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Concerned about tingling

Hello
I have been suffering recently from pins and needles in my left hand - mainly in the ring and little fingers and on the little finger-side of the palm. It tends to occur when I'm holding the telephone, have my elbow on the table or sometimes at night when I'm sleeping with my arms stretched upwards. The tingling is relieved when I move my hand/arm.
I also have a reduced sensation in the inside tip of the big toe on my left foot. I have quite bad back pain ever since I had a car accident 9 years ago and since being pregnant last year I have quite bad lower back pain.
I went to see 2 neurologists who both told me that this was nothing to be concerned about and recommended that I see a physiotherapist for my back.
During the clinical exam, nothing was noted apart from that my reflexes are slightly brisk in all 4 limbs. The doctor concluded that they are undoubtably always been this way and given that I am particularly anxious at the moment, it was not cause for concern.
The pins and needles have been going on for approx 3 months now and the reduced sensation in my big toe has been present for over a year (as far as I can remember).  
Despite this, I am still worried about multiple sclerosis - do the above symptoms justify this concern?
Thank you in advance for your help.
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Avatar universal
MEDICAL PROFESSIONAL
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

It sounds like you have been suffering from pins and needles sensations in your 4th and 5th digit. Two possibilities are ulnar neuropathy or cervical radiculopathy. Regarding your loss of sensation of your toe, this could be a radiculopathy or neuropathy as well. While I can not say definitively that this is not MS, your symptoms do not sound like this.

Ulnar neuropathy is similar conceptually to the more commonly known carpal tunnel syndrome. The ulnar nerve supplies innervation to some of the muscles and the skin on the side of the arm closer to the body (the "medial" forearm and hand), including the pinky and ring finger. Ulnar neuropathy is a type of irritation of the ulnar nerve. Ulnar neuropathy causes numbness, tingling, or pain into the arm and hand on the side of the little finger. This is sometimes called "handlebar palsy", because it frequently happens in bicyclists who sustain repeated shocks and bouncing that can occur while holding the handlebars when riding. Other activities that involve stress on the hands and wrists may also irritate the ulnar nerve and cause ulnar neuropathy. This is best diagnosed with a study called EMG/NCS, which tests how nerves conduct electricity and how muscles respond. Treatment involves reducing movements that irritate the nerve, and in some cases surgery.

Another possible cause of your symptoms include a herniated disc affecting a portion of the nerves that eventually form the ulnar nerve (specifically the area involved would be a nerve root, the C8/T1 nerve root). Other areas that could be affected is what is called the brachial plexus, a collection of nerves near the collar bone and armpit that eventually move down the arm to form the nerves that innervate the pinky finger and ring finger etc.

The spinal cord is encased by bones called vertebra. Nerves start to form as they come off the spinal cord and exit through holes formed between the vertebra. If a nerve is compressed on as it exits through these holes, particularly in an area called the nerve root, a radiculopathy results. The compression could be due to arthritis of the spine or due to a herniated disc or other lesions. The symptoms include pain at the level of the problem (i.e. neck or back etc) and pain that may radiate down the arm or leg (depending on where the problem is; in your case, one level could be at the neck causing finger symptoms and the other at the back causing toe symptoms). A radiculopathy is often diagnosed based on history, physical examination, and MRI of the spine.

Brisk reflexes in all 4 limbs, when symmetric (not more on one side or the other) could signify cervical spine disease, but more often than not is a normal finding, particularly in younger women.

Continued follow-up with your neurologist is recommended; evaluation by a neuromuscular specialist (a neurologist specialized in neuromuscular problems such as neuropathy) may benefit you.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Helpful - 0
Avatar universal
Try neuromuscular therapy and if that does not help go back to the doc and have them scan you.  MS seems to be difficult to diagnose until things are bad.  Why?  Maybe doctors can give us an explanation as to why they take so long. Sometimes the muscles can get so tight that they do constrict and cause those symptoms.  Again, try therapy, then if it does not work (but give it a chance at least a month).  A good neuromuscular therapist (if it is muscles) can do treatment and you will notice a difference in a month.  If it does not work, then you can tell the doc,  you tried it, didn't work, so do his JOB and figure out what it is.
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