Hand pain/weakness

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MaeBillB

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I am a 30 year old female, and I am having some new symptoms that are very concerning to me. On Wednesday, I noticed dull pain in my pinky and ring finger and my wrist on that side of my dominant right arm. The pain became worse throughout the day as I typed on the computer at work and maneuvered the touch pad on my laptop. I tend to flex my pinky finger up when I use the mouse. The pain began to radiate up my arm into my funny bone and a little in my shoulder. A coworker said it was probably nerve pain due to tweaking something. Over the next few days, the pain continued.

On Friday, I rested my arm more and told my husband to order me a brace for cubital tunnel. I felt this was the most likely culprit. I have a six month old, and I have been lifting his car seat and him on a regular basis. I have also been sleeping on the side with the affected arm and thought the pain could be from sleeping as well as work. I have noticed elbow pain a bit off and on but mainly dull aching wrist and finger pain in my pinky and ring finger. I have not had any numbness or tingling, maybe a slight itchiness once. This has also worried me since numbness and tingling are more common symptoms and I believe pain alone is not often described.

I only became worried this weekend when in addition to the pain getting a bit more intense, this could be from testing my wrist and stretching it to see what caused pain. I know my wrist was very tight on that side when I did some cubital tunnel stretches. This weekend I also began to notice that my pinky and ring finger felt a bit weak and less coordinated than they had even a few days before. The weakness and lack of coordination worried me, so I googled a bit and stumbled on an article for chiropractors that discussed a woman who had been diagnosed with cubital tunnel due to pain while typing and some weakness, but was misdiagnosed and had ALS.

The article then sent me to several other stories of people who were misdiagnosed with carpal tunnel or cubital tunnel that was actually ALS. I wore the brace last night and since then I have noticed when I take it off my fingers are locking a bit or feel much weaker. I was shopping today without the brace on and felt weak and unstable when I reached for light objects like baby toys. When changing my son’s diaper, I also feel that my ring and pinky finger are a bit clumsy and weak. We in addition to this, they are still in almost constant dull achy pain. My wrist on my pinky side has also continued to hurt in the same way.

My husband says immobilizing the wrist is allowing it to heal and causing it to hurt more. He thinks the pain is causing the instability and weakness since my overall hand grip feels strong and I can wiggle and move my fingers normally. I have noticed that when typing my right hand feels a bit slower at times. He also said that my muscles may not be as warm due to the immobilization which could make them a bit slower at first until they warm up after being out of the splint. I have noticed that after stretching them and doing a few things they feel a bit more coordinated.

The weakness and feeling of sluggishness or lack of dexterity in my two fingers is most concerning to me. It feels off when I hold a pencil or fork in my right hand. I can eat and write normally, but I don’t feel as stable. My fingers have also been a bit shaky this evening when I open my palm and leave them at rest. The pain is mostly on the back side of my fingers and the outside of my wrist. I have noticed the pain is more intense with twisting motions and extension of my pinky to reach for keys on the far right side of the keyboard. I can still pick up my son who weighs 18 pounds and do not feel fatigued or unstable in my arms or whole hand. Just the wrist and the two fingers.

My fear is that the weakness is not due to cubital tunnel or tendon issues or strain, but ALS since I have seen that others had this misdiagnosis with similar initial symptoms of pain and weakness in these fingers. I know pain is not an initial symptom and I would not post except for the lack of coordination and dexterity in my two fingers. Does this sound suspicious? I am rushing to my general doc hopefully tomorrow for her first available appointment. I had a grandmother who passed from ALS in September and her diagnosis was wrong several times. I am afraid of this disease and I know I have health anxiety related to it. Any insight you can offer regarding my symptoms and ALS would be helpful. Do you think I should ask for an EMG at some point for peace of mind or should I dismiss ALS concerns based on my symptoms?

In the spirit of full disclosure: In the past year, I have had twitching all over which I believe to be stress related, and I visited an ent who conducted a swallow study based on some perceived symptoms I was having back in the fall. I passed a swallow study, and I know that both of these concerns were health anxiety and sinuses manifesting in ways that worried me. I had hand pain and swelling during my pregnancy that did not concern me because I know that is a normal pregnancy symptom, but I have not experienced weakness or lack of coordination/dexterity till now. This is what concerns me.
 
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lgelb

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I'm glad you can acknowledge last year's health anxiety, and I hope you can acknowledge now that it's back. Please get help for it this time, so it doesn't consume your life, marriage, and relationship with your son.

I would not continue to wear the brace without consultation with a doctor or PT, but as before, I don't see any reason to worry about ALS.

Best,
Laurie
 

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The very best thing you can do for yourself and your family is to go to a doctor and get yourself checked right over, and that wrist examined. Allow yourself to get a clear diagnosis on everything bothering you so that you can get the correct treatments started now and the best result happening. Your doctor will know where to start and how to figure it all out, even if you start with a televisit.
Do come back once you have had a solid diagnosis and let us know the outcome.
Like Laurie I see nothing of ALS to worry about.
 

MaeBillB

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I went to the doctor last week, and she tested my hand strength which was fine. She recommended wearing a brace that did not immobilize my two fingers. She felt it was a strain injury and recommended ibuprophen. She said if it was not better in a week and a half to let her know. I wore the new brace for a day and a half, but the skin on my thumb went numb. I stopped wearing the brace, two days later the feeling was finally fully back in my thumb. I rested my arm some over the weekend and the nerve pain I was feeling was limited to mornings and some slight evening pain in my wrist and forearm. Nothing like the previous week. My strength also improved and most of the time, my arm felt normal. When I wake up, my hand is a bit more stiff and swollen. After about an hour, that resolves.

I went ahead and booked a chiropractor appt. for tomorrow because I am still sore off and on in my hand, wrist, and arm. I think I could be sleeping in a bad position. Overall, I feel like my symptoms are getting better, but today while driving home my right hand cramped on the fleshy part of the pinky side a bit while holding the steering wheel. It was not a charley horse type cramp, more like the tight/sore muscle feeling you get in your back or occasionally when lifting weights in your hands. This made me anxious about ALS again. I had some hand cramps when grabbing handles while I was pregnant, but today is the first day I have had one since. I am going to mention it to the chiropractor, but does this new symptom seem concerning? I have not found it difficult to grip the steering wheel or anything else, just had the cramp. For the most part my arm and hand/wrist feel normal and are able to lift and do all the normal things accept when I first wake they are a bit sore and weak.
 

lgelb

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No, it doesn't raise any ALS concerns.

As you say, sleeping in the wrong position or not having a supportive pillow or mattress is often the culprit. When these supports give out, they can really give out.

Chiro in such circumstances is a costly and potentially harmful way to address upper limb issues, so I advise you to do some detective work. For example, you can video your sleep and see what's happening with that arm.
 
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