Hand weakness

Chrissylee916

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Hi, I am a 33 year old female who has been having symptoms for three weeks. My right hand is very weak. I can not grip things properly and it seems as though I have lost strength in it. I do have muscle twitching throughout my body but I am more concerned about my hand weakness. My elbow is also hurting and my wrist almost like tennis elbow/carpal tunnel. I have read where people thought they had carpal tunnel but it was actually ALS. A year ago I started getting muscle twitching and I was send to a neurologist and did an emg that came back clean. I had the emg in January and at the time I did not have any muscle weakness but now I do. Do you think this could be ALS? I know you guys are not doctors but I just don’t seen anxiety causing someone to have weakness in a hand. Thank you.
 

ShiftKicker

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Hi Chrissy-

Your best bet is to go back to see the doctor and get re-assessed. If you saw them in January, they would already have a baseline, so would be able to track any changes and make decisions about diagnostic directions based on their clinical exam.

It would be really hard for people here to tell you what is wrong based on what you've reported. Please read here: Important - READ BEFORE POSTING! Answers to common concerns about possible symptoms! to give you some idea of all the things that people worry mean ALS. Twitching is just so common- healthy people twitch.
 

Chrissylee916

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Hi Shiftkicker,
I understand what you are saying and I was apprehensive to post bc I did read the stickes, but my doctor said the weakness in ALS is gradual and I definitely notice weakness in my hand and arm. I do want to go back to the neurologist but my primary care doctor didn’t think I needed to. If my emg was clean in January could it just not have showed up. I do have pain in my thumb, hand, arm, and elbow and I have heard that points away from ALS but the weakness is really scaring me at this point.
 

ShiftKicker

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Your doctor would still be the person to guide you in your next steps- particularly if they don't think you need to see a neurologist. Another option is a physiotherapist. More so, in that they can provide structural assessment and exercises to help strengthen, along with feedback to your doctor, should they feel there's something beyond structural/muscular issues.
 

Chrissylee916

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Hi thank you for your response. I am going back to the doctor but I feel as if my hand continues to get weaker. Do you think it could be ALS? I’m just really worried. I haven’t been dropping things but I feel like it’s harder for me to write with my right hand and do normal activities. If I had a clean emg in January could I have developed it in the time past? Sorry for all the questions. I just feel like my dr isn’t taking me seriously.
 

lgelb

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An EMG in January would not have been "too early" to see ALS, even without weakness, Chrissy. Given progressive weakness/pain in your R hand/arm, the suggestion to pursue hand therapy is a good one. Your PCP can write an order for PT evaluation. If the therapy isn't effective, that would be a reason to pursue further diagnostics, but you haven't tested the simplest and most likely explanation yet.

Best,
Laurie
 

Chrissylee916

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Ok thank you Laurie. You’re so nice. I’ve read so many reply’s you’ve made to people. I know that people on this forum are suffering from ALS but can weakness all be related to anxiety? Could it just be in my mind? I have suffered from PTSD and when I first started having the wide spread twitching in January I went to my dr and he then sent me to neurologist. I was better after going to neurologist and clean emg but now about 3 weeks ago the weakness in my hand and arm has started. I feel true weakness/clumsiness/pain along with twitching again. I went back to my pcp but doesn’t seem to think I need to go to neurologist. In your experience do you think this could just be anxiety/PTSD? Sorry for all the questions. I know you’re not a doctor just asking for your educated opinion.
 

ShiftKicker

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Chrissy, it would be very difficult for people to be able to assess physical signs of PTSD for you. A physician can see if there is measurable weakness (clinical) as opposed to a feeling of weakness. This forum is for those with ALS and their caregivers and really can't be used as a place for anything more than the most basic of inquiries. It's clear your physical condition concerns you, so your absolute best bet is continuing to focus on in-person help and assessment and therapy by a doctor or a physiotherapist to figure out what is going on.

All the best
 

lgelb

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We have seen many people here whose physical symptoms are magnified by anxiety and depression, both of which can be PTSD features. Obviously, I can't tell if you're one of them from afar, but if you're asking the question, it is worth exploring.

Meanwhile, most everyone can benefit from some stretching, de-stressing, etc. To stress-test the idea that you are not clinically weak, you can try (1) acting as if, going about your day and (2) ever so often, seeing someone like a doc or PT who can "baseline" your strength as you squeeze their hand, etc. and tell you if they see changes over time. If you get a PT referral from your PCP, the first thing s/he will do is evaluate your hand function, which can be a valuable perspective.

Having a more objective insight about your physical abilities may help you sort this out. If you are not in counseling for the PTSD, it is something to consider, if only short-term to check in. It is a twisty road, but it is much easier than living your life afraid.
 

Chrissylee916

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Thank you both for your insight. I understand the purpose of the forum but I do feel objective weakness and I will go back to my doctor it’s just really worrisome at this point. I’m sorry to be difficult, but I just don’t know what to think at this point. Thank you both for your time. I will keep you posted after I’ve seen my doctors. God bless.
 

Nikki J

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You can’t “ feel objective weakness”. By definition it is weakness found by the doctor on clinical exam. Everything you feel and experience is considered subjective data. Objective consists of physician findings and test results.

Even if you do have clinical ( objective) weakness there are many many far more likely causes. Let us know what the doctor finds
 

Chrissylee916

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Thank you Nikki. I will. It’s going to be awhile because of waiting on appointments. I’m just feeling worse because the same hand I feel weakness in now my thumb has been twitching in on and off.
 
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