Nerve Pain and Tingling After COVID-19: A Guide

Q: Nerve Pain and Tingling After COVID-19: A Guide

Hello： 1. <br>The symptoms in your upper arm/lower leg are likely caused by nerve compression from the cervical/lumbar spine. <br>2. <br>It is not uncommon for symptoms on the left side to switch to the right side, depending on the location of the nerve compression. <br>It is rec

Occasional tingling and pain in the hands and feet?

Hello, doctor.
Since I tested positive for COVID-19 in June, I have been experiencing occasional soreness in my left eye for about one to two weeks.
I went for a consultation, and the doctor said my eyes are fatigued.
After examination, he confirmed that my fundus, cornea, and optic nerve are all normal, and there is no glaucoma.
I have a history of cervical spine issues; an MRI previously confirmed that I have herniated discs at C3, C4, and C5 with nerve compression, which has been ongoing for nearly ten years.
I had physical therapy in the past, which improved my symptoms by about 70%.
The symptoms are primarily on the left side, and occasionally I feel some pain in my left arm, with occasional tingling sensations in my left fingers.
Additionally, I sometimes experience pain in my left leg (thigh and calf), extending to my knee and the soles of my feet, with occasional tingling in my toes.
These symptoms fluctuate.
Recently, however, I have experienced soreness in my right arm and tingling in my right fingers, along with some pain in my right thigh, but these symptoms are significantly milder compared to the right side in the past and often resolve the next day.
Occasionally, my right arm experiences sudden tingling or a goosebumps sensation lasting about 1-2 seconds.
I recently had X-rays of my cervical and lumbar spine, and the reports indicate: "Less lordotic curvature of the cervical spine.
Disc space narrowing at the levels of C3-4, C4-5, and C5-6.
Disc space narrowing at the levels of L4-5 and L5-S1.
Anterior slip of L3-4 during flexion.
Retrolisthesis of L1-2."
I would like to ask:
1.
Are these symptoms primarily related to nerve compression from the cervical and lumbar spine issues?
2.
Why have my symptoms, which were originally only on the left side, suddenly started to appear on the right side as well?
3.
I have ulcerative colitis (currently stable, with mucosal recovery), but I am concerned whether this could be a precursor to multiple sclerosis?
4.
Additionally, can herniated discs in the cervical spine causing nerve compression lead to soreness in the eyes?

Cheng, 40~49 year old female. Ask Date: 2023/08/08

Dr. Lai Zhaokang reply Neurosurgery

Hello: 1.
The symptoms in your upper arm/lower leg are likely caused by nerve compression from the cervical/lumbar spine.
2.
It is not uncommon for symptoms on the left side to switch to the right side, depending on the location of the nerve compression.
It is recommended to consult a neurosurgeon.
3.
It is still preferable to explain your symptoms in terms of cervical and lumbar spine issues, as multiple sclerosis is rare in Taiwan.
If you are very concerned, please see a neurologist for appropriate evaluation.
Wishing you a speedy recovery.
By Dr.
Lai Chao-Kang, Neurosurgery, Changhua Hospital.

Reply Date: 2023/08/08

More Info

Understanding nerve pain and tingling after a COVID-19 infection can be complex, especially when there are pre-existing conditions like cervical disc herniation and ulcerative colitis involved. Based on your symptoms and medical history, let’s address your questions systematically.

1. Primary Cause of Symptoms: Given your history of cervical and lumbar disc issues, it is indeed plausible that your symptoms—such as pain in the left arm, tingling in the fingers, and discomfort in the legs—are primarily related to nerve compression from your cervical and lumbar spine. The MRI findings indicating disc space narrowing and retrolisthesis suggest that there is ongoing pressure on the spinal nerves, which can lead to radicular pain and sensory changes in the arms and legs. The fact that you have experienced these symptoms predominantly on the left side but are now noticing them on the right side could indicate that the nerve irritation is not limited to one side and may be affecting both sides due to the nature of your spinal condition.

2. Shift in Symptoms from Left to Right: The sudden appearance of symptoms on the right side, which were previously confined to the left, can occur for several reasons. One possibility is that the underlying cervical or lumbar spine condition has progressed or changed, leading to irritation of nerves on the opposite side. Additionally, compensatory mechanisms in the body may lead to overuse or strain on the right side, especially if you have been favoring the left side due to pain. This can create a cycle of discomfort that manifests as new symptoms on the right side.

3. Concerns about Multiple Sclerosis (MS): While your concerns about multiple sclerosis (MS) are understandable, especially given the neurological symptoms you are experiencing, it is important to note that MS typically presents with a variety of symptoms, including visual disturbances, coordination issues, and fatigue, among others. The symptoms you describe—tingling, pain, and changes in sensation—can be attributed to nerve compression from your spinal issues. However, if you are experiencing new neurological symptoms that are unusual for you, or if your symptoms are progressively worsening, it would be prudent to consult a neurologist for a thorough evaluation. They may recommend additional imaging studies or tests to rule out MS or other neurological conditions.

4. Eye Pain and Cervical Disc Herniation: Cervical disc herniation can indeed lead to referred pain or discomfort in various areas, including the eyes. The cervical spine houses nerves that can affect not only the upper extremities but also the head and neck region. If the cervical nerves are irritated or compressed, it can lead to symptoms such as headaches, neck pain, and even eye discomfort. This could explain the occasional pain you feel in your left eye, especially if there is associated tension or strain in the neck muscles.

In summary, your symptoms are likely related to the existing cervical and lumbar spine issues, exacerbated by the recent COVID-19 infection. It is essential to continue monitoring your symptoms and maintain communication with your healthcare providers. They may recommend physical therapy, pain management strategies, or further diagnostic testing to address your concerns effectively. Additionally, maintaining a healthy lifestyle, including regular exercise and stress management techniques, can help alleviate some of the discomfort associated with nerve pain and improve your overall well-being. If you experience any new or worsening symptoms, do not hesitate to seek medical attention promptly.

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