Limb Numbness and Muscle Weakness: A Rehabilitation Perspective

Numbness in the limbs and muscle weakness?

Hello, doctor.
I would like to ask you about the issue of numbness and weakness in my limbs.
Since around August 2015, I have gradually experienced some discomfort.
Initially, I would feel a tingling sensation in the extremities whenever I tilted my neck backward, which could last for a long time, at least half a day.
Then, after 2 to 3 months (around November 2015), the tingling and numbness became constant throughout the day, and I noticed a significant decrease in my ability to feel the ground under my feet, making it feel as if I wasn't stepping on the ground while walking.
I visited the Neurology Department at Kaohsiung Medical University, where I underwent a cervical X-ray and nerve conduction studies for both feet.
The reports showed no significant abnormalities.
After another 2 months (February 2016), I found that I could no longer manage jogging or jumping, and I occasionally tripped while walking.
Wearing flip-flops became difficult as they would easily slip off, and my sensitivity in the soles of my feet worsened; sometimes I wouldn't even notice stepping on small objects.
I then went to the Orthopedic Department at Chung Cheng Hospital for further evaluation.
An MRI of my lumbar spine revealed slight compression at the fourth and fifth intervertebral discs.
I am currently receiving treatment in the Rehabilitation Department.
I would like to ask if there are any tests that I might have overlooked, or if the areas and directions of the tests conducted are appropriate.
Now, even squatting gives me a feeling of almost falling.
Thank you, doctor.

Mai Te, 20~29 year old female. Ask Date: 2016/04/23

Dr. Zhou Jianwen reply Rehabilitation

It is suspected to be a problem with the cervical spine muscles.

Reply Date: 2016/04/23

More Info

Understanding limb numbness and muscle weakness can be complex, especially when considering the various underlying causes and the rehabilitation process involved. Based on your description, it seems that you have been experiencing progressive symptoms of numbness and weakness in your limbs, which have significantly impacted your daily activities and mobility.

Initially, the symptoms began with a tingling sensation in your extremities when you tilted your neck backward, which then evolved into persistent numbness and a decreased sense of touch in your feet. This progression is concerning, especially since it has led to difficulties with balance, coordination, and even basic movements like running and jumping. The fact that you have undergone various diagnostic tests, including X-rays and nerve conduction studies, without significant findings suggests that the issue may not be straightforward.

Given your symptoms and the MRI findings indicating slight compression at the fourth and fifth lumbar vertebrae, it is possible that you are experiencing a condition related to nerve compression or irritation, such as lumbar radiculopathy. This condition occurs when a nerve root in the lumbar spine is compressed, leading to symptoms that can include pain, numbness, and weakness in the legs. The fact that your symptoms have worsened over time and are now affecting your ability to perform daily activities is a critical factor to address in your rehabilitation.

In terms of rehabilitation, it is essential to focus on a comprehensive approach that includes physical therapy, which can help improve strength, flexibility, and coordination. A physical therapist can design a tailored exercise program that addresses your specific weaknesses and helps to alleviate any discomfort associated with your symptoms. This may include exercises to strengthen the core and lower extremities, improve balance, and enhance proprioception (the sense of body position).

Moreover, it is crucial to ensure that any underlying conditions, such as cervical or lumbar spine issues, are adequately managed. If you have not already done so, consider consulting with a neurologist or a spine specialist who can provide further insights into your condition and recommend additional diagnostic tests if necessary. Tests such as an electromyography (EMG) can help assess the electrical activity of your muscles and determine if there is any nerve damage.

Additionally, if conservative measures do not yield improvement, further interventions may be warranted. This could include epidural steroid injections to reduce inflammation around the affected nerves or, in some cases, surgical options to relieve nerve compression.

In summary, your symptoms of limb numbness and muscle weakness warrant a thorough evaluation and a structured rehabilitation plan. Engaging with healthcare professionals who specialize in neurology and rehabilitation will be crucial in addressing your concerns and improving your quality of life. It is essential to remain proactive in your treatment and communicate openly with your healthcare team about your symptoms and any changes you experience.

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