New Numbness

[ablonde]

I am a 29 y/o with 2 small kids no medical problems. A few weeks ago I started having numbness on my first steps out of bed in the morning.  It dissappears after a few steps completely in left but stays although less in the right foot.  I also have numbess in my right arm with soreness in my shoulder and muscle twitching. The right side is the side I usually hold the kids on and heavy bags.  I figured that this is probably nerve impingement from my neck, but when the feet started I wasn't sure what to think.  Previously I did have the sensation of numbess in my tongue but didn;t think of it until this happened.  Would the feet be a related neurologic problem or more related to circulation.  I guess I could have a nerve problem in my lower back from lifting and holding kids on that side as well.  Thanks for your input.

[Esteban Cheng-Ching, MD]

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 take a full history and examine you, I can not tell you what you have. However, I will give you some more information that I hope will be useful.
Numbness and tingling are sensory symptoms that could be related to different conditions, the first thing is to find out if they are associated with a neurologic condition or not, and to get to this, as well as to the diagnosis, a detailed history and neurologic exam are required. The pattern and distribution are important.
A peripheral neuropathy can cause numbness and tingling, this is commonly presented either in a distribution of a specific nerve, or in a "glove" and "stocking" distribution. The symptoms could be characterized by numbness-tingling, sometimes even pain, and in some cases, with weakness in the same regions. The diagnosis is supported by studies like EMG and nerve conductions studies. When the tests do not show abnormalities, and the history and exam suggests other diagnosis, work up for small fiber neuropathy can be entertained, including sweating tests of the extremities, and in some cases, even skin biopsy. When the diagnosis of neuropathy is confirmed, the cause should be investigated, as the treatment is focused on targeting the cause. Causes for neuropathy includes metabolic problems like diabetes, inflammatory conditios and vascular conditions, infectious like Lyme disease, but sometimes the cause cannot be determined.
A radiculopathy can cause pain and sensory symptoms in a distribution of a nerve root, and this usually causes severe pain. Compression of the root can be determined by imaging studies.
Sometimes spinal stenosis or other problems compressing the cord and the nerves can produce sensory symptoms. In spinal stenosis, the history suggests a pattern of worsening with specific positions, with improvement with changes in position and posture.
Central nervous conditions can also present initially with numbness and tingling, but usually associated with other neurologic symptoms like weakness, or other manifestations. The history is very important as well as the exam.
Regarding the predominance of symptoms on the right upper extremity, this, as you suggest, may be caused by some compression of a nerve, however the exact distribution of the problems will help to determine the location and the diagnosis.
I am not sure about the muscle twitching, and about the tongue symptoms, as they are not usually associated with the other symptoms you describe in your lower extremities.
As I said, without being able to obtain a detailed history and examine you, I cannot tell you what the cause of your symptoms is, or what is the diagnosis. I think you should see a neurologist to determine if your symptoms are caused by a neurologic disease, and to look for the cause, and begin treatment.
I hope this information is useful. Good luck.

[Lesie07]

Hi Dr,
I have tingling and numbness on my leftside (arm, hand, leg, foot, face and tongue) I have been to a few neurogists, and medical Dr's and no one seems to be able to diagnose what is wrong. Do you know anyone who had these symptoms and what was the diagnoses? I have had CT scans, MRI's and the only thing the MRI showed was a spot on my brain, but they all said they do not believe the tingling or numbness is coming from that.