了，就先松哪里。

Short answer: waking at night with a numb hand is most often the carpal tunnel at the wrist, but for many people the squeeze starts higher, at the neck or in the passage between the collarbone and the first rib. Which fingers go numb and what makes it worse help you tell them apart. At Virtue TCM we do not stop at the wrist: we follow the neck, the upper chest and the shoulder line, and release whatever is narrowing the passage first.

先分三個地方

手腕（腕管）：拇指、食指、中指，加上无名指的一半最麻；夜里或早上起床最明显，甩一甩手会好一点；拿手机、骑车、握滑鼠久了也会麻。
颈部：麻是从颈肩一路往下走的，常伴随颈肩紧；低头、转头或往后仰时会加重。
胸口那条通道（胸廓出口）：手举高、晾衣服、提重物时特别容易麻或没力，整只手觉得沉，常偏小指那一侧；锁骨一高一低、胸前很紧的人比较常见。

Wrist (carpal tunnel): thumb, index, middle and half the ring finger; worst at night or on waking, eased by shaking the hand; also after holding a phone, riding or using a mouse. Neck: numbness that travels down from the neck and shoulder, often with a stiff neck, worse when you bend, turn or tilt the head back. The passage at the top of the chest (thoracic outlet): numbness or weakness when you lift your arms, hang laundry or carry something heavy, a heavy arm, often on the little-finger side; common when the collarbones sit at different heights and the chest is tight.

很多人不只一个地方。手腕本身有点卡，加上上面的通道也窄，两处加起来，晚上就麻醒了。

Many people have more than one. A slightly stuck wrist plus a narrow passage higher up is often what finally wakes you at night.

什麼情況要先看西醫？

・突然一边手脚没力、脸歪、说话不清楚：可能是中风，请立刻去急诊。
・麻的范围越来越大，或两手两脚都麻；大小便控制出问题。
・跌倒、车祸或受伤后开始麻。
・拇指根部的肌肉变薄、扣扣子或拿筷子越来越没力。
・有糖尿病、甲状腺问题，或手麻同时体重下降、发烧。
这些情况请先找西医检查，有报告可以带来，我们再一起看下一步。

Sudden weakness on one side, a drooping face or slurred speech may be a stroke: go to A&E now. Also see a doctor first if numbness is spreading or affects both hands and feet, if bladder or bowel control changes, after a fall or accident, if the muscle at the base of the thumb is wasting or buttons and chopsticks are getting harder, or if you have diabetes, thyroid problems, weight loss or fever. Bring any reports and we can plan from there.

SRM 怎麼看手麻：麻的地方，不一定是被壓的地方

从 SRM 系统还原手法‧结构疗法的角度，我们会看三件事：
一、肩胸那条横向的线歪了没有。锁骨一高一低、胸前的肌肉绷着、颈部前侧的斜角肌拉紧，颈胸交界往前陷，头往后仰会卡。这条线一歪，锁骨和第一肋骨之间的空间就变窄。
二、惯用手被带到哪里。常用的那只手，手腕和前臂的层次容易黏在一起，屈肌那一面缩着，腕管自然比较挤。
三、层次有没有空间。神经经过的地方，皮肤、筋膜和肌肉之间需要能滑动；黏住了，一点压力就麻。

Through SRM we look at three things. The shoulder-chest line: uneven collarbones, a tight chest, tight scalene muscles at the front of the neck, a neck-chest junction sunk forward so the head will not tilt back. When this line is off, the space between the collarbone and the first rib narrows. Where your working hand has been pulled: on the hand you use most, the layers of the wrist and forearm tend to stick and the flexor side shortens, crowding the carpal tunnel. Room between layers: where a nerve passes, skin, fascia and muscle need to glide; once they stick, a little pressure is enough to cause numbness.

所以我们通常不会一开始就只按手腕。先把胸前、肋骨和肩胸那条线调顺，让上面的通道有空间，再处理手腕和前臂；需要时加上 SRA 系统还原针法，很细、很浅地松开黏住的层次。每做一步都会当场检查：手举高还麻不麻、握拳顺不顺、头能不能往后仰。

So we usually do not start by pressing on the wrist. We first ease the chest, ribs and shoulder line to open the passage above, then work on the wrist and forearm, adding SR Acupuncture (SRA), very fine and shallow, where layers are stuck. After each step we check on the spot: does lifting the arm still bring on numbness, does the fist close smoothly, can the head tilt back.

