Weakness, tingling, hand coordination, paresthesia

@craigjulian. Hi Craig and welcome to Mayo Clinic Connect. On Mayo Connect we’re not medical professionals so we can’t make a diagnosis. But we can draw on our own experiences. For years, I’ve had similar issues with my arm, neck and shoulder on one side with numbness, tingling and zaps of electricity. It was very disconcerting and inhibited my work. Do your remember what activities you were involved in prior to experiencing the numbness in your arm when you wake up? Do you do repetitive work which has your posture compromised? Are you lifting more with one side than the other?

You’ve seen neurologists, had two MRIs and your labs are good. You’re under a great deal of stress caring for Covid patients. A heightened state of stress and panic can eat us alive, I swear. We can easily tell ourselves stories that take over our logical thinking. You’re being proactive so that’s excellent.
Have you tried another avenue; this may not be neurological. Have you considered or been recommended to try a massage with a professional who works with myofascial release? My symptoms actually ended up being related to muscles and tendons in my back, affected after years of working in a dental office using poor posture. After exhausting all other avenues, I was referred to a Massage Therapist who specialized in deep tissue massage and Myofascial Release therapy. I also worked with a licensed acupuncturist who brought me the most relief on a long term basis. If nothing else, a good massage would help calm your anxiety until your doctors can get to the bottom of this. Lori.

@craigjulian Welcome to connect I'm sorry your having these symptoms have you gone to a chiropractor? It might be a pinched nerve In no Dr just retired nurse but one time I thought I was having a heart problem with pain radiating from middle of back to chest It was pinched nerve Went to chiropractor and after he treated me it was gone This is just a suggestion I wish you the best Let us know how you are doing

Thanks for the great advice. I haven’t been to a massage therapist in years. I’m going to give it a try. I am definitely open to acupuncture, never tried it. My problem is, I should have never started searching online for a diagnose. I went down a rabbit hole with ALS. The EMG will hopefully rule that out and I can have some sanity again.
I’m glad you found some relief from your similar issue. Thanks again for responding to my post.

@craigjulian Oh, we’ve all been drawn to those rabbit holes!! A total labyrinth of trouble down there. LOL. Joking aside, I’m really sorry you’re having all this anxiety. It could even be a bit of PTSD from being an essential worker in the midst this pandemic. Thank you for being so brave and caring for patients who truly needed your assistance. It can’t help but take a toll emotionally, physically and mentally.

My experience with acupuncture was nothing short of miraculous! It’s totally painless and quite relaxing. The results were profound in relieving all the symptoms! I went into this with absolutely no expectations and had my doubts. But after the first session I was speechless by the time I got home! It was like magic! Each treatment had a lasting affect of about 6 weeks. The follow up massages then prevented a recurrence.

Have you tried any mindfulness techniques or meditation just to refocus your thoughts to alleviate some stress?
Wishing you all the best with results of the EMG, Monday. Please let us know the results, won’t you? Lori.

@craigjulian I'm glad you reached out, and bless your heart for being a worker on the front lines of Covid. That surely is a source of a lot of stress and anxiety. I had the opportunity to speak with a nurse who worked with Covid patients and she said that this is different because when patients get to the end stage, there is nothing that can be done to save a patient who is suffocating. When you are trained to save people and you can't, it affects the medical worker. I asked her how do you decompress from that, and she told me she can't. You probably have been working longer shifts and must be exhausted.
Please know that you have my support.

Take a deep breath. Use your mind to take you somewhere else that is beautiful and is a safe space to just be. Look around and notice that there are birds singing and perhaps the sounds of a gentle brook nearby. Maybe your place of safety will be different than mine, so go ahead and explore.

This is one of my techniques when I'm scared, and I have been through a lot. I had to face my own rabbit hole when I needed spine surgery 4 years ago. I am an artist and as a visual person, I can use imagery to my advantage. Art is also very healing and you can express things that there are no words for. I was having anxiety attacks every day for 4 months until I figured out how to deprogram the learned pathways from past experiences that were taking me there, and I learned how to manage and embrace my medical issues and to feel some sense of control in my choices. I went a lot of years un-diagnosed with thoracic outlet syndrome and it does exactly what you describe with an arm going numb at night. Stress will affect it a lot as you brace against it.

