Hand pain

[Swiffdrew]

Hello so I recently started twitching About one and a half month ago in the abdominal area which then quickly began wide spread twitching. Since then I’ve had symptoms of post nasal drip, jerks in toes and fingers, tremors in thighs, as well as the persistent twitching. I had a clean clinical one week ago and I had a clean emg on Monday where they tested both legs, arms, neck, sternocleidomastoid process, and back. He said that he had no findings of als present and that all that was the was chronic nerve pinching from the last but nothing active. Since then I’ve started to have joint problems in my fingers where they click or pop when I do simple tasks like holding my phone or putting my fingers at rest. Along with this I’ve been having pain in side and top of my hands which sometimes radiates Into my fingers, forearm, and tricep. Also been having finger stiffness. I usually only notice all these finger symptoms when on my phone but not when at work etc and it gets better with rest. I’m worried because I’m the emg they didn’t get my hands so I wanted to know if they did multiple muscles in my arm but didn’t do the emg in my hand would it have picked up abnormalities in my hand? And also is this how hand stiffness presents in als?

 

[Bestfriends14]

Nothing you've described even remotely resembles ALS onset. Hand muscles most often are not tested, from my experience, do yiu can leave that worry behind.

Try stretching, proper hydration, and try for restful sleeps. This may vastly improve all your sensory issues.

Good luck

 

[Swiffdrew]

Thank you for your response from what I’ve seen this isn’t how als presents but my anxiety keeps persisting. What worried my is the finger stiffness because I saw that is how some people’s symptoms persisted. I will be scheduling an appointment with a Physical Therapist while doing all of the advice you recommended so thank you for that! Just for my anxiety to be addressed though if they emg’d multiple muscles in my arm would any nerve damage in the hand be picked up?

 

[ShiftKicker]

Hello-

Here is a very long post that provides answers to the questions that bring people to this forum when they search various symptoms online:

Read Before Posting

Respectfully, this forum can not be used as a replacement for proper anxiety support. This is not the purpose of the forum.

To answer your question, yes, the emg along nerve pathways in the arm would pick up any nerve damage that might affect your hands.

All the best with your physio.

Take care

 

[Swiffdrew]

Thank you for your responses since then I’ve had my appointment with a PT who recommends median nerve stretches. I’m still worried because this is a pain that starts in the top of my hand then radiates up to wrist forearm shoulder blade and even tricep sometimes it results in me having to rest my hand/arm. This has made gripping feel very weird at time but with no loss of strength at. I’m hoping that the emg would pick something up if there was something going on but no active nerve pinching. It’s reassuring knowing that emgs in lmn can’t be too early but I’m still concerned something might have been missed. Is it normal for a patient to not get their emg results on paper from the neurologist all I was told was no als and old nerve pinching.

 

[lgelb]

You have the right to an EMG report. Just ask or look through the portal.

ALS is a diagnosis that comes from exams, history, and the EMG -- not just any one of these. I don't see anything in what you have said that raises concerns for it.

 

[Swiffdrew]

Thank you for the response. I requested a record of my emg which they told me they have to fax to my pcp who will go over the results with me. They have no online patient portal unfortunately. It’s just inconvenient because now I’ll have to wait to schedule an appointment. And I’m worried because it feels like the weird gripping sensation is progressing to weakness or a lack of strength.

 

[Swiffdrew]

Hello I have updated symptoms. About one month ago when fixating on my swallowing I had a delayed swallow reflex which made the food feel stuck there. I eventually forgot about it and swallowed with no problem for about one month. I then thought about swallowing again and started to have this delay occasionally especially while being hyper aware on it if this were due to als would it have been picked up on the emg. I’ve seen conflicting information on the forum that swallowing problems are umn and lmn. Could this swallowing problem be umn?

I also feel pain in the back of my throat sometimes when swallowing and throughout the day.

 

[lgelb]

This does not sound like ALS-linked swallowing issues at all. And if it only shows up once you think about it, it's unlikely to be anything physically serious in any case. You don't have to worry that the EMG missed ALS.

There are many ways to address the stuck feeling. Drinking during and after eating and staying hydrated is one example. But if you're stressed out about it, an ENT and/or a counselor may provide you with reassurance.

 

[Swiffdrew]

Hello thank you for your response I’ve already met with an ENT during when this problem first arrived and I told him of the regurgitation problems I was having etc and he did a laryngoscope where he told me he saw evidence of acid reflux. I think that made me forget about it initially until now. Can I just follow up on my question from earlier and ask if swallowing is a umn problem which wouldn’t be detected on an emg?

 

[lgelb]

You saw an ENT who scoped you and didn't see swallowing problems, but rather acid reflux. So it'd make a lot more sense to treat the reflux on medical advice, than to keep obsessing about swallowing and ALS.

Adding to that, if you had bulbar dysfunction, which includes swallowing, because of ALS, you would not have a normal EMG (if it were significantly abnormal, I cannot see the neuro sending it back to your PCP). ALS shows EMG abnormalities in multiple areas, including ones you think are fine.

I hope this answers your question.

 

[Swiffdrew]

Thank you for your Response. I’ve recently started taking pantoprazole and my swallowing a has gotten better somewhat. I’ve noticed recently however When I eat sometimes, food particles make their way into a part of my nasal passage that seems to be the nasopharynx And I have to swallow it again. Is this worrying?

 

[ShiftKicker]

Hello-

I am glad you are experiencing positive response to your medication. That's great news.

With regards to your question- clearly your swallowing is still very worrying to you. We can not provide the kind of answers you are looking for, as you have been cleared every which way from Sunday by more than one medical professional. If you have questions specific to your swallowing and you have not yet been reassured by all the answers you have received, you will have to return to your doctor so you can explain to them what you are experiencing and they can observe what you're talking about. Then they and you can sit and discuss what it might mean.

Please, no more posting. This forum really has provided you with as much support and reassurance as possible- keep working with your doctor to deal with your GERD and think about finding ways to address your anxiety about and focus on ALS.