Muscle Twitches and Nerve Sensitivity in the Arm

Tremor issues?

Hello Doctor: I am currently in the United States, and accessing healthcare is not very convenient.
I would like to request your assistance, thank you.
For the past five days, I have been experiencing involuntary twitching in the upper left arm, specifically in the bicep area.
Occasionally, I also notice twitching in the triceps or chest muscles.
The twitching occurs about five to ten times a day, lasting approximately five to ten seconds each time.
I feel some soreness in my left arm, but due to the recent pandemic, I haven't had much opportunity to use my left hand, as I have been working in front of the computer for extended periods.

Regarding the ulnar nerve, it has been quite sensitive over the past five days; any movement, pressure, or even light touch causes a tingling sensation that extends from my elbow to my ring and little fingers.
My muscles do not feel weak, but they do feel somewhat tense.
Sometimes, when I sleep on my side or press on my arm at other times, I can feel a pulsing sensation in the artery, which is more pronounced compared to my right arm.
I would like to ask if this is due to heightened nerve sensitivity or if there might be some nerve compression involved? Should I take any over-the-counter medication?

QQQ, 20~29 year old female. Ask Date: 2020/05/22

Dr. Jiang Junyi reply Neurology

Hello, based on your described symptoms, they are very similar to cervical myofascial pain syndrome.
Clinically, it often presents as pain in the affected area, discomfort, muscle stiffness, or a heavy sensation, and sometimes palpable myofascial trigger points can be felt under the skin.
Symptoms may worsen in the morning or with changes in weather, but can be alleviated with stretching activities, and they often recur.
During acute episodes, there may be local muscle tension and spasms, with limited mobility.
This may be due to prolonged poor posture with the head bent forward, leading to cervical spine curvature, narrowing, and deformity, which can compress the nerves responsible for shoulder pain between the fourth and fifth cervical vertebrae, as well as the nerves to the upper arm and fingertips between the fifth and sixth cervical vertebrae, resulting in numbness and weakness in both hands.
For treatment:
1.
Medication: When nerves are compressed, an inflammatory response occurs, leading to symptoms such as pain, numbness, and weakness.
Non-steroidal anti-inflammatory drugs (NSAIDs) are used for treatment, as they have both anti-inflammatory and analgesic effects, which can reduce inflammation and alleviate pain.

2.
Physical Therapy:
- Heat Therapy: Primarily increases local blood circulation and improves muscle ischemia.
- Shortwave and Ultrasound Therapy: Mainly promotes blood circulation in deeper tissues.
- Transcutaneous Electrical Nerve Stimulation (TENS) and Medium Frequency Interferential Current: Can provide local pain relief and alleviate tension in the neck and shoulders.
- Cervical Traction: Commonly used for degenerative cervical spondylosis, herniated discs (cervical osteophytes), with associated nerve root compression, and cervical injuries without fractures or joint instability.
Prior to traction, X-rays should be performed to confirm joint stability.
- Cervical Collar: Used to prevent cervical instability and avoid further nerve tissue damage, suitable for injuries such as those from sports, car accidents, or falls that lead to excessive flexion or extension of the cervical spine.
I recommend that upon your return to Taiwan, you consult with a rehabilitation specialist or a neurologist/neurosurgeon to discuss examination and treatment options.
Wishing you good health and peace.

Dr.
Jiang from the Department of Neurology at Taoyuan Hospital cares about you.

Reply Date: 2020/05/22

More Info

Understanding muscle twitches and nerve sensitivity in the arm can be quite complex, especially when considering the various factors that may contribute to these symptoms. Based on your description, it appears that you are experiencing muscle twitches (fasciculations) in your left upper arm, particularly in the biceps, along with some sensitivity in the ulnar nerve distribution, which affects the little finger and ring finger. Let’s break down the potential causes and considerations regarding your symptoms.

Muscle Twitches (Fasciculations)
Muscle twitches can occur for a variety of reasons. They are often benign and can be caused by:
1. Overuse or Fatigue: Even if you feel you haven’t used your arm much, prolonged periods of inactivity followed by sudden activity can lead to muscle fatigue, resulting in twitching.

2. Stress and Anxiety: Psychological factors can lead to increased muscle tension and twitching. If you’ve been under stress, this could contribute to your symptoms.

3. Nutritional Deficiencies: Deficiencies in certain vitamins and minerals, particularly magnesium, potassium, and calcium, can lead to muscle twitching.

4. Nerve Irritation or Compression: If a nerve is compressed or irritated, it can lead to twitching and sensitivity. This could be due to poor posture, especially if you’ve been spending long hours at a computer.

Nerve Sensitivity
The sensitivity you describe, particularly in the ulnar nerve distribution (from the elbow to the little and ring fingers), suggests that there may be some form of nerve irritation or compression. This could be due to:
1. Cubital Tunnel Syndrome: This occurs when the ulnar nerve is compressed at the elbow, leading to symptoms such as tingling, numbness, and weakness in the hand.

2. Cervical Radiculopathy: Nerve roots exiting the cervical spine can become compressed, leading to symptoms in the arm. This is often associated with neck issues, such as herniated discs or degenerative changes.

3. Thoracic Outlet Syndrome: This condition involves compression of nerves or blood vessels between the collarbone and the first rib, which can lead to similar symptoms.

Recommendations
1. Posture and Ergonomics: Ensure that your workstation is ergonomically set up to reduce strain on your neck and arms. Take regular breaks to stretch and move around.

2. Hydration and Nutrition: Ensure you are well-hydrated and consuming a balanced diet rich in essential vitamins and minerals.

3. Stress Management: Engage in relaxation techniques such as deep breathing, meditation, or yoga to help manage stress levels.

4. Over-the-Counter Medications: If you are experiencing discomfort, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help alleviate pain and inflammation. However, consult with a healthcare provider before starting any medication, especially if you have underlying health conditions or are taking other medications.

5. Consult a Healthcare Professional: Given the persistence of your symptoms, it may be wise to consult a neurologist or a healthcare provider specializing in musculoskeletal disorders. They may recommend diagnostic tests such as nerve conduction studies or electromyography (EMG) to assess nerve function and muscle activity.

Conclusion
While muscle twitches and nerve sensitivity can often be benign, they can also indicate underlying issues that may require further evaluation. It’s essential to listen to your body and seek medical advice if symptoms persist or worsen. Keeping track of any additional symptoms, such as weakness, pain, or changes in sensation, can provide valuable information for your healthcare provider.

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