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Neurology (Expert Forum)
Tingling, numbness in Arm and Leg
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Tingling, numbness in Arm and Leg
by aapetyo, Sep 05, 2008 10:21AM
Earlier this year I went to urgent care with pain in the groin area. Because I was exercising at the time pretty regularly, I thought it might be related to that. I was checked for a hernia and the doctor told me that she didn't think it was a hernia but just a muscle strain. The pain has come and gone since then but now I am getting pins and needles, weakness and some amount of numbness down my right leg to my foot. I've also had numbness, weakness in my right arm (pinky finger and ring finger). Now recently I've been getting some dizziness as well. I suffer from anxiety and have bouts with depression. I typically get to the point of panic attacks when I don't know whats going on with my body. My best friend has MS and I'm worried that I have MS now. I wanted to note that I had mono in college as well as I know there are some bodies of research showing a correlation between the two.
Doctor's Answer
by Lama Chahine, MD, Sep 08, 2008 12:38PM
, Sep 08, 2008 12:38PM
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.
It sounds like you have had groin pain, tingling in R arm and leg, and dizziness. While I can not tell you whether or not you have MS or provide you with another diagnosis without being to obtain a history or examine you, I will try to provide you with some information.
First, I will say that while it is possible you have MS, from your symptoms it does not seem like the most likely cause of your symptoms. MS requires neurologic dysfunction to occur in 2 separate areas at different points in time; while you meet these criteria, your story does not fit MS otherwise. However, the best way to have your question answered would be to see a neurologist who can examine you and obtain a history and may decide to do further investigations such as MRI or LP to determine MS if he/she suspects it.
One possibility is that there is a buldging disc or arthritis in your lower spine, impinging on the nerves as they exit the spine, and this could lead to both tingling and pins and needles in your leg as well as the groin pain.
However, this would not explain your hand symptoms. It is possible that your hand symptoms are entirely unrelated to your leg symptoms. Numbness and weakness in the 4th and 5th digit could be due to either a problem in the nerve that supplies these areas (it is called the ulnar nerve). The cause could be irritation of the nerve at the elbow or at the wrist. Problems at the wrist commonly occur in bicycle riders when the lean forward on their hands too long. Also, the problem could be coming from higher up, arthritis or a disc buldge pressing on the nerves that supply that area as they come out of the spine (called the C8 and T1 nerve roots). The symptoms in both your arm and leg would again be best evaluated by a neurologist. He/she may decide to order an MRI of the spine or a test abbreviated EMG/NCS, which tests the way that electricity is conducted along nerves and how well muscles contract.
Below, I will expand on the causes of groin pain.
The problems that can cause groin pain can be divided into muscular causes, nerve causes, and bone causes. Also, hernias can cause groin pain, I will not discuss hernias though.
Muscular problems are generally due to strains. There is a group of muscles that move the leg inwards (what is called adduction). These are called adductor muscles and a sprain in them can cause acute groin pain. These strains are often due sports, or certain movements during lifting heavy objects. Physical therapy is the best treatment for this condition.
Osteitis pubis is a painful condition characterized by pain over the symphysis pubis (the bone that connects the two hip bones).
A small fracture in the symphysis pubis, a stress fracture, can occur with minimal trauma and can lead to groin pain. Problems in the hip joint can also cause referred pain to the groin. There are other muscular and orthopedic causes of groin pain.
Nerve entrapment can lead to groin pain. There is usually associated sensory loss or muscle weakness depending on the nerve entrapped. The most common cause of nerve entrapment is entrapment in a nerve in a bundle of tissue or muscle. Nerve injury can also cause similar symptoms. Problems in the spine or the nerves as they exit the spine can also cause pain, such as buldging discs. Tests called electromyography and nerve conduction studies may be helpful in making the diagnosis and localizing the site of the nerve injury, and may assist in differentiating spinal from peripheral nerve injuries. MRI is useful in diagnosing nerve root compression. Diagnostic blocks will often confirm the diagnosis of peripheral nerve injury. Surgical exploration with decompression and/or neurolysis (release of the entrapment) is sometimes necessary.
Radiculopathy, a problem of the nerves as they exit the spine, often due to bulding discs, can cause hip and groin pain with pain the anterior (front part) of the thigh.
If the illioinguinal nerve is entrapped, it causes pain around the suprapubic area and in the groin.
