Seeking A Few Answers

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Hello all,
I have recently donated to the ALS Association upon google searching my symptoms bringing me to this forum, may god bless anyone suffering from this terrible disease, I have read the sticky post as well before creating this thread, thank you in advance for taking the time to answer my questions. I am 32/F so I understand my age makes this rarer for me.

7 weeks ago: realized my dominant hand was “stiffing” up- it happened one morning with basically not being able to bend my fingers or like grip my fingers around a fork so perceived weakness/stiffness in my hand/wrist: fast forward to present day and the hand/wrist/forearm muscle tires easily with quick use, for example folding clothes, holding coffee cup, texting, etc. I don’t have pain, numbness or tingling - I do not believe it’s carpal tunnel because it seems to be on the top of my hand/wrist especially the radial part and thumb tendon movements and then into my forearm (not really the palm)... the last few days I began noticing brief twitching idk if that is the correct term so I apologize in advance- just a brief involuntary muscle contraction/spasm only a few seconds that I can visibly see and feel around my inner elbow, bicep, and armpit sometimes at rest or sometimes right after having used that hand/wrist/forearm it only lasts a few seconds.

Neurologist at the ER did a brain/full spine/neck MRI all came back clear. Blood work was clear. This was done several days after the unable to bend my fingers feeling first occurred about 7 weeks ago- she had me do a grip strength test (I believe they were thinking mini stroke but ruled that out after brain MRI) however neurologist noted my dominant hand was weaker in grip.
I have since gained some strength back I rested it for the first few weeks and I guess I am forcing myself now to mostly to use it as normal and avoid repetitive movements, I have used heat and hand ball therapy but my hand/wrist is continuously stiff or just tires easily, especially when holding something or attempting to type as I am now, I somewhat have the same feeling in my other non dominant hand/wrist/forearm now recently as of the past week but it is not as bad.

I understand an EMG is the gold standard however I haven’t been able to get one with covid. I also know RSI/wrist tendonitis is far more common so maybe something is just overworked and finally caught up with me? I have just never experienced this continuous stiffness and the recent twitching and I would say I use my hands/wrists as much as the average person. My questions:

1. Would something necessarily show on a brain/spine MRI? As in the absence of anything from my brain/spine means it cannot be ALS.
2. Is muscle stiffness something in the sense of ie my muscle is stiff and it’s making me weaker in being able to brush my hair or text as fast or do something as effortlessly as before for example?

Thank you again for your time.
 
A hand nerve problem would not show up on a brain/spine MRI. Overuse injuries such as you are envisioning can certainly manifest pretty suddenly, though. The fact that you have seen improvement with rest argues strongly against ALS and for some kind of injury, whether overuse over time or a change in your work positioning, as may have occurred if you are working more at home, for example.

Stiffness can make it harder to do things but is not the clinical weakness that is the hallmark of ALS.

I would start with your keyboarding setups and you could also consult with a PT or ergonomic expert on line to get another perspective.

Best,
Laurie
 
Thank you for taking the time to reply Laurie. As you have dismissed ALS, I won’t take up any more of your time. I will be sure to keep all those suffering from this disease in my continuous prayers and will include the ALS Association in my future charitable donations. God bless.
 
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