Pinched Nerve or MND?

[Brian30]

I am currently 32 years old, 5 ft 11 in, 175 lbs.

About 5 months ago, I started noticing that my hands would cramp up when working with small things, like threading a screw or a bolt. I didn't really think a whole lot about it at the time. The cramping may not have a thing to do with what you're about to read. I just thought that I would include that in case it is a symptom.
As time went on, I started noticing weakness in my right arm (only in a curling motion). As time went by, it got to the point that I was having a hard time buttoning my pants when getting ready for work & even turning the ignition in my truck. I don't have what I would call pain. It's kind of a numb feeling that starts from my shoulder & goes all the way down to my thumb (primarily in my bicep & hand). At this point (Oct. 23, 2007) I can barely curl a loaf of bread. I have noticed some atrophy in my right hand & in my bicep/forearm area. I do have fascilations, but have had them for as long as I can remember. I have been to an Orthopedic Doctor who looked at me for about 10 minutes & said that he thought it was nerve related. I went to a Neurologist & have had a nerve conduction study performed on my leg & both arms as well as an EMG. I have also had an MRI of my neck & spine. I have had blood work done. Nothing was found abnormal. And this past Friday, I had a myelogram & a catscan performed. I am awaiting the results of those tests, but I did speak with the Doctor who performed the myelogram & I asked him if he saw anything & he said that he looked at the xrays briefly & they looked okay, but that my Neurologist would have to give me the official results.
I am only having weakness in my right arm & hand. I fear that this test will come back okay (no pinched nerve, bone spur, etc.) & that I may be facing something like a motor neuron disease like ALS. ALS or any motor neuron disease does not run in my family.

A few questions:
1) Is it possible that all of these tests can come back okay, but there is in fact a pinched nerve or a bone spur that the Doctor is not seeing?
2) Can a Chiropractor fix something like what I am going through?
3) Is it possible that I have something going on in my arm itself? I have not had an MRI of my arm.
4) Do I fit the symptoms of someone with ALS?
5) Is ALS detectable through any kind of test or are you just diagnosed with it when nothing surfaces from other tests

[caregiver222]

First of all, I know nothing about ALS, and am not prepared to comment. You have many legitimate questions and it appears yout physicians have been very conscientious and thorough. I would stay away from a chirpractor at this point. Not that I am against chiropractic medicine, however they are not M.D.'s and there is the possibility you have something very serious wrong. These are my two cents worth. Cramping of the hands is often the result of a calcium problem. Drinking a big glaass of milk a day often solves the problem. If not try to get a prescription for quinine sulfate. Your doctor, upon request, will probably call this in to the pharmacy over the phone. The fact you are having weakness only in one side is a positive because neurological diseases are generally (but not always) systemic (there are exceptions) and do not produce focal symptoms. I strongly suspect a cervical etiology, specifically spinal stenosis. The EMG might come back negative if the problem were intermittant. Generally an MRI will detect such abnormalities. An x-ray is worthless. Requesting an MRI of the spine was a good idea and your physician was on the money. Are you sure you had an MRI and not just a CAT scan? My gut instinct tells me you have a pinched nerve based upon your presentation. There is one definitive method to perform a differential diagnosis. When you have your symptoms axial traction must be applied to your head. If the symptoms disappear you have a pinched nerve, regardless of what the MRI and the EMG results state. Because your physician did not perform this simple test, he loses three points and will have to spend an extra thirty days in purgatory. In addition he should have to pay an extra ten percent on his car insurance.

[Brian30]

Thank You very much for your reply. I did have an MRI with & without contrast a few weeks ago & I also had a myelogram & a catscan performed last Friday. I just received the results of my Myelogram & catscan & they were okay. I am very confused as to why all of these tests are coming back okay, but yet I have no strength in my right arm & hand accompanied by some atrophy. I have all strength in my tricep & shoulder, I just can't lift anything in a curling motion.

What exactly do you mean when you say axial traction?

Thanks!

[caregiver222]

Okey dokey. Axial traction is traction in line with the axis of the spine, directly upwards.  Lie down flat on the floor. Have your girlfriend/wife/mom/personal trainer place both hands on each side of your head. Have them exert force gently upwards in a line with the spine. If you have nobody purchase an axial traction device ($35), discard the water balloon, and hang it from a hook between doors. Put a chair under you and gentloy use the device to pull your head upwards. If the numbness and paralysis disappears you have a pinched nerve in the cervical area, which could explain all your symptoms.