I also lived with advancing cervical spinal cord compression that sent pain, numbness, tingling and spontaneous muscle spasms all over my body. That was enough to scare several surgeons out of wanting to help me and many of them believed that my issues were related to something else like MS, or a separate problem with my legs that I was told to fix with a rehab doctor first and then come back for spine surgery. The problem was that my issues were caused by the spinal cord compression that could only be fixed with decompression surgery, and the doctors didn't understand the problem. Five turned me away over 2 years. I was in the position of loosing control of my arms and increasing weakness from muscle atrophy and I had to give up painting when I could no longer hold my arms up for any length of time. When you are the patient with a condition that is misunderstood and misdiagnosed, it is a difficult place to be and you have to find another specialist who understands the problem. I had multiple problems together compressing my nerves in my spinal cord, in multiple places between my collar bone and rib cage and carpal tunnel. My hands used to turn blue and get cold and the position of my neck could bring that on. TOS is a positional and postural problem. One of the tests for it is when you turn your head or raise your arms, it cuts off the pulse in your neck and arm. With the nerve and vascular bundle of the brachial plexus passing through some tight spaces, it causes nerve compression and circulation issues, and if you add any neck muscle spasms from a spine issue, it gets worse. I used to drop things all the time and had trouble writing.

Speak with your neurologist about TOS and if they don't have expert knowledge about it, then seek a specialist at a medical center that lists TOS as a condition that they treat. That is why I came to Mayo in search of specialists who could understand this interaction between TOS (which had been diagnosed) and my spine condition. I also found a neurosurgeon at Mayo who understood all the crazy body pain I was getting, and when I read one of his papers, I found a term that I looked up, "funicular pain" and that lead me to medical literature that explained cases like mine. The five surgeons who had evaluated me should have been able to figure that out. Specialists for TOS would be neurologists and vascular thoracic surgeons. The preferred treatment for TOS is physical therapy which I have done for several years with myofascial release. There is surgery for TOS, but it can create more problems with scar tissue and tightness that makes it worse. Some people have an extra rib that causes TOS. If your specialists don't know what is going on, searching online can help you figure out how to get to the right specialist, so don't blame yourself. Just avoid making your own diagnosis, keep an open mind and write down the questions you would ask a specialist about your symptoms to make them think about your condition. TOS is more common in spine patients likely because of injuries that also cause the spine issues, but it is glossed over in med school, so many doctors miss it and think it is rare. What is rare about it is finding a doctor who understands it.

Here are some links. We have an art for healing discussion. I also write about that online outside of Connect. Music with deep breathing and relaxation helps ease stress and I did a lot with that on my count down to spine surgery. We also have a Myofascial release discussion with a lot of detailed information at the beginning pages. Here are some links too about Thoracic Outlet Syndrome. There are a lot of good articles on the MSK Neurology site written for physical therapists. Even if you don't get a confirmed diagnosis for that, physical therapy and MFR can help and progress will be slow over a long period. Let me know if I can be of further help. Please check back and let us know how you are doing.
https://mskneurology.com/how-truly-treat-thoracic-outlet-syndrome/
https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
Provider search for MFR http://mfrtherapists.com/
https://connect.mayoclinic.org/discussion/art-for-healing/
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
https://connect.mayoclinic.org/discussion/music-helps-me/
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

Hi Lori,
Thanks again for all your advice. My EMG showed c8 and L4 radiculopathy, and no motor neuron disease. I have appointments for acupuncture and massage next week- thanks for those suggestions.
I’m still having the same symptoms but with more pain in my thumb and leg. I think you’re right, this might all be caused by living in a highly emotional and anxious state for almost a year. It’s hard to believe what prolonged stress can do to your body and how it can cause so many physical symptoms.
Amyway, I just wanted to say thanks again and I hope you’re doing well.