SRM 系统还原手法‧结构疗法 →

在家可以先注意的

・睡觉时手不要压在头下或枕头下，手腕不要弯着睡。
・手机拿高一点，不要长时间低头、手腕往下折。
・用电脑时手肘有地方放，滑鼠不要离身体太远。
・提重物尽量两手分担，不要总是同一只手。
这些只能减少诱因；如果麻已经反覆好几个星期，还是需要找出被压的地方。

Do not sleep with your hand under your head or pillow, or with the wrist bent. Hold your phone higher and avoid long periods of looking down with the wrist folded. Rest your elbow when using a computer and keep the mouse close. Share heavy loads between both hands. These reduce triggers; if numbness has kept returning for weeks, the place being squeezed still needs to be found.

中醫內科會看什麼？

如果手麻同时手脚冰冷、容易累、睡不好，或月经前后特别明显，中医会一起看气血和体质，必要时配合中药。结构和内在两边一起照顾，比较稳。

If numbness comes with cold hands and feet, tiredness, poor sleep, or gets worse around your period, the practitioner will also look at qi, blood and constitution, and may add herbs. Caring for both structure and the inside tends to hold better.

在醫道閣

第一次可以直接预约「初次评估＋SRM」：吉隆坡 45 分钟 RM235（林江豪医师 RM400），槟城 60 分钟 RM410。不确定是不是结构问题，也可以先约 15 分钟问诊（RM60）。下面就可以预约。

For a first visit you can book “initial assessment + SRM” directly: Kuala Lumpur 45 minutes RM235 (RM400 with Dr. Douglas Lim), Penang 60 minutes RM410. Not sure it is structural? Start with a 15-minute consultation (RM60). You can book just below.

延伸閱讀

妈妈手：手腕拇指那一侧痛

颈肩痛 Neck & Shoulder Pain

哪里痛？互动人体图

30 秒自我检查

个人情况因人而异，疗程建议需经问诊与医师评估后决定。
Individual conditions vary. Recommendations follow consultation and practitioner assessment.

试试看 · Try：哪里痛？互动人体图 · 30 秒自我检查 · 体质小测验

形 · Your first SRM visit · 第一次做 SRM

For pain that keeps coming back.

反覆的腰背、颈肩痛，或旧伤、疤痕的牵扯。第一次来，医师会先找出拉扯是从哪里开始的。

1. 1 评估Assess posture & movement
2. 2 手法First SRM session
3. 3 计划What next, if anything

Casey Wong 黄佩文医师Registered TCM practitioner · SRM

Kuala Lumpur · Bangsar / Mont Kiara

RM 235 · 45 min · assessment included 已含评估

Initial assessment + SRM-30 · 初次评估＋SRM-30

Book in KL · 预约吉隆坡

“This was my first time trying SRM. It’s a gentle and soothing method of adjustment… Miss Wong is a very patient and experienced physician.”★★★★★ Jacinta K. · Mont Kiara · Google review

Founder

Dr. Douglas Lim 林江豪医师Registered TCM practitioner · SRM

Kuala Lumpur · Bangsar / Mont Kiara

RM 400 · 45 min · assessment included 已含评估

Initial assessment + SRM-30 · 初次评估＋SRM-30

Book with Dr. Lim · 预约林医师

“I’ve been seeing Dr. Lim for years. He’s knowledgeable, genuinely cares about his patients… He can get to the root problem and treats the cause, not just symptoms.”★★★★★ Ying Xian W. · Bangsar · Google review

June Chan 田钊柔医师Registered TCM practitioner · SRM

Penang · The Qing Suites

RM 410 · 60 min · assessment included 已含评估

Initial assessment + SRM-60 · 初次评估＋SRM-60

Book in Penang · 预约槟城

Prefer a shorter first session? Book SRM-60 only (RM 350) with a separate consultation.

“I opted for SRM treatment with June. She was extremely good and thorough in checking my whole posture… She explained in detail what and why she was treating.”★★★★★ Vivianne S. · The Qing Suites · Google review

Not sure SRM is right for you? 不确定适不适合？ Start with a 15-min consultation (RM 60): KLPenang · or WhatsApp BangsarMont KiaraPenang

Individual conditions vary; your practitioner will advise after assessment. 个人情况因人而异，疗程建议需经医师评估后决定。

Related care · 相关疗程：SRM 系统还原手法‧结构疗法 · 腰背痛调理 · 针灸