Shoulder tension and perceived weakness

[jitteryjen]

Since the end of October i have been experiencing perceived weakness in my upper arms and shoulders.  The symptoms first occured at a very stressful time in my life.  I had a 13 month old baby and just gave birth to twins. I was returning to work from maternity leave and for the first time, I had to take them to daycare(they were cared for in-home prev.). after a very bad morning of going to the sitter for my 13 month old, I woke up the following morning with horrible arm shakes. I chalked it up to anxiety and ignored it.  It felt as if my arms were weak, however, I could do everything I needed to do like carrying the babies, etc.  We quit daycare and found  in home care again & my anxiety seemed to be going away, however the perceived arm weakness was not.  I even started having hand tremors quite strongly in the mornings and whenever I had to use them. I visited my dr. who told me it was all due to the anxiety and stress of my busy life. He sent me to a neurologist to ease my mind of serious diseases (I was sure I had one) and he diagnosed me with essential tremor. HOWEVER, when researching essential tremor, I really have a hard time believing this is my problem, especially since I am only 26 and it is not in my family and I do not have trouble perforning fine motor skills. My handwriting is not shaking the least bit, etc. I have been reading self-help books on anxiety and really feel that my anxiety is so, so much better and I am off of the fear of a serious disease however the symptoms are quite annoying. The hand tremors in the morning have stopped but not the shoulder tension and weakness when I use them or my upper arms. I occasionally get a numb feeling in my pinkies and little jerky movements in my hands and feet, but these are minimal and rare. Also hand pain and sore thumb joints on days where I am picking the kids up a lot.No MRI or test were performed by my neurologists who gave me the essential tremor diagonosis. In fact, he spend a total of 3 minutes with me. Had me to touch my finger to my nose, and other small tests to rule out Parkinsons, etc. He also seemed uninterested in any anxiety/stress I was dealing with.
Could these symptoms be caused by any back/ pinched nerve problems? I have been having sharp shoulder pains and occassional back pain. After having 3 babies in 13 months, I'm sure some things could have gotten pinched and moved! I am visiting a chiropractor this week and getting a massage also to see if it is tension related. Even though I have a handle on the anxiety, I still have a lot of everyday stress with the 3 children, work and school.
Sorry so long! Just having a hard time accepting this diagnosis and wondering what this could really be.

[jitteryjen]

What about the essential tremor diagnosis? Seems that my anxiety was doing better until he told me this and then it was through the roof again.  I have been reading about it and am just not sure that is what I have.

[Godofredo MD]

Hi.

Yes, stress and anxiety can indeed cause somatic symptoms such as what you have experienced over the course of your condition. However, you mentioned that your anxiety is "so, so much better" so I had to think of this possibility as less likely.

If you do believe that your anxiety has been causing much of your symptoms, it would be advisable to talk to a counselor or psychiatrist to assess your psychological status and help you manage the stress that you have been experiencing. You could also be enrolled in a stress management program which may be helpful in your situation.

Hope this helps.

[jitteryjen]

what about stress and anxiety? Can they manifest themselves in such a way? I ask because the condition started at the same time I was having horrible anxiety and stress but I had no symptoms before.

[Godofredo MD]

Hi.

I am so sorry to learn that you have been suffering from pain for the last few months. I do hope your condition would improve soon.

To answer your query, yes, it is indeed possible for nerve compression or impingement to cause such symptoms that you are experiencing. Although the back and shoulder pains could also be muscular pains, it would be unlikely in your case. A shoulder condition such as bursitis or rotator cuff tear, though a common cause of shoulder and back pain, does not present with tremors and you do not present with any limitation of shoulder movement.

It would be best to talk to your neurologist to have an MRI done and rule out degenerative disk disease or disk herniation that could be causing any nerve compression, especially at the cervical spine level.

Hope this helps.

Good luck.