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Numbness and tingling in arms and legs - urgent condition?
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Numbness and tingling in arms and legs - urgent condition?

Im am a 30 years old male. I have tingling in my arms and legs (and vague ones to the neck, though I might be imagining it), and during the night my arms "fall asleep" and I wake up with a very unpleasant sensation.

It's strongest in my right arm, which also has pain in addition to numbness and tingling, and it had happened to my right arm a few years ago (back then, the pain was even stronger), but it had subsided until now. But now it has started again and spread.
I use the computer a lot and when it first happened I thought it could be from mouse overuse.

This actually started a couple of weeks ago with a feeling of pressure and then tingling in the chest, which have now mostly subsided. But my heart and lungs are ok, as I've had an ECG, echo, and chest x-rays.

Do you think it's important to seek help about this as soon as possible? I ask because my doctor is on holiday, and I was about to go on holiday myself. So this would have to wait until September unless it turns out to need urgent attention.

Also, assuming I can't or there is no need to see a doctor right away, would it hurt to take a B12 supplement, since I've read these symptoms could be caused by B12 deficiency? These supplements give MUCH higher doses than the daily recommended intake (like, from 100µg to 2000µg instead of the RDA of 2-3µg), that's why I'm asking.

I'm already taking ALA 600mg, which was suggested by my cardiologist when I briefly mentioned these symptoms.
Avatar_dr_m_tn
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 a doctor.

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

From the symptoms you are describing it appears unlikely that this is something which requires urgent evaluation. Also you are 30 years young and have already had a cardiac workup to evaluate for a dangerous cardiac cause

From the symptoms you describe one thing to consider is something called a compressive cervical radiculopathy.

Radiculopathy occurs when nerve roots (coming out of the spinal cord) become compressed at the neck or spine and this results in pain, tingling, and numbness, with or without loss of function in the area supplied by the affected nerve (which can explain why your arms “fall asleep”). Common causes of cervical radiculopathy are neural foramen narrowing (neural foramen is the canal through which the nerve exits) , usually caused by cervical arthritis in older adults, and cervical disk lesion caused by disk degeneration or herniation. Disk degeneration results in loss of disk space, with closer approximation of the vertebrae on either side of the involved disk space and subsequent impingement on the neural foramen. The decrease in size of the neural foramen results in nerve root compression. The cervical disk spaces are more often affected. Disk herniation also occurs more often in these.

Common symptoms include pain radiating to the shoulder or down the upper extremity, which may be aggravated by coughing, sneezing, or straining; tingling of the fingers; and less often, weakness in the extremity. You may have  tenderness on the neck, limitation in certain movements of the neck.

Diagnostic tests include radiographs of the cervical spine, which may appear normal or may show loss of normal cervical lordosis, narrowing of the disk space, and bone spurs with foramen encroachment. MRI identifies soft tissue structures and may show displacement of the disk.
Treatment relieves pressure on the affected nerve and is mainly conservative, including rest, pain relief, stress reduction, and short-term muscle relaxants. In your case, this may include posture correction and good neck and back support wihen you sit at the computer. If symptoms are persistent you may need structured physical therapy and referral to a neurologist. Neurologic signs and symptoms and loss of strength are also indications for referral to neurosurgery. A few patients require surgical intervention.

Other possibilities which are less likely include a carpal tunnel syndrome or a compressive neuropathy at your elbows if the numbness/pain is restricted to your forearm or hand respectively.

I would recommend evaluation by a neurologist. Good luck
2 Comments
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Avatar_n_tn
Sorry, I'm new here; I received two emails saying I had responses to this question, but I'm seeing none... is there something I'm missing?
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