Arm Fatigue

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mp123

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Hi everyone,

First off, thank you so much for your time in reading my question. I am a 36/F who recently began experiencing some unusual (for me) symptoms, with the most bothersome being a fatigued feeling in my right (dominant) arm. I also have intermittent, random twitching all over my body and have one area of parasthesia (buzzing/vibrating) on my outer calf. But it’s mostly the arm that is concerning me. It feels like I’ve been working out and it’s fatigued, but I haven’t. I saw my primary care physician who did a complete physical and said all was normal, including bloodwork. I am able to complete normal tasks (jars, using a pen, buttons), though it sometimes feels as though I am having to think about them, or they feel maybe just a bit delayed, or like I am having to exert more effort, as opposed to them just happening naturally, if that makes sense. I acknowledge that I do wonder if this “thick fingered” feeling has something to do with my recently focusing my attention on tasks I normally just do.

I have read the stickies (incredibly helpful, thank you) and some other posts; I am hoping I can better understand whether this might be the very early start of something, or if that’s not really how ALS manifests (like it’s more of a sudden weakness). Some of the reading I did elsewhere indicated abnormal limb fatigue as an ALS symptom, but didn’t elaborate on what that might feel like. I think I just need a better understanding.

My primary doc does not think I need to see a neurologist or have further testing at this time. He loosely suspects carpel tunnel (though I don’t seem to have many of the classic symptoms—my mom had it badly before surgical correction, and hers was much different than this). I do trust him, but I admit I still feel unsettled. I’ve never experienced anything like this before.

My main question is, do I just go along for a bit and see what happens with my arm, or should I push for more evaluation now?

Thank you so, so much for your time and advice. I really appreciate it.
 

ShiftKicker

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Doctors really look for some specific signs when providing a clinical examination. While folks can provide subjective impressions (how things feel), a doctor can see when something doesn't look or act "right", including strength. Clinical weakness isn't about feeling weak or tired with effort, it's the inability for a particular muscle to work.

There are so many reasons why the feel of a limb movement can be altered- the most common one being structural/postural. A physiotherapist/kinesiologist may be able to provide you with an assessment and some exercises and stretches to help with things if they see some issue. If your doctor suspects carpal tunnel, this would be the logical next step.
 

mp123

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Hi, thank you so much for your reply! I truly appreciate your time. So, just to make sure I understand, this does not sound like the start of ALS to you, so no need to pursue neurological testing. But, I should pursue a physical therapy evaluation to try and get to the bottom of it (which is a great idea!) Is that correct?

Thank you again!
 

affected

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MP the point is that you need to go to your doctor, not talk about ALS, but explain your symptoms, have an examination and ask your doctor what they think needs to be investigated.
Fatigue is not a precursor to clinical weakness, I think the sticky is clear on that one.
Let your doctor lead, after all they have the training to work through this.
If you don't think your doctor is right, go get another opinion from a doctor who can examine you.
I'm so sorry, but you must understand we can't tell you what is going on and advise you on what you should dictate your doctor should do.
 

mp123

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Hi there, thank you for your message. I apologize if I didn’t express myself clearly in my reply. I was only trying to clarify whether Shift thought there is/isn’t reason to suspect this is ALS. My clinical exam by my PCP was “normal” with no recommendations from him as to next steps, as he doesn’t think there is anything to address at this time. Just let him know if it worsens.

I only sought insight from this group as I figured if my symptoms set off any ALS alarm bells for you, I would likely go back sooner and request further evaluation/referral from my doctor, or seek a second opinion, as you mentioned. I truly wasn’t hoping for anything more than a “gauge” as to whether I should press (if it sounded suspicious) as this is all very new to me.

Thank you for your time; I do appreciate it.
 

lgelb

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MP, there is nothing wrong with your seeking that reassurance. My response is that it's likely a localized condition or sequelae of a virus. You can test both with resting/gently stretching the fingers and ultimately seeing a hand therapist if there is not improvement, in consultation with your PCP and possibly an orthopedist.

To answer your question, you have presented no reason to worry about ALS.

Best,
Laurie
 

mp123

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Thank you so very much, Laurie. I really appreciate your response and your time!
 

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Please be aware that no one answering you here is a doctor, it is always wise to seek advice from your doctor on everything.
 

mp123

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Of course. l will certainly continue to work with my doctor on this as needed. Thank you again.
 
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