Body Tingling: Causes and When to Seek Help

Tingling sensation in the body?

Hello, doctor.
I have been experiencing tinnitus, general weakness, and tightness along my neck, shoulders, and legs, along with numbness and pain.
I consulted a neurosurgeon and had a cervical MRI, which showed degeneration and bone spurs, but there was no nerve compression.
I was then referred to a rehabilitation specialist, who believes my issues are related to overuse, specifically myofascial and muscular problems.
Currently, I have pain in one elbow that swells and feels numb when bent for too long, and I am unsure if this could be tennis elbow.
Additionally, my heels continue to hurt and sometimes feel warm, and while sitting, my calves experience numbness and swelling.
My feet also hurt even when lying down, and occasionally my hips hurt.
I am resting, undergoing rehabilitation, and trying to avoid standing for long periods.

Could there be other causes for my symptoms besides those mentioned, such as nerve or vascular issues? Can myofascial or muscle tightness lead to various strange symptoms, like systemic imbalance? Which type of clinic would be best to consult for these issues?

Ahao, 40~49 year old female. Ask Date: 2022/03/13

Dr. Jiang Junyi reply Neurology

Dear Mr.
Ahao,
You mentioned symptoms such as "tinnitus, generalized weakness, tightness and numbness in the neck, shoulders, and legs...
pain in one elbow, swelling and tingling after prolonged bending." Your symptoms are more indicative of peripheral nerve injury.
This may be related to nerve traction, tearing, sustained muscle contraction and tightness, hypertrophy, or edema causing nerve compression.
The issues may arise from prolonged fixed positions, repetitive motions over time, or excessive training, which includes prolonged sitting, standing, or exercising, all of which can lead to peripheral nerve compression.
Additionally, scar tissue or old injuries may also be sources of nerve compression.
Common symptoms of peripheral nerve compression include: pain, numbness, and weakness.
Typical symptoms include:
1.
Pain characterized by burning or electric sensations.
2.
Symptoms with a specific dermatomal distribution, which can be triggered by touch or pressure.
3.
Accompanied by muscle soreness and weakness.
For examination:
1.
Nerve conduction studies utilize very fine electrical currents to stimulate the nerves, assessing their response and the extent of injury.
2.
Electromyography (EMG) involves inserting needle electrodes to understand whether there is any nerve damage.
I recommend consulting a neurologist specializing in peripheral nerves, as they have more experience with EMG diagnostics.
Thank you for your inquiry.
If you have further questions, feel free to discuss!
Wishing you good health and peace,
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2022/03/13

More Info

Understanding body tingling and associated symptoms can be complex, especially when multiple factors are involved. Based on your description, it seems you are experiencing a range of symptoms including tinnitus (ear ringing), generalized weakness, tightness and tingling in your neck, shoulders, and legs, along with localized pain in your elbow and heel. You have already consulted with a neurosurgeon and a rehabilitation specialist, who have provided insights into potential causes related to degenerative changes in the cervical spine and overuse injuries.

Possible Causes of Your Symptoms
1. Cervical Spine Issues: The MRI findings of degeneration and bone spurs in your cervical spine could contribute to your symptoms. Even if there is no direct nerve compression, inflammation or irritation in the surrounding tissues can lead to referred pain and tingling sensations in the arms and legs.

2. Muscle and Fascia Problems: As your rehabilitation doctor suggested, overuse injuries can lead to muscle strain and myofascial pain syndrome. This condition can cause tightness and discomfort in various muscle groups, which may explain the sensations you are experiencing in your neck, shoulders, and legs.

3. Tendonitis or Bursitis: The pain in your elbow, especially if it worsens with certain movements, could indicate conditions like tennis elbow (lateral epicondylitis) or other forms of tendonitis. These conditions can cause localized pain and may also lead to referred sensations in the arm.

4. Peripheral Nerve Issues: Tingling and numbness can also arise from peripheral nerve issues, such as carpal tunnel syndrome or ulnar nerve entrapment, especially if you have repetitive strain in your arms or hands.

5. Circulatory Problems: Symptoms like swelling and tingling in your legs could suggest vascular issues, such as venous insufficiency or even deep vein thrombosis (DVT), particularly if you have prolonged periods of immobility.

6. Systemic Conditions: Conditions such as diabetes, hypothyroidism, or vitamin deficiencies (like B12) can also lead to neuropathy and generalized weakness. If you have not had these conditions ruled out, it may be worth discussing with your healthcare provider.

When to Seek Further Help
Given the complexity of your symptoms, it is crucial to monitor your condition closely. Here are some indicators that you should seek further medical evaluation:
- Worsening Symptoms: If your symptoms become more severe or if you experience new symptoms such as loss of coordination, significant weakness, or changes in bowel or bladder function, you should seek immediate medical attention.

- Persistent Pain: If the pain in your elbow or heel does not improve with rest and rehabilitation, or if it begins to interfere with your daily activities, a follow-up with an orthopedic specialist may be warranted.

- Neurological Symptoms: If you experience any signs of neurological compromise, such as sudden numbness, difficulty speaking, or visual disturbances, seek emergency care.

Recommended Specialists
For your symptoms, consider consulting the following specialists:
- Orthopedic Surgeon: For evaluation of your elbow and heel pain, especially if conservative treatments do not yield improvement.

- Neurologist: If you have concerns about nerve-related issues or if your symptoms suggest a neurological condition.

- Physical Therapist: A physical therapist can help you with rehabilitation exercises tailored to your specific needs, focusing on strengthening and flexibility to alleviate muscle tightness and improve function.

- Rheumatologist: If there is a suspicion of systemic conditions affecting your joints and muscles, a rheumatologist can provide further evaluation.

Conclusion
In summary, your symptoms may stem from a combination of musculoskeletal issues, nerve irritation, and possibly vascular concerns. It is essential to maintain open communication with your healthcare providers and to advocate for further evaluation if your symptoms persist or worsen. With the right approach, many of these issues can be managed effectively, allowing you to regain function and improve your quality of life.

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