Entrapment of the pudendal nerve leads to groin pain. Symptoms include burning, tingling, electric shocks, numbness in the anal region and perineal area (around the penis/scrotum or clitoridal/labial regions). The pain gets worse in the seated position. There is usually no objective sensory loss on examination. Pain is often relieved by such positions as sitting in the toilet. If the pain gets worse with standing or walking, the diagnosis is unlikely to be from pudendal nerve entrapment. A varied technique of the EMG, called electroneuromyographic (ENMG), is often performed based on needle electromyography and the study of sacral reflex and pudendal nerve motor nerve responses.
Thank you for the opportunity to answer your questions, I hope you find this information useful, good luck.
It sounds like you have had groin pain, tingling in R arm and leg, and dizziness. While I can not tell you whether or not you have MS or provide you with another diagnosis without being to obtain a history or examine you, I will try to provide you with some information.
First, I will say that while it is possible you have MS, from your symptoms it does not seem like the most likely cause of your symptoms. MS requires neurologic dysfunction to occur in 2 separate areas at different points in time; while you meet these criteria, your story does not fit MS otherwise. However, the best way to have your question answered would be to see a neurologist who can examine you and obtain a history and may decide to do further investigations such as MRI or LP to determine MS if he/she suspects it.
One possibility is that there is a buldging disc or arthritis in your lower spine, impinging on the nerves as they exit the spine, and this could lead to both tingling and pins and needles in your leg as well as the groin pain.
However, this would not explain your hand symptoms. It is possible that your hand symptoms are entirely unrelated to your leg symptoms. Numbness and weakness in the 4th and 5th digit could be due to either a problem in the nerve that supplies these areas (it is called the ulnar nerve). The cause could be irritation of the nerve at the elbow or at the wrist. Problems at the wrist commonly occur in bicycle riders when the lean forward on their hands too long. Also, the problem could be coming from higher up, arthritis or a disc buldge pressing on the nerves that supply that area as they come out of the spine (called the C8 and T1 nerve roots). The symptoms in both your arm and leg would again be best evaluated by a neurologist. He/she may decide to order an MRI of the spine or a test abbreviated EMG/NCS, which tests the way that electricity is conducted along nerves and how well muscles contract.
Below, I will expand on the causes of groin pain.
The problems that can cause groin pain can be divided into muscular causes, nerve causes, and bone causes. Also, hernias can cause groin pain, I will not discuss hernias though.
Muscular problems are generally due to strains. There is a group of muscles that move the leg inwards (what is called adduction). These are called adductor muscles and a sprain in them can cause acute groin pain. These strains are often due sports, or certain movements during lifting heavy objects. Physical therapy is the best treatment for this condition.
Osteitis pubis is a painful condition characterized by pain over the symphysis pubis (the bone that connects the two hip bones).
A small fracture in the symphysis pubis, a stress fracture, can occur with minimal trauma and can lead to groin pain. Problems in the hip joint can also cause referred pain to the groin. There are other muscular and orthopedic causes of groin pain.
Nerve entrapment can lead to groin pain. There is usually associated sensory loss or muscle weakness depending on the nerve entrapped. The most common cause of nerve entrapment is entrapment in a nerve in a bundle of tissue or muscle. Nerve injury can also cause similar symptoms. Problems in the spine or the nerves as they exit the spine can also cause pain, such as buldging discs. Tests called electromyography and nerve conduction studies may be helpful in making the diagnosis and localizing the site of the nerve injury, and may assist in differentiating spinal from peripheral nerve injuries. MRI is useful in diagnosing nerve root compression. Diagnostic blocks will often confirm the diagnosis of peripheral nerve injury. Surgical exploration with decompression and/or neurolysis (release of the entrapment) is sometimes necessary.
Radiculopathy, a problem of the nerves as they exit the spine, often due to bulding discs, can cause hip and groin pain with pain the anterior (front part) of the thigh.
If the illioinguinal nerve is entrapped, it causes pain around the suprapubic area and in the groin.
Entrapment of the pudendal nerve leads to groin pain. Symptoms include burning, tingling, electric shocks, numbness in the anal region and perineal area (around the penis/scrotum or clitoridal/labial regions). The pain gets worse in the seated position. There is usually no objective sensory loss on examination. Pain is often relieved by such positions as sitting in the toilet. If the pain gets worse with standing or walking, the diagnosis is unlikely to be from pudendal nerve entrapment. A varied technique of the EMG, called electroneuromyographic (ENMG), is often performed based on needle electromyography and the study of sacral reflex and pudendal nerve motor nerve responses.
Thank you for the opportunity to answer your questions, I hope you find this information useful, good luck.
