Neck Pain, Numbness, and Facial Twitching: When to Seek Advanced Care

Q: Neck Pain, Numbness, and Facial Twitching: When to Seek Advanced Care

Hello, Sir： You mentioned experiencing "tingling in the left foot" and "intermittent electric shock-like sensations and pain in the muscles on both sides of the neck (right side)." Based on your description, it may be necessary to consider cervical spine disorders. <br>Typical di

Neck issues, numbness in the limbs, facial nerve twitching?

Initially, I experienced tightness in my shoulders and neck along with numbness in my hands (more severe in the right hand).
Subsequently, I began to feel numbness in my left foot, and the muscles on both sides of my neck occasionally feel like electric currents running through them, sometimes accompanied by pain (on the right side).
Now, the facial nerves on the right side of my face have started to twitch involuntarily.
When the hand numbness began, I visited a physical therapy clinic and a neurology department at a hospital (where they only performed simple tests like raising my arms and legs and tapping to check reflexes without any further examinations, stating it was a modern civilization disease).
I also consulted a rehabilitation department (where I underwent cervical traction), but none of these treatments have been effective.
My job requires me to lift heavy objects and use a computer, and I often stand for long periods.
Additionally, I frequently use my phone and sit for extended periods.
Should I consider undergoing more advanced examinations, or is it sufficient to just rest and relax? Thank you.

zero, 30~39 year old female. Ask Date: 2023/02/27

Dr. Jiang Junyi reply Neurology

Hello, Sir: You mentioned experiencing "tingling in the left foot" and "intermittent electric shock-like sensations and pain in the muscles on both sides of the neck (right side)." Based on your description, it may be necessary to consider cervical spine disorders.
Typical discomfort symptoms associated with cervical radiculopathy include pain in the shoulder or arm, as well as numbness, tingling, and weakness in the palm and fingers.
As for the tingling in the left foot, it may be necessary to first consider compression of the lumbar nerve roots.

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) can be used for treatment, as they have both anti-inflammatory and analgesic effects, reducing the inflammatory response and alleviating 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 interferential current therapy: Can provide local pain relief and alleviate tension and discomfort in the neck and shoulders.
4.
Cervical traction: Commonly used for degenerative cervical arthritis, herniated discs (cervical osteophytes), with concurrent nerve root compression, as well as cervical injuries without fractures or joint instability, and when there is nerve compression.
Cervical traction can be utilized for rehabilitation, but X-ray examination is required beforehand to confirm joint stability.
Nerve injury requires laboratory diagnostic assistance to determine the location and severity of the nerve damage, which helps in assessing prognosis and deciding on treatment principles.
The tools that can definitively diagnose nerve injury include nerve conduction studies and electromyography (EMG).
In particular, EMG can utilize needle electrodes to assess whether there is nerve damage in the relevant areas.
I recommend that you consult with a neurologist or a rehabilitation physician to discuss examination and treatment options.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health, peace, and happiness.

Dr.
Jiang Junyi, Taoyuan Medical Center, cares about you.

Reply Date: 2023/02/27

More Info

When experiencing symptoms such as neck pain, numbness in the arms and legs, and facial twitching, it is essential to take these signs seriously and consider seeking advanced medical care. Your symptoms suggest a potential underlying issue that may require further investigation, especially given the progression from localized discomfort to more widespread neurological symptoms.

Initially, the tightness in your neck and the numbness in your hands, particularly the right hand, could indicate a cervical spine issue, such as a herniated disc or cervical radiculopathy. These conditions can compress the nerves that exit the spinal column, leading to pain, numbness, and weakness in the arms and legs. The fact that you are now experiencing numbness in your left foot and electrical sensations in the muscles on both sides of your neck raises the concern for more extensive nerve involvement.

Facial twitching, particularly on one side, can be indicative of several conditions, including facial nerve irritation or dysfunction. This could be related to cervical spine issues, but it may also suggest other neurological conditions that need to be ruled out. Given that you have already consulted with physical therapy and neurology without significant improvement, it may be time to consider more advanced diagnostic imaging, such as an MRI of the cervical spine and brain. These imaging studies can help identify any structural abnormalities, such as herniated discs, spinal stenosis, or lesions that may be affecting nerve function.

In addition to imaging, it may be beneficial to undergo nerve conduction studies or electromyography (EMG). These tests can evaluate the electrical activity of your muscles and the speed of nerve conduction, helping to pinpoint the source of your symptoms. If there is evidence of nerve compression or damage, this information can guide treatment options.

Your work environment, which involves heavy lifting and prolonged computer use, may contribute to your symptoms. Poor ergonomics, repetitive strain, and physical stress can exacerbate neck and upper extremity issues. It is crucial to assess your posture and work habits, ensuring that you have a supportive workstation and take regular breaks to stretch and move.

While rest and relaxation are important, they may not be sufficient if there is an underlying structural or neurological issue. Therefore, I recommend that you seek a comprehensive evaluation from a neurologist or a spine specialist who can perform a thorough examination and recommend appropriate imaging and tests. Early intervention can prevent further complications and improve your quality of life.

In summary, given the progression of your symptoms and their impact on your daily activities, it is advisable to pursue advanced care. This may include imaging studies and nerve assessments to identify the root cause of your discomfort and guide effective treatment strategies. Remember, addressing these symptoms early can lead to better outcomes and prevent chronic issues.

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