Right Leg Tightness and Hand Numbness: Possible Causes and Solutions

Q: Right Leg Tightness and Hand Numbness: Possible Causes and Solutions

Hello： 1. <br>The hand <the right hand also feels a bit prone to numbness, particularly the ring and little fingers...> is mainly due to nerve compression in the hand. <br>It may also be caused by cervical spine issues, and a nerve conduction study (NCS) is needed for differentia

There is an abnormal tightness sensation in the right thigh, accompanied by slight numbness in the hand?

Hello Dr.
Lai, I would like to ask if you could help me with a preliminary diagnosis of my condition.
It started around February of last year, and my current symptoms include stiffness in my right leg, with occasional tightness.
Initially, it was localized to the inner thigh of my right leg, but it has now extended throughout the entire leg, most noticeably after getting out of bed in the morning.
In the past month, I have also experienced some numbness in my right hand, particularly in the ring and little fingers, which feels like poor circulation, somewhat stiff, but it does not affect functionality—it's hard to describe.
I experience leg numbness after sitting on the toilet for just a few minutes, and I often wake up in the morning with both hands numb.
I also wake up with numb hands after sleeping on the train.
(Additionally, I have been dealing with unexplained constipation, which started about a year and a half ago, and I am currently taking Movicol to relieve the symptoms.)
Notes:
1.
In February of last year, while sitting in a chair with my legs crossed, I experienced significant numbness in my hands and feet, which disappeared after I got up.
After that, I had several months of sciatica, which resolved after I did some stretching exercises.

2.
In April of last year, I had X-rays taken from my cervical spine to my sacrum, which showed no issues.

3.
There is no pain in my legs, and I can move normally.

I would like to ask:
1.
What could be the underlying issue?
2.
Currently, a doctor in Australia has ordered a CT scan of my lumbosacral spine.
I would like to know if my symptoms warrant this, and whether an MRI could achieve the same results (as I want to avoid unnecessary radiation).

3.
If there is an issue with my lower back, could it be related to the numbness in my hands? (I want to ensure that the correct area is being examined, especially if a CT scan is necessary.)
Thank you very much for your time, and I look forward to your response.

Xiao Xiao, 40~49 year old female. Ask Date: 2019/08/03

Dr. Lai Zhaokang reply Neurosurgery

Hello: 1.
The hand is mainly due to nerve compression in the hand.
It may also be caused by cervical spine issues, and a nerve conduction study (NCS) is needed for differentiation.
/// For the right thigh and calf, lumbar nerve compression causing sciatica should be considered first.
2.
For spinal issues, MRI (Magnetic Resonance Imaging) provides clearer images than CT and involves less radiation.
If you return to Taiwan, it can be covered by health insurance.
3.
and : are unrelated.
Best wishes.
// Dr.
Lai Chao-Kang, Chief of Neurosurgery and Spine Surgery, Changhua Hospital.

Reply Date: 2019/08/03

More Info

Your symptoms of right leg tightness and hand numbness are indeed concerning and warrant a thorough evaluation. Based on your description, there are several potential causes for your symptoms, and I will address them in detail.

1. Possible Causes of Right Leg Tightness: The tightness you feel in your right leg, particularly in the inner thigh and extending throughout the leg, could be due to several factors. One possibility is muscle tightness or strain, which can occur from prolonged sitting or improper posture. Another potential cause could be related to nerve compression, particularly if you have experienced sciatica in the past. The sciatic nerve runs from the lower back down the legs, and any irritation or compression along this pathway can lead to sensations of tightness or discomfort in the leg.

2. Hand Numbness and Circulation Issues: The numbness in your right hand, particularly in the ring and little fingers, raises the possibility of ulnar nerve involvement. The ulnar nerve runs along the inner side of the arm and can become compressed at the elbow (cubital tunnel syndrome) or wrist (Guyon's canal syndrome). This could explain the numbness and the feeling of poor circulation in those fingers. Additionally, the fact that you experience numbness upon waking or after sitting for extended periods suggests that your posture or positioning may be contributing to nerve compression.

3. Connection Between Leg and Hand Symptoms: You asked whether issues in your lower back could affect your hand symptoms. Yes, they can be interconnected. Conditions such as a herniated disc or spinal stenosis in the lumbar region can lead to nerve root compression, which may manifest as symptoms in both the legs and arms, depending on the specific nerves affected. For instance, if there is a problem in the lumbar spine, it could potentially lead to referred symptoms in the upper extremities.

4. Diagnostic Imaging: Regarding your question about the appropriateness of a CT scan versus an MRI, both imaging modalities have their uses. A CT scan is excellent for visualizing bone structures and can help identify issues like fractures or significant degenerative changes. However, an MRI is superior for evaluating soft tissues, including nerves, discs, and muscles. If your symptoms suggest nerve involvement, an MRI might provide more relevant information without the radiation exposure associated with a CT scan. Discussing this with your physician is essential, as they can guide you based on your specific clinical scenario.

5. Constipation and Its Potential Link: You mentioned experiencing constipation for over a year. While this may seem unrelated, chronic constipation can sometimes be associated with nerve issues or pelvic floor dysfunction. If the nerves that control bowel function are affected, it could lead to both constipation and other neurological symptoms.
In summary, your symptoms could stem from a combination of muscular, neurological, and possibly structural issues. It is crucial to follow up with your healthcare provider, who may recommend further diagnostic tests, such as an MRI, to clarify the situation. Additionally, physical therapy may be beneficial for addressing muscle tightness and improving posture, which could alleviate some of your symptoms.
Please ensure to keep track of your symptoms and discuss any changes with your doctor, as this will aid in forming a comprehensive treatment plan tailored to your needs.

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