Tingling and weakness

[Quest10]

About two weeks ago I started to feel some tingling- quite mild- in some of my fingers in both hands. It was mainly in the tips of my little fingers and thumbs. My arms also feel 'heavy' and tired on and off during the day. I woke up for a few nights with pins and needles but have been sleeping fine since. My doctor told me to try to relax and ignore it and it was unlikely to be anything serious. He also said it wasn't carpal tunnel syndrome as this wouldn't present in both hands at the same time. As I am a bit of a worrier I went to see a physiotherapist who thought I had some tenderness at the T4 vertebrae of the thoracic spine which he thought could be causing the tingling. The tingling has eased a lot since it first presented although my arms (in particular my left arm) feel very tired and heavy at times during the day.  I am very worried as I am due to get married shortly and can't seem to shake off the feeling that something is wrong. I admit to being a little stressed recently with wedding plans and moving house. However, I'm not sure if stress brought this on or whether the symptoms are making me stressed?! I am also hesitant to return to the doctor as he seemed sure that it would be ok. I would appreciate any advice you may have. I am 33, female and otherwise fit and healthy.

[annefox]

A related discussion, what do these findings from my MRI of the spine mean? was started.

[Suzanne85938]

I have been having tingling, numbing in my hand and arm. I had an MRI done. The report says that at the C4-5 there is bulging of a disc and that it is greater to the right. There is foraminal narrowing on the right by unciate joint hypertrophy.

C5-6 there is a large broad-based centeral protursion with moderate to severe noted. Bilaterally, greater on the right, primaly by uncinate joint hyprertrophy. The thecal sac diameter measures minimally 6 mm, due to the disc protrusion, there is some aquired spinal stenosis.

C6-7 Disffuse bulging of disc is seen, mild effacement of the thecal sac noted. Forminal narrowing noted on the right by uncinate joint hypertrophy. this is lesser extent on the left side.

This is actually a question, what are my options to stop the pain and aching feeling continuously?

Please help Thanks Suzanne85938

[CCF-Neuro-M.D.-SH]

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes. The symptoms you describe are most consistent with carpal tunnel syndrome (CTS), but are non-specific.  Carpal tunnel syndrome does not have to be asymmetric and can present at the same time.  It most commonly presents with numbness and/or pain with gripping steering wheels, holding the telephone and numbness/tingling and/or pain at night.  The most common etiology is repetitive stress injury, such as typing, factory workers, etc. Another etiology is increased swelling, such as during pregnancy.  If your symptoms are related to carpal tunnel a pair of wrist splints to wear at night would be indicated if you continue to have discomfort. An EMG would evaluate for any electrical evidence of changes consistent with CTS.
   Stress and hyperventilation can also cause a similar numbness/tingling.  This typically occurs in the finger tips and occasionaly around the mouth. This can also occur with disorders of calcium metabolism.  Reasonable tests would include a ionized calcium and a PTH (parathyroid hormone) level.
   However, given your symptom of "heaviness" could suggest lots of things, but developing weakness would be the primary concern to rule out.   Again an EMG may be helpful, after a thorough neurologic motor exam.
   Finally, a lesion at T4 would not explain your symptoms. The hand areas are supplied by the C8/T1 roots.  T4 sensory distribution is on the chest/flank.  An EMG would be able to decipher if you have changes consistent with a radiculopathy (disc disease).   I hope this has been helpful.