Muscle weakness, joint pain, spasticity

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Freakingout

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Hi everyone,

I’ve had intermittent muscle weakness/fatigue since around July 2021. I had pretty significant hand tremors as well but since stopping drinking a little over two months ago they’ve greatly reduced, so I wouldn’t say those are a primary symptom for me anymore.

However, my hands have been feeling so weak that I feel like I can barely grip things, especially in the morning and at night. I have an awkward grip on things when I hold them, and a few months ago I noticed what appears to be bilateral muscles wasting in both hands. It only is apparent when my hand is flexed when I’m gripping something, particularly thinner objects. There’s a large indentation on the top of my hand in the crook between thumb and index finger. Unfortunately, I don’t know if this indentation has always been there or not because I didn’t pay attention to this stuff until I started feeling like something was wrong with me. So I dont have any baseline pictures to even tell if there’s a difference. I have a grip strength measurement device and both hands measure within the low end of normal limits.

My joints have been really sensitive and every time I exercise I feel like I come away with yet another problem. I know that ALS is muscular, but I read that loss of muscle can be hard on joints and lead to joint pain, so I’m wondering if it’s that. My shoulders, knees, and back have been stiff, sore, and achey. The joints in particular. And for no real reason. I’m not doing any high intensity exercise because I end up feeling worse physically afterward. Each time I exercise it feels like I hurt another joint.

I also have muscle fascilations all over, especially after exercise. Not really cramps, per say, although a few months ago I had cramps in the front of my shins every time I ran. That has since stopped but I also haven’t been running because now my knee is messed up. I have to use handicap bars at work to lift myself up off the toilet because I can barely put any weight on my knee at certain angles. The outside of my right knee has begun to hurt as well.

I frequently feel that my arms are heavy and that my endurance and stamina have drastically reduced. I experience a lot of jerky feelings (from what I gather, spasticity) when moving, especially in certain positions. For example, when I move my head from right to left it feels like a camera with a low frame rate. This also happens if I tuck my chin to my chest and move it upwards. Also, when I reach for things my arms often sway a bit and I have trouble consistently hitting my target. I frequently feel uncoordinated and like I’m tripping over my own limbs, but I haven’t had foot drop or anything.

The weakness and hand stuff are scaring me so much I can barely focus on anything else. I’m only 28 but I’ve basically convinced myself that I have ALS and am miserable. I’ve considered MS and other neuromuscular stuff, but this is the one I’m most worried about for obvious reasons.

I’ve talked to my doctor about the joint pain and tremor. She told me to keep an eye on the joint pain because it could indicate something auto immune. My blood pressure is also high and I’m monitoring that as well. Not sure if that can be related to ALS as well. I’m going to reach out to her again about the weakness. My therapist thinks that I’m extremely anxious and that whatever the physical symptoms are, they’re being made worse by anxiety. I agree with him about the worsening being caused by a lot of anxiety, but the symptoms I’m feeling are very real. I just feel so weak, clumsy, and uncoordinated. I’ve attached pictures of my hands relaxed and while holding something so you all can see the indent I’m talking about.

I used to be in pretty good shape, but I don’t feel anywhere close to where I used to be and I feel like it’s getting worse. I guess I’m mainly wondering, like so many in this part of the forum, is if it sounds like ALS or if I should pursue a different route (perhaps MS or something). Any help is much appreciated.
 
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Hello-

We always ask that people read here first. It contains many answers about the things that bring people to the ALS forums. I've removed photos, as they do not help- only a doctor can properly assess for atrophy.

It sounds like you're already under the care of a doctor. I would continue letting them guide you. You list many symptoms not at all related to ALS (per the link provided above), so you really should not be looking here. Great news, as it means it's one thing you can remove from your list of things to be worried about. I would like to add, while you may think jerky movements mean spasticity, that is not at all what spasticity is. Again, only something a doctor can asses.

Please keep working with your doc- it sounds like they're providing you great and thorough care.
 
Since you acknowledge that anxiety may play a role, it can be helpful to get treatment for that and then see what is left, physically, for you and your PCP to address.
 
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