Don't think i have ALS but don't know.

[Joe24]

8 months ago i started feeling pain in my left arm. Thought it was CTS because my hand would go numb at night. Went to the doctor he told me tendinitis. I took some meds but they didn't work. Started getting twitching in my ring finger which spread to the rest of my fingers. Pain and aching persistent in my arm and hand. Started getting a burning sensation in forearm. I get a tingling feeling when i run my hand under running water. Fingers get really stiff. Went to a orthopedic and he seemed very concerned noticing i lost alot of muscle in my left forearm. I tried to stop using it frequently thinking it was overuse that was preventing me from healing so i thought that was the reason for the atrophy. He immediately mentioned ALS. He gave me a reflex test and when he hit my legs with that lttle hammer my legs went straight up in the air.(don't know if that has anything to do with ALS) i know i sound like an idiot but i am worried now. going to a neurologist soon. was hoping for some insight.

 

[Nikki J]

I certainly understand your concern since your orthopedist brought up ALS. There are many things that can cause atrophy. Did he mention other causes? Have you had an mri or ct scan? Or were you just referred to the neuro? Brisk reflexes ( the hammer test) happen in ALS and many other things. Some people are just naturally that way. If you have no symptoms in your legs and the legs reacted the same on both sides try not to worry too much. ( easy for me to say I know). ALS does not affect the sensory nerves so starting with numbness burning pain etc sounds like something else. I hope your neuro appointment is soon and sends you in a different direction. Please let us know what happens

 

[Joe24]

Yeah both of my legs reacted the same. I have bad anxiety too so i guess that wouldn't help the twitching and the quick reflexes in the hammer test. haven't had a mri or ct scan yet and was just referred afew days ago. I thought it was just so odd for him to almost immediately start with ALS. After that he said it could be a spinal problem. my ring finger on the right side twitches some too. I still walk constantly and jog. but i've learned that doesn't necessarily mean anything.

 

[Nikki J]

Anxiety can certainly bring on or exacerbate twitches and brisk reflexes. I too find the bringing up ALS so quickly rather odd. Search for threads by Energy1. He had atrophy in an arm and was quite convinced he had ALS but it ultimately turned put to be a much more benign answer. You have not had any imaging yet. There are many answers far more likely than ALS. Again good luck with the neuro

 

[Kosmoskatten]

First, it was not a good thing of your doctor to even mention ALS this early. Please try to get that out of your system for now.

As I take it you have only had physical testing for CTS? From what I have learned, these tests can be unreliable. EMG and/or NCS is usually done nowadays if a patient is exhibiting visible symptoms. (muscle loss etc.)

If the outer edge of your hand is causing issues, it might also be the ulnar nerve that is the culprit. Tingling, numbing, especially at night all points a finger towards CTS or Ulnar.

Pain, aching, tingling, numbing all point away from ALS, since it is non-sensory.

From what I have learned, brisk reflexes can be normal if symmetrical. It is very common that people with anxiety have brisk reflexes, since their symptoms are on a high all the time. This usually goes hand in hand with a brisk startle reflex, eg. one is easily scared. All the adrenaline and cortisol pumping around is wrecking the body.

I would go back to your doctor and talk about further tests, you should pershaps take an x-ray as well to rule out rheumatoid arthritis. If your doctor wants to examine the median nerve in your hand, he could also do an ultrasound.

Best of luck.

 

[Joe24]

Thank's for replying to me guys. Got an appointment friday. Minds messing with me i think. been feeling and seeing twitching since last appointment.

 

[Dusty7]

Nikki and Kosmo said it all. Your symptoms are sensory and that does not point to ALS. And brisk reflexes can be indicative of many things.

Atrophy of the FDI (the muscle on the back of the hand between thumb and forefinger) and the APB (muscle on palm side of base of thumb) is sometimes seen in ALS, so I can understand why a doctor might think this--even with little else to indicate ALS. Some on this site have had CTS surgery only to discover it was ALS and the surgery was a waste of time. Of course they had many other ALS symptoms also. I can see how a doctor who misdiagnosed CTS previously might jump to ALS the next time.

Also, we have talked previously on this forum that there appear to be two types of doctors--first is the group that likes to put the possibility of ALS on the table first thing, sort of like, "Well, this is the worst it could be and hopefully I'll be able to give you some good news after a little testing and we find out what it really is." Second is the group that follows the El Escorial criteria strictly and will only talk about ALS once their testing meets the EE criteria... including eliminating everything else.

Your doctor clearly is in the first group as your symptoms don't sound to me like ALS and I don't think he actually expected you to believe you have ALS. He was just giving a possible range--from something self-healing like tendinitis to ALS. Obviously, see a neuro, get a full clinical exam and an EMG and see what a neuro thinks. And try to relax. Those who have responded to you don't think it sounds like ALS. Good luck! And let us know how it goes.

 

[MaxEidswick]

>there appear to be two types of doctors

well said, Dusty!

 

[Joe24]

Thank you all for your replies. gotta go see a Neuro in afew hours. Seems like ever since that orthopedic mentioned it i've been terrified. Can't sleep. been feeling and seeing twitches(although they may not all exist). My legs have been cramping terribly. Once again though thank you all. I know it must be troubling to hear so many ppl complain to you about symptoms that don't compare.

 

[monster]

I understand your fears joe. After I went to a neurosurgeon, for something else, he told me I had Als. That was back in 2011. It's been a emotional roller coaster since.
Good luck today. I hope it's all good news!

 

[Joe24]

Blood work came back fine so i guess that's good. Got an EMG set up for Tuesday. The neuro said he didn't think it was anything that serious. He would know. Have a good weekend ppl.