Numbness and Pain in Limbs: A Neurological Perspective

Q: Numbness and Pain in Limbs: A Neurological Perspective

Hello： Based on your description, it may be necessary to consider spinal-related diseases. <br>Excessive force during neck rotation and other external factors may lead to cervical instability, dislocation, and cervical disc herniation. <br>Typical symptoms of lumbar nerve root pa

Numbness in the limbs?

Since I woke up last Friday morning (I usually sleep on my left side and mostly sit during work hours), it has been four days.
When I walk, I feel pain in my legs, particularly behind my knees, which worsens with bending my legs.
The pain is more pronounced in my calves (including walking and going up and down stairs).
When standing, my feet hurt, but sitting provides some relief; however, I experience numbness in my lower limbs.
There is also a sensation of numbness in my extremities (more noticeable in the lower body), and I feel tightness from my waist down to the back of my knees.
When performing detailed tasks, my hands tremble involuntarily, but this does not occur when I am typing on the computer or not using my upper arms.
Sometimes, when lying down or sitting, I feel an involuntary warmth around my knees.
Currently, if I suddenly stop while walking, I experience more severe pain that takes some time to alleviate.
All these issues are bilateral, but comparatively, the left side is somewhat more severe, though not significantly.
When I sleep on my stomach, I feel tightness at the upper part of my neck.
I hope the doctor can provide some answers.
Thank you very much!

Qing, 20~29 year old female. Ask Date: 2021/01/25

Dr. Jiang Junyi reply Neurology

Hello: Based on your description, it may be necessary to consider spinal-related diseases.
Excessive force during neck rotation and other external factors may lead to cervical instability, dislocation, and cervical disc herniation.
Typical symptoms of lumbar nerve root pathology include pain radiating from the buttocks down to the lower limbs, as well as numbness, tingling, and weakness in the toes.
If there are changes in the cervical joints, it can cause neck pain and stiffness, resulting in pain due to compression of nearby nerve roots, which may even extend to the shoulders, arms, and hands, causing discomfort.

Treatment can be divided into pharmacological therapy: 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 the inflammatory response and alleviate pain.

Physical therapy includes:
1.
Heat therapy: Primarily increases local blood circulation and improves muscle ischemia.

2.
Shortwave and ultrasound therapy: Mainly promotes blood circulation in deeper tissues.

3.
Transcutaneous electrical nerve stimulation (TENS) and medium-frequency vector interference waves: Can provide local pain relief and alleviate tension in the neck and shoulders.

4.
Spinal traction: Commonly used for degenerative arthritis of the cervical or lumbar spine, herniated discs (bone spurs), with concurrent nerve root compression, spinal injuries without fractures or joint instability, and nerve compression.
Spinal traction can be utilized for rehabilitation, but X-ray examination is required beforehand to confirm joint stability.

However, if the numbness in the nerves rapidly extends upward, acute demyelinating polyneuropathy may need to be considered, which is a neurological emergency.
Immediate medical attention in the emergency department is necessary.
It is advisable to consult with a neurologist or a rehabilitation physician for examination and treatment.
Due to the recent COVID-19 pandemic, please ensure self-protection and sanitation before and after seeking medical care.
Wishing you good health and safety.

Best regards,
Dr.
Jiang, Department of Neurology, Taoyuan Hospital

Reply Date: 2021/01/25

More Info

Understanding numbness and pain in the limbs can be quite complex, especially when considering the interplay between neurological and musculoskeletal factors. Your symptoms, which include pain in the legs, numbness, and a feeling of tightness from the waist down to the knees, suggest that there may be multiple underlying issues at play.

Firstly, the pain you experience when changing positions or walking could indicate a mechanical issue, such as a problem with the lumbar spine or the surrounding musculature. Conditions like lumbar disc herniation or spinal stenosis can lead to nerve root compression, which may manifest as pain, numbness, or weakness in the legs. The fact that you feel relief when sitting but experience pain when standing or walking could further support this idea, as sitting often alleviates pressure on the lumbar spine.

The tightness you describe from the waist to the knees could be due to muscle tension or spasms, which can occur as a protective response to pain or discomfort. This tightness may also contribute to the numbness you feel in your lower limbs, as tight muscles can compress nerves and restrict blood flow, leading to sensations of numbness or tingling.

Moreover, the tremors you experience in your hands during fine motor tasks could suggest a neurological component. While it may not be directly related to your leg symptoms, it is essential to consider that neurological issues can manifest in various ways, including tremors, weakness, and sensory changes. The fact that these tremors occur during specific activities may indicate a need for further evaluation of your neurological health.

In terms of the bilateral nature of your symptoms, it is not uncommon for conditions affecting the spine or peripheral nerves to produce symptoms on both sides of the body. However, the fact that your left side seems to be more affected could indicate a more pronounced issue on that side, possibly related to muscle imbalances or nerve involvement.

Given the complexity of your symptoms, it is crucial to pursue a comprehensive evaluation. A thorough neurological examination, including imaging studies like MRI or CT scans, may be necessary to assess for any structural abnormalities in the spine or potential nerve compression. Additionally, nerve conduction studies or electromyography (EMG) could help identify any peripheral nerve issues.

In the meantime, conservative management strategies may help alleviate your symptoms. Physical therapy focusing on strengthening the core and lower back muscles, as well as stretching tight muscles, could be beneficial. Additionally, practicing good posture, especially while sitting at work, can help reduce strain on the spine and improve overall comfort.

If your symptoms persist or worsen, it is essential to follow up with a healthcare provider who specializes in neurology or pain management. They can provide a more tailored approach to your treatment and help identify any underlying conditions that may require specific interventions.

In summary, your symptoms of numbness and pain in the limbs could stem from a combination of mechanical and neurological factors. A thorough evaluation by a healthcare professional is crucial to determine the underlying causes and develop an appropriate treatment plan.

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