Occasional Numbness and Tingling in Limbs: Causes and Concerns

Occasional tingling or numbness in the hands and feet?

Hello doctor, last week I experienced soreness in my left eye for four to five days and consulted a physician who mentioned that my eyes were fatigued.
During this time, I occasionally felt tingling sensations in my left arm and fingers, with varying durations—sometimes it resolved quickly, while other times it lasted for a few hours.
Additionally, I sometimes felt soreness in my left leg.
From yesterday to today, I have experienced similar sudden tingling sensations in my right arm and fingers, which sometimes feel like goosebumps, but they also resolve after a while.
My right calf and ankle have a bit of soreness as well.

I previously underwent an MRI that confirmed a herniated disc at the C3-C4-C5 levels with nerve compression.
An X-ray of my lumbar spine indicated mild disc narrowing, but it was not severe.
In the past, I experienced pain and occasional numbness in my left arm and fingers, as well as some discomfort in my left foot and toes.
After undergoing rehabilitation, there was improvement; however, most of my symptoms were primarily on the left side, with very few symptoms on the right side.
Recently, I have noticed similar symptoms on the right side, but they are much milder compared to the left side previously.

I would like to ask if these symptoms are primarily related to cervical spine issues, or could they possibly be early signs of multiple sclerosis? Do symptoms typically present bilaterally?

Zhe, 40~49 year old female. Ask Date: 2023/07/29

Dr. Jiang Junyi reply Neurology

Hello Mr.
Zhe,
You mentioned that "the right side has somewhat similar symptoms," which may still warrant consideration of spinal nerve root compression.
Additionally, cerebrovascular diseases should also be ruled out.
Multiple sclerosis is considered a rare disease in Taiwan.
I recommend that you consult a neurologist to discuss examination and treatment options.
Thank you for your inquiry, and feel free to discuss any related questions further! Wishing you good health, safety, and happiness.
Dr.
Jiang Junyi, Tao Medical Center, cares about you.

Reply Date: 2023/07/29

More Info

Understanding the symptoms you are experiencing, particularly the occasional numbness and tingling in your limbs, is crucial for determining the underlying cause and appropriate treatment. Based on your description, it seems that you have a history of cervical disc herniation at the C3-C4-C5 levels, which can lead to nerve compression and resultant symptoms in the upper limbs. The fact that you have previously experienced similar symptoms primarily on the left side, but are now noticing them on the right side, raises some important considerations.

Potential Causes of Your Symptoms
1. Cervical Disc Herniation: Given your history, it is quite possible that the cervical disc herniation is contributing to your current symptoms. When a disc herniates, it can press on nearby nerves, leading to pain, numbness, or tingling in the arms and hands. The fact that you are experiencing symptoms on both sides now could indicate that the condition is affecting multiple nerve roots or that there is a change in your posture or activity that is exacerbating the issue.

2. Nerve Compression: The symptoms you describe, such as tingling and a sensation similar to "pins and needles," are often associated with nerve compression. This can occur not only from herniated discs but also from other conditions such as cervical spondylosis or even thoracic outlet syndrome, where nerves or blood vessels are compressed in the neck or shoulder area.

3. Peripheral Neuropathy: While less likely given your history, peripheral neuropathy could also cause similar symptoms. This condition can arise from various factors, including diabetes, vitamin deficiencies, or autoimmune diseases.

4. Multiple Sclerosis (MS): You mentioned concerns about MS, which is a demyelinating disease that can cause a wide range of neurological symptoms, including numbness and tingling. However, MS typically presents with additional symptoms such as vision problems, muscle weakness, and coordination issues. The bilateral nature of your symptoms could align with MS, but it is essential to consider other more common causes first.

Recommendations for Further Evaluation
1. Neurological Examination: It would be prudent to undergo a thorough neurological examination by a specialist. This can help determine if there are any signs of nerve damage or dysfunction.

2. Imaging Studies: An MRI of the cervical spine may be warranted to assess the current state of your cervical discs and any potential nerve root compression. If there are new changes compared to previous imaging, this could explain the new symptoms.

3. Electromyography (EMG) and Nerve Conduction Studies: These tests can help evaluate the function of your nerves and muscles, providing insight into whether there is any nerve damage or compression.

4. Monitoring Symptoms: Keep a detailed log of your symptoms, noting when they occur, their duration, and any activities that seem to trigger or alleviate them. This information can be invaluable for your healthcare provider.

5. Physical Therapy: If your symptoms are indeed related to cervical spine issues, physical therapy focusing on neck and shoulder strengthening and flexibility may help alleviate some of the pressure on the nerves.

Conclusion
While your symptoms could potentially be related to your cervical spine issues, it is essential to rule out other causes, including more serious conditions like multiple sclerosis. A comprehensive evaluation by a healthcare professional, including imaging and possibly nerve studies, will provide clarity and guide appropriate treatment. In the meantime, maintaining good posture, avoiding activities that exacerbate your symptoms, and engaging in gentle stretching or strengthening exercises may help manage your discomfort. Always consult with your healthcare provider before starting any new treatment or exercise regimen.

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