Craig

@craigjulian Hi Craig, That’s fantastic news with the results of your EMG! Ok...in so much that you don’t have ALS or any other motor neuron disease. What a relief. I’m sure you’re breathing a lot easier now with that positive news. Coincidentally, my EMG had shown the same C-8 and another in the Thoracic area. So truly, I hope the massage and acupuncture help relieve the symptoms you’re having. Probably just not having the stress of the unknown will help too! :-). Those two treatments have brought such a huge improvement to my life with managing the discomfort and side effects, on multiple levels. Like who doesn’t need a good massage?!

Besides the two therapies, I also use a tennis ball or Lacrosse Ball for myofacial release techniques on either side of my spine and shoulders when I need a quick fix after working too long in one position. One of my hobbies is making paper, which I did today. Really messes with my shoulder. So I rolled that area with the LaCrosse Ball and dodged a muscle spasm. It actually reminded me of you and I wondered how you were doing. Weird timing that you wrote just a few minutes later! Great minds and all that. LOL.

A suggestion when you see the massage therapist is to ask about myofacial release and see if they have any suggestions for your particular affected areas.

Thank you for sharing your good news...it made my day. I’ll be eager to hear about your experience with the acupuncturist.
Best, Lori.
http://www.wisconsinwellnessclinic.com/uploads/8/3/9/6/8396859/self_myofascial_release_with_tennis_ball_to_release_muscle_tension.pdf
https://sportsmedicine.mayoclinic.org/condition/radiculopathy/
https://www.mayoclinic.org/diseases-conditions/back-pain/expert-answers/myofascial-release/FAQ-20058136

I’m going through the same thing now Craig. As I read your post I was like, man, that’s me. It started with BFS worries which turned into ALS worry, but then I got all the symptoms you are facing now like tingling and numbness in the arm and tingling along/around the spine. Also pain and stiffness in the little finger which is probably C8. And cervical MRI came back rather OK aside from some level of herniation. My Physio suspected TOS as well but very hard to diagnose so we just went ahead to strengthen the neck and t-spine.

I think everyone here is right. It’s stress and anxiety which can send you spinning (I’ve spent hours and hours searching for symptoms of ALS, MS, etc). I think it’s the myofascial release and posture that needs to improve and I’m keen to hear how your journey goes, I will post mine as well and hopefully soon we will be symptom free and focusing on positive thoughts without worrying thoughts about underlying issues which can be even more detrimental than the symptoms we are feeling.

Thanks for sharing it here

Borko

One good article from a neurologist / neuroscientist that can explain what you were saying about mind (stress) causing actual physical symptoms:

“our day to day experience in life is absolutely FILLED with inconsequential symptoms that our brain and body naturally filter out.

Think about the onslaught of information overload your brain must deal with each day. Peripheral nerves spontaneously shooting off, either in response to some stimulus (appropriate) or not (inappropriate).

I'm sure everyone can remember a random grabbing pain in one part of their body that came on for no particular reason (ie. you weren't actually being stabbed) and passed just as quickly.

This is NORMAL. Our body is not perfect, and the brain's mammoth task is mostly to filter the infinite information to make sense of its environment. Is that jabbing pain a potential attack, or is it muscle spasm?

Mental health disorders, including anxiety, disrupt the normal pathways that sort through this information. Thus, what was once a transient, benign symptom suddenly becomes interpreted as potentially threatening.

Much like the Princess and the Pea, once your brain locks in on something and decides it's important, it then focuses additional resources on investigating it further - invariably this means such usually-benign symptoms are increasingly detected, and the symptoms then become self-fulfilling:

"It'd go away if it was nothing, but now I'm feeling it often, it must be something".

Interesting point of view and very relevant to my situation where stress and anxiety, irrational fears and hypochondria kind of came together and instead of focusing on moving forward I obsess with looking for some underlying issues that I convince myself it’s there.

Good luck with acupuncture and massage - I scheduled the same 🙂

@craigjulian Hi Craig, not to be an nosy old lady...just checking in to see how you’re doing. Have the massage and acupuncture had any positive effects on your symptoms? Hopefully you’re feeling better and stress is melting away! Lori.