Right-Sided Numbness: Possible Causes and Solutions

Continued inquiry: The right side of the limbs is experiencing numbness?

Hello Doctor, I have been experiencing numbness in my right hand and right foot for the past six months.
It tends to improve after I get up and move around.
However, I do experience pain in my lower back, which only occurs when I lean back or bend forward.
I have undergone numerous tests, but the cause remains unidentified.
My blood tests are normal, and I have had a carotid ultrasound, cervical MRI (with contrast), head CT scan (with contrast), nerve conduction studies, and lumbar X-rays.
There is a thyroid nodule, but a biopsy confirmed it is benign with no hyperthyroidism or hypothyroidism.
All other tests have returned normal results.
I feel relatively normal only right after waking up, but throughout the day, my left and right limbs feel different.
I do not experience weakness in my right hand or foot, but the sensations are more pronounced in the palms of my hands and feet, with some sensation in my calves and thighs, and slight sensation below my elbows.
The symptoms include tingling and numbness, but the cause remains elusive.
What could be wrong with me?
Response from Neurology / Dr.
Jiang Junyi, 2016/09/22: Based on your description, your symptoms improve after moving, which raises the question of whether you have been tested for ankylosing spondylitis.
Additionally, current imaging tests have a limitation; they do not provide dynamic analysis.
For instance, does your intervertebral disc compress the nerve roots when you are standing in the afternoon? I recommend changing positions frequently—every 15 minutes—to allow your back tissues to rest.
Maintaining a position for too long can lead to fatigue and inflammation in the tissues, so moving around briefly can reduce the chance of muscle inflammation.
After the acute pain phase, it is advisable to develop a routine of gentle stretching every 15-20 minutes at angles that do not cause discomfort in your back.
Additional information: I am 168 cm tall and weigh 54 kg, with no hypertension.
My symptoms initially started with numbness in my feet, which later extended to my right hand, with the palms being the most affected.
Currently, I feel numbness in my right limbs, with the sensation being less pronounced closer to my body.
The symptoms have been more noticeable over the past two months.
The CT and MRI scans were performed at Yuan General Hospital between February and March of this year, while my symptoms began in early November of last year.
Since I am from Qishan, I would like to consult Dr.
Lan regarding my symptoms, which closely resemble those of a stroke.
I wonder if your hospital can conduct tests to rule out stroke-related symptoms, even if it requires out-of-pocket expenses.
Although the symptoms are not severely painful and do not affect my work, they are concerning, and I only feel relatively normal for a few hours after waking up in the morning, with the sensations being most pronounced in my palms and soles.

Xue Xiansheng, 30~39 year old female. Ask Date: 2016/09/26

Dr. Lan Shengxing reply Neurology

Experiencing unusual sensations that do not affect daily life or work may not necessarily indicate a condition that requires treatment or intervention.
Generally, those who feel concerned about such sensations tend to be more sensitive than the average person, so it is recommended to spend more time outdoors.
As for ruling out a stroke, a self-funded brain MRI would suffice.

Reply Date: 2016/09/26

More Info

Understanding right-sided numbness, particularly when it is accompanied by pain in the lower back, can be complex and multifactorial. Based on the symptoms you've described, there are several potential causes that could be contributing to your condition.

Firstly, the numbness in your right hand and foot, which seems to improve with movement, may suggest a neurological issue, possibly related to nerve compression or irritation. Conditions such as a herniated disc in the lumbar spine can lead to nerve root compression, resulting in symptoms like numbness, tingling, or pain radiating down the legs. Since you mentioned that the pain in your lower back is exacerbated by bending or arching backward, this could indicate that the lumbar spine is involved, potentially affecting the nerves that innervate the lower extremities.

Additionally, the fact that your symptoms began in your feet and have progressed to include your right hand suggests that there may be a systemic issue at play. Conditions such as multiple sclerosis or peripheral neuropathy could lead to similar symptoms. However, given that you have undergone extensive testing—including blood tests, imaging studies, and nerve conduction studies—these conditions may have been ruled out.

Another possibility to consider is the role of posture and ergonomics in your daily activities. Poor posture, especially during prolonged sitting or standing, can lead to muscle fatigue and nerve compression. It is advisable to take frequent breaks to change positions, as you have already been advised. Incorporating stretching exercises into your routine can also help alleviate muscle tension and improve circulation, potentially reducing numbness and discomfort.

You mentioned that your symptoms are most pronounced after waking up, which could indicate that your sleeping position is contributing to nerve compression. It may be beneficial to evaluate your mattress and pillow, ensuring they provide adequate support for your spine and neck. Sometimes, sleeping on your back or side with proper alignment can help alleviate morning symptoms.

Given your concern about the possibility of a stroke, it is crucial to consider the risk factors associated with cerebrovascular accidents. While your symptoms do not seem to align perfectly with typical stroke presentations, it is always wise to consult a healthcare professional for a thorough evaluation. If you are experiencing any sudden changes in your symptoms, such as weakness, difficulty speaking, or severe headaches, seek immediate medical attention.

In conclusion, while your symptoms of right-sided numbness and lower back pain may stem from various causes, including nerve compression, posture-related issues, or even systemic conditions, a comprehensive evaluation by a neurologist or orthopedic specialist is recommended. They can provide a more targeted approach to diagnosis and treatment, potentially including physical therapy, medication for pain management, or further imaging studies if necessary. Remember to maintain an active lifestyle, practice good posture, and listen to your body’s signals to manage your symptoms effectively.

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