Body Tingling: Possible Causes and Concerns

Tingling sensation in the body?

Hello, doctor.
Last night, I suddenly felt a tingling sensation on the left side of my torso, which went away while I was sleeping after about 4-5 hours.
I have experienced this symptom occasionally in the past, and it usually resolves within 1-2 days.
Today, my left pinky finger feels a bit numb, and my left arm is somewhat sore.
My toes feel strange, and my left back still feels a bit tight and odd.
Recently, since I tested positive for COVID-19 in early June, I have occasionally felt lower back pain or pain in my left thigh's front side and calf.
Sometimes, my left knee also hurts a bit.
The symptoms seem to move around and sometimes are not as pronounced.
I am concerned that this might indicate a serious underlying condition.

Two weeks after my diagnosis, I noticed some spots resembling petechiae on my calf and went to the hospital for an examination.
The doctor said it might be immune-mediated vasculitis.
I took steroids for a week and recovered.
I also had some blood tests and a urinalysis, most of which were normal, except for a positive cold agglutinin IgM (1+), positive cryofibrinogen, and RF IgM 13.92 (>6).
Since I tested negative for hepatitis B and C, I am worried about multiple myeloma and have asked my doctor for further blood tests to rule this out.

Recently, I also had an abdominal ultrasound, and the doctor mentioned some fatty liver and a 0.3 cm gallbladder polyp (which has been monitored for two years), while everything else was normal.
About seven or eight years ago, I had an MRI of my neck, which showed nerve compression at the C3-4-5 intervertebral discs, leading to finger numbness and arm pain.
At that time, rehabilitation helped me recover about 80%.
However, I stopped rehabilitation over time.
Recently, turning my neck to the left or downward causes tightness and some pain.
As for my lumbar spine, I have only had X-ray examinations, including radiography of the cervical spine (A-P view, lateral view), lumbar spine (flexion and extension lateral view), and KUB + lumbar spine lateral view (standing).
The findings showed less lordotic curvature of the cervical spine, disc space narrowing at the C3-4, C4-5, and C5-6 levels, disc space narrowing at the L4-5 and L5-S1 levels, anterior slip of L3-4 during flexion, and retrolisthesis of L1-2.

It seems that my health records indicate some issues with my lumbar spine, but the doctor in the clinic said it looked fine.
I would like to ask if my symptoms could indicate multiple sclerosis, or is it more likely to be multiple neuritis, or are they primarily related to issues with my cervical and lumbar spine?

Guang, 40~49 year old female. Ask Date: 2023/07/21

Dr. Jiang Junyi reply Neurology

Dear Mr.
Guang,
You mentioned, "Is it possible that it's multiple sclerosis, or is it multiple neuritis? ...
Could it be caused by issues with the cervical and lumbar spine?" Your symptoms may need to first consider problems with the cervical and lumbar spine.
The cervical spine may be compressing nearby nerve roots, leading to pain that can extend to the shoulders, arms, and hands, causing discomfort.

The diagnosis of multiple sclerosis is based on clinical history and examination, which shows multiple lesions in the nervous system.
A diagnosis of multiple sclerosis is made after excluding other diagnoses, and previous imaging typically reveals abnormal findings.

As for acute inflammatory demyelinating polyneuropathy, typical clinical symptoms include bilateral symmetric progressive weakness, limb pain, and tingling or mild sensory abnormalities in the hands and feet.
These symptoms may gradually worsen over a period of days to four weeks.

I recommend that you consult with a neurologist or a rehabilitation specialist to discuss examination and treatment options.
Thank you for your inquiry, and feel free to discuss any related questions further!
Wishing you good health and peace,
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2023/07/21

More Info

Understanding body tingling and related symptoms can be quite complex, especially when considering the various potential causes and underlying conditions. Based on your description, it seems you are experiencing a range of symptoms, including tingling sensations, pain, and discomfort in various parts of your body, particularly on the left side. These symptoms have been occurring intermittently and have been exacerbated since your COVID-19 diagnosis.

Firstly, it's important to recognize that tingling sensations, often referred to as "paresthesia," can arise from numerous causes. Some common reasons include nerve compression, poor circulation, vitamin deficiencies, and even anxiety. Given your history of cervical spine issues, it's plausible that your symptoms could be related to nerve compression or irritation in the cervical region. The cervical spine houses nerves that innervate the arms and hands, and any structural changes, such as disc herniation or degenerative changes, can lead to symptoms like tingling or numbness.

In your case, the MRI findings of disc space narrowing and retrolisthesis suggest that there may be some degree of nerve involvement. This could explain the tingling in your left hand and arm, as well as the discomfort in your back and legs. Additionally, the fact that you have experienced these symptoms intermittently over the years indicates a chronic issue that may require ongoing management.

The recent development of symptoms following your COVID-19 infection raises additional considerations. Some patients have reported neurological symptoms post-COVID, including tingling and muscle pain, which may be related to immune responses or inflammation. The mention of immune abnormalities and vasculitis following your COVID-19 diagnosis is particularly noteworthy. Vasculitis can lead to inflammation of blood vessels, potentially affecting nerve function and causing symptoms like tingling or pain.

Your concerns about serious conditions such as multiple sclerosis (MS) or polyneuropathy are understandable, especially given the complexity of your symptoms. MS is characterized by a range of neurological symptoms, including tingling, weakness, and coordination issues, often accompanied by MRI findings of lesions in the central nervous system. However, the presence of specific findings in your imaging studies and blood tests may help rule out MS. Polyneuropathy, on the other hand, can result from various factors, including diabetes, vitamin deficiencies, and autoimmune conditions, and may also present with similar symptoms.

Given your history of cervical spine issues, the potential for nerve involvement, and the recent complications following COVID-19, it would be prudent to consult with a neurologist. A thorough neurological examination, along with targeted imaging studies and possibly nerve conduction studies, can help clarify the underlying cause of your symptoms. Additionally, addressing any potential vitamin deficiencies or metabolic issues may also be beneficial.

In summary, while your symptoms may be related to cervical spine issues, the recent onset and nature of your symptoms warrant further investigation to rule out other potential causes, including post-viral syndromes or autoimmune conditions. It's essential to work closely with your healthcare provider to develop a comprehensive management plan that addresses both your physical and emotional well-being.

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