Weakness versus Soreness

[Bob1988]

Hi Everyone,

I just wanted to first say thank you for taking the time to look at this post. I'm sure for most of you these posts can be annoying and a bother but I appreciate any feedback or help.

Now I understand the difference between clinical/perceived weakness but my question is where does pain come into play? When your at the point of clinical weakness is it that the pain is so severe that you can't perform whatever function you are trying to do or is it simply the muscle will not work? I've also seemed to pick up from the different postings that ALS is not about "feeling" or "sensory" issues. Does that mean there is no pain involved at all and your body's muscles simply stop working and die off? If the muscles in your arms are painfully sore for no apparent reason and that pain is noticeable in day to day activity is that a cause for concern or is "feeling pain" a good thing?

I would like to apologize in advance if these questions are at all ridiculous.

Thanks again for your time,
Bob

 

[Mediasmart]

I have fairly severe pain in my left arm and right leg; both limbs are clinically weak - not just perceived. I assume we are not talking about cramps which you must be familiar although ALS cramps are not your garden variety charlie horses.

My team is sympathetic to the limb pain but it is not caused by ALS. They feel, in my case for instance, that the muscles are so weak and atrophied that the limbs fall under stress from being in the wrong position to take the stress of the joints etc. For instance, I find myself sitting wih my arms crossed, hands holding shoulders when I sit or putting my hand in a pocket when I walk or lay down (particularly).

What I am saying (badly) is yes there is pain and discomfort but not as part of the disease itself but the secondary reaction to wasting away....at least in my case and DON'T believe me as I am often told I'm full of it.

 

[Mediasmart]

Hi Everyone,

or is "feeling pain" a good thing?
Bob

Only if you are Morticia and Gomez Addams

 

[Atsugi]

Good questions, Bob, deserve a good answer.

It helps to know a little about the nerve systems. There are sensory nerves that feel things, and motor nerves that make muscles move.
ALS destroys the motor nerves, and does not affect the sensory nerves. So yes, pain is a good thing. It means that whatever is ailing you is related to the sensory nerve system, not the motor nerves, not ALS.

Once a motor nerve is destroyed (this happens up near the brain and brain stem), that particular muscle no longer works.
There's no sensation at all, no feeling of weakness, it just doesn't move anymore. And it will never move again.

After your muscle has been paralyzed (limp and immobile) for a while, the joints will become uncomfortable, or even painful when somebody lifts up your limp foot for you. Also, because there is no movement, there can be fluid swelling, and that's painful too.

To be specific, a paralyzed person doesn't move his foot, not because it's painful to do so (it's not cramped or stiff), he doesn't move his foot simply because the nerve is destroyed, and the muscle lies limp forever. Forever, never to be better, not even for a moment.

Pain is good, because it points toward something ELSE being wrong, not ALS. I hope that helps.

 

[Bob1988]

Atsugi and Mediasmart thank you very much for your responses!

Atsugi: Would it be safe to assume that any sensations of tightness or light cramping in your hands/feet would also fall into the category of sensory nervous system as well. When you visit the als website it mentions such things as muscle tightness/stiffness and cramping as possible systems. Which is slightly confusing to say the least.

Thanks again,
Bob

 

[Atsugi]

Bob, I know exactly what you mean by confusing. I can only say two things about that, based on all the things I've learned about ALS over the years. (I'm not a doctor but I used to sleep with one.)

First, failure to activate is the big thing. Can you physically lift your foot/hand? My wife (RIP) never ever complained of cramping or stiffness. Her muscles simply failed, one by one, without any sensations behind it.

Second, it takes an experienced doctor, preferably a neurologist, to truly understand these things. And frankly, I don't expect the doctor to fully explain it to the patient, because frankly, WE don't have enough education to really understand the answers.

 

[Dusty7]

"When your at the point of clinical weakness is it that the pain is so severe that you can't perform whatever function you are trying to do or is it simply the muscle will not work?"

The muscle simply will not work. You could try to fight through the pain (if there were any) all day long and you would never get the muscle to work.

 

[SwedenBiggie]

Hello Bob. Me myself have problems with my Peripheral Nerves. I have a demyelinating disease. My sensory nerves is very sensitive. I have pins/needles in hands/feets. When i sit down, my legs fall asleep very fast, and it is painful. I have soreness in muscles, and it can feel abnormal to walk somethimes, and do other things with hands. I just wanted to explain the diff between motor nerves and sensory nerves. And Believe me.. You can feel when there is something with the sensory or motor nerves.. It is not "i wonder if i can have this"... It is feeling very abnormal! Hope i helped you.. Pm if you want..