43 yo female, hands & forearms weakness and ache for several months

DublinIE

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Hi everyone,

Posting reluctantly in the absence of clear available information. My symptoms started about 6 months ago and while they haven’t particularly worsened, they are present everyday and cause great discomfort, even when I’m busy/immersed in my work.

My first awareness felt like deep seated bone pain in both hands and forearms, and mostly dull and achy. I find it hard sometimes to identify it as muscle or bone pain but i feel sure it’s not joint related. My middle fingers also both cramp up regularly, I haven’t experienced any twitching anywhere that I can tell. Its also not specifically worse in the morning or evening but definitely present everyday at various times. No visual atrophy in hands but my forearms do look thinner.

Went to my general practitioner who prescribed anti inflammatories and ordered full blood count (all clear). On a return visit referred me to a rhuematologist which I’m due to meet in a few days.

I’ve felt from the outset that this is more nuero than rheuma but didn’t feel right to challenge the recommendation.

Im otherwise in good health, no other symptoms. Just can’t shake the feeling that this is something degenerative and I’m seeing the wrong specialist.

I understand mnd can start in hands and arms and early progression can be slow. I wonder should i request nuero appointment instead. Curious also if people are often referred to rhuematology in early onset.

Many thanks for allowing me to share my concerns.
 

DublinIE

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Also, important to note grip is weaker and I’m finding fine motor skills challenging (writing, cooking, keys, laundry) and dropping things frequently. Thanks again.
 

KarenNWendyn

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Hi Dublin. Please read this if you have not already done so: Important - READ BEFORE POSTING! Answers to common concerns about possible symptoms!

Your posts do not suggest ALS. Discomfort is a sensory symptom. ALS is a disease of motor neurons. Pain in ALS/MND would be a late stage finding due to severe muscle atrophy and contractures.

The symmetrical presentation in both hands also points away from ALS. ALS rarely starts symmetrically. On the other hand, the symmetrical presentation and discomfort is very suggestive of an inflammatory process. Pain in inflammatory arthritis can sometimes be very difficult to localize and can feel deep. Are you especially stiff on first awakening? That can also be a sign of inflammation.

A rheumatologist is definitely the person to see. Best of luck.

I was a practicing rheumatologist for 25 years and saw many people with symptoms similar to yours. None of them ended up having ALS.
 

DublinIE

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Many thanks for your reply Karen which is very reassuring.
 

Vincent

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If i might weigh in, it sounds way more like carpal tunnel syndrome. Pain in hands and forearms plus cramping sounds like a pinched ulnar nerve. Through working with your hands repetitively, it tends to wear on the sheath that your flexor tendons and ulnar nerve run through. It doesn't sound bad but may require surgery to correct. It is only progressive in that it will get worse, but it does not spread to other places.
Vincent Quinn
 

DublinIE

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Thanks Vincent. I have read about and considered CTS too, I guess the rhuematologist will advise soon
 

DublinIE

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Met with rheumatologist. On hearing symptoms his initial thoughts were Carpal or Reynaud but on examination wasn't convinced. Ordered nerve conduction and EMG with neurophysiologist in same facility. His specialty is MND. They called and have fast tracked my appointment for the morning. Terrified is not the word, I just know in my bones this is not going to be good.
 

KarenNWendyn

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Carpal tunnel syndrome can be diagnosed by the nerve conduction tests that are done with the EMG. The EMG can help when looking for carpal tunnel syndrome and to see if nerve compression is severe enough to have affected the muscles. The tests can look for other forms of nerve compression as well.

Your symptoms are not at all suggestive of ALS in any way. Please reread my previous post to you. It’s your choice if you choose to be terrified going into the visit with the neurophysiologist. Wouldn’t it be better to go in there with an open mind and think of it as information- gathering to get answers as to what’s going on?
 

DublinIE

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Absolutely Karen and that’s what I intend to do. I’ve read your post and the sticky (more than once). Very much hoping it’s nothing serious. Sorry to have bothered you.
 
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