What does arm and leg weakness feel like? An attempt at a definitive answer.

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bluedog

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I've searched the archives and it seems that no one has clearly answered the question "What does ALS arm and leg weakness feel like."

The difference between perceived and clinical weakness had been made clear. And I know there is a sticky about Fatigue vs Weakness. But it isn't clear whether, as weakness progresses, PALS feel perceived weakness (burning and fatigued muscles, etc.) or just have the inability to do something. I think that is what many undiagnosed people want to know: whether the perceived weakness they have now is a precursor to clinical weakness or if there is _absolutely_ no feeling associated with progressive weakness.

It has been said so many times on this forum that ALS is about failing, not feeling. So in an attempt to make this clear, can you please answer A or B:

A. As weakness progressed, my arms and/or legs felt _completely_ normal. There was just the increasing inability to do something, such as climbing a staircase or picking up a glass. There was _absolutely_ no accompanying feeling of weakness or anything else, such as tired, fatigued, burning, or heavy muscles or muscles that felt drained of energy. For example, it became increasing difficult to climb stairs because of difficulty raising my legs, but my legs felt _absolutely_ normal all the time, there just wasn't any power. Or I couldn't lift certain objects, such as a gallon of milk, or the objects felt heavier than usual, but my arms felt _completely_ normal all the time, with _absolutely_ no feeling of weakness, fatigue, burning, etc.

B. As weakness progressed, the muscles in my arms and/or legs felt weak, tired, burning, heavy, etc. upon exertion or at all times. For example, it became increasingly difficult to climb stairs, and when doing so my leg muscles burned or felt heavy, weak, fatigued, etc. Or my arms felt stiff, weak, fatigued, and drained of energy all the time, and it became increasingly difficult to pick up objects.

Thanks.
 
I have A and B both.
 
Mostly A sometimes B
 
A mostly, unable to open a bottle or lift a pitcher
 
Sorry to say you won't get a clear cut answer here, ALS affects each person differently. As others have stated, i would say 80% A, 20% B
 
"Perceived" weakness is what you feel by yourself.
If today, let's say you can effortlessly lift a full gallon of orange juice, open a tightly closed bottle of water, turn a doorknob, turn your car keys, raise your arm all the way up over your head, etc. but...the next month, you no longer can accomplish these tasks, you surely have "Perceived" weakness.

"Clinical" weakness on the other hand, it's the one determined by your Neurologist at his/her office using some calibrated equipment to determine it.

They may be equivalent but, you cannot numerically measure the "Perceived" weakness, you only know you have it because you can no longer do things you used to whereas your Neuro can measure the "Clinical" one.


NH
 
for my PALS there is some of both A and B

for example yesterday he said that his legs were feeling 'heavy'. To date he has had no leg involvement at all it has been bulbar and arms/hands.
then today he said that he is feeling 'heavy' all over and as we walked together, holding hands, down a flight of stairs at a hospital I can tell you his walking was WEIRD, very uncoordinated looking. So he was 'feeling' some heaviness, and I could see he was moving differently to usual.

as we watch the muscle wasting, his weakness increases and is evident when he tries to do things, rather than he 'feels weak' say when sitting or walking.

as already stated, everyone is different and progress differently.

I can also note that it took 9 months from the first noticeable symptoms that became a concern, until we were diagnosed provisionally by a speech pathologist and then finally got referrals to a neurologist. So I know and sympathise that the waiting whilst symptoms progress is so difficult.
 
BlueDog, thanks for what I feel is one of the best written threads on the site. And most of all, thanks to all the pals for sharing, It sounds as if most weakness is sort of "transparent", no weak or strained feeling, but rather a lack of muscle response that's unexplained. Forgive me if I'm off on that. Mostly just wanted to say thanks.
 
Thanks curtrill. While you are checking this site, I'd like to ask you about large MUPs and how you are doing. I noticed that you had large MUPs appear in one of your EMGs. Did they go away at some point, and what did the neuros say about them? Why don't they think ALS in your case, even with the large MUPs. And how are you doing now? Thanks.
 
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Thank you, I haven't gotten that far yet but exercise has become harder and harder lately, I have been wonder what to expect, thank so much, you explained it very well.
 
Mostly A. But sometimes B. At first it was all A.
 
I think this was an interesting question/thread. It seems as though the people who have already been diagnosed with ALS have replied mainly A. I have had a normal EMG and clinical and my answer is B. My diagnosis was Post Viral Fatigue Syndrome and severe mineral deficiency Vit D. Anyway, just wanted to respond as someone who has symptoms but a different diagnosis. My weakness was worse in the beginning (almost 6 months ago) than it is now, but my body initially felt awful, pain, twitching, stiffness, fatigue, limb heaviness and perceived weakness..So B.
 
My dad's was mostly A. Thank you for asking a reasonable and intelligent question and for reading the stickies first before posting.
 
Thanks curtrill. While you are checking this site, I'd like to ask you about large MUPs and how you are doing. I noticed that you had large MUPs appear in one of your EMGs. Did they go away at some point, and what did the neuros say about them? Why don't they think ALS in your case, even with the large MUPs. And how are you doing now? Thanks.

Bluedog, Large Motor Units Potentials (polyphasics some with increased duration) have appeared on multiple EMGs. More than half, however, how been clean. The reports have alternated from clean to polyphasic and back to clean only months apart. Confusing!
I have been adamantly told after all 13 EMG's, yes 13, "no als". None of the emgs have shown fibrillations or positive sharp waves. Almost every emg says "normal exam".

My clinical exams by the specialists have been consistantly declared normal.
My exams with two gps, surgeon, neuro surgeon quickly note "loss of soft tissue or muscle wasting and asymmetry. No "clinical weakness" has been found by anyone in what has now been more than 2 and a half years.

I do not wish to comment much on my symptoms in respect to pals and their families. You can read them on my previous posts or visitor page. I will just say they are constant, progressive and spreading. They have altered my abilities but I am ambulant and functional.

Curtrill
 
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