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Getting Pins And Needles In Hands And Feet. Diagnosed With Spondylosis. Can Lumber Spine Be Affected?

Posted on Mon, 22 Apr 2013

Question: Hi,
I recently asked you about pins and needles sensations in my hands and feet and you mentioned spondylosis. My appointment is one week away with the neurologist. Is it possible for the lumbar spine to be affected by spondylosis with similar symptoms to when the cervical spine is affected?
Can spondylosis present as numbness and pins and needles only without any pain at all?
Could spondylosis be caused by carrying quite a heavy backpack (over 5kgs) during parts of the day for a few years?
Also, I have noticed that the funny bone in my left arm is about 3-4 times more sensitive to tapping than the right one (more sense of electric shock up to the little finger and one next to it with thumb also moving if the bone is tapped hard enough). I wonder if this is related to the left arm and legs mainly feeling the pins and needles and numbness and left side mainly having muscle fasciculations.

Answered by Dr. Gopal Krishna Dash (1 hour later)

Hello,

Thanks for the query,

I understand your concern and your problem

Yes, the lumbar spine can be affected in the same way cervical spines are affected. This is called as lumbar spondylosis.

Spondylosis is usually associated with pain and very rarely be associated with pins and parasthesia alone. This depends upon the way nerves are compressed in the spinal cord.

Spondylosis does not happen the way you have described. What happens by carrying quite heavy weight in awkward positions is that the already existing spondylosis gets aggravated and a sudden heavy weight, trauma, jerk etc can result in disc prolapse in a pre-existing spondylosis.

Regarding your left arm sensations the possibilities could be 1. Local problem in the arm which might be the cause of local nerve compression or cervical spondylosis with nerve compression. If you have current like sensations/fasciculations in the leg it could be related to lumbar spondylosis with symptoms. Regarding the hand symptoms, the second possibility of local nerve compression either in arm and/or wrist is likely. Leg symptoms could be related to lumbar spondylosis. If your waiting time is long, you may try medications like gabapentine, pregabaline, duloxetine etc along with physiotherapy. You may consult a local neurologist and get evaluated with investigations like nerve conduction tests, MRI scans of the spine and other blood tests.

I hope that I have clarified your query,
In case you have more query or concern, please feel free and get back to me
I will happy to help you in this issue

Best wishes

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gopal Krishna Dash (43 hours later)

Dear Dr. Dash,

Thanks for your thoughts and information. I would like to know how the pain would manifest usually in spondylosis. Would it be a sharp pain or a dull pain and would it be felt in the limbs only or in the spinal region? I have only experienced a dull pain the lower back but that has mostly ceased. Where the pain is rarely experienced, would you still recommend the medications mentioned?

Is there any possibility that the condition could be connected with a sensation of ice-cold, which I have experienced a few hours after carrying a backpack but it's not an ongoing sensation. It was felt in the area just below the neck. Could having a stooped posture be related to the condition at all?

Thanks.

Answered by Dr. Gopal Krishna Dash (1 hour later)

Hello,

Thanks for the feed back.
Let me tell you that it becomes difficult (not always) for us to diagnose a condition from the online description given by a patient. Further without clinical interview and examination things may change. With this limitation in mind, Let me respond your question point to point

Q: I would like to know how the pain would manifest usually in spondylosis. Would it be a sharp pain or a dull pain and would it be felt in the limbs only or in the spinal region?
A: To start with the pain of spondylosis will be localized, dull aching. Later if the nerve roots are compressed, pain would be sharp, current like. Rarely pain can even be felt in the limbs only.

Q: I have only experienced a dull pain the lower back but that has mostly ceased. Where the pain is rarely experienced, would you still recommend the medications mentioned?
A: The medications that I have suggested may not be required for you if you have improved completely.
Q: Is there any possibility that the condition could be connected with a sensation of ice-cold, which I have experienced a few hours after carrying a backpack but it's not an ongoing sensation. It was felt in the area just below the neck. Could having a stooped posture be related to the condition at all?
A: Yes, It could be and I agree with you

If you have improved you need not visit a physician at all. All the symptoms that you have related to minor musculoskeletal complaints which is in an improving trend. You can continue daily exercise to avoid muscle stiffness and your pain also improve.

Hope this clarifies
Let me know if I can help in any way
Best wishes

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gopal Krishna Dash (47 hours later)

Dear Dr. Dash,

Thanks again for the answers. My appointment with the neurologist is a few days away.

At the moment, I am also considering inflammation of the muscles or nerves as a possibility as lying on my left side causes the twitching to present on the left leg and arm and increased heat also seems to bring about the twitches and vibrations. Could inflammation cause muscle twitching or pins and needles sensations? What could be a way to test whether inflammation is involved? Is it possible to take certain anti-inflammatory medications?

Recently (past few days), pain in the legs has been felt at times. Prior to this, it was very rarely felt and not as strong. Could my benign fasciculations be changing to a cramp fasciculation and what would be the difference?

Thanks.
Regards,

Answered by Dr. Gopal Krishna Dash (11 hours later)

Hello,

Thanks for the feed back

Yes, inflammation can cause twitching and pins etc

Muscle inflammation can be diagnosed by blood tests like blood enzyme (CPK) and also by a special test called electromyography. In this test one small needle will be put in to the muscle and the potentials will be recorded. It will so changes if inflammation are present.

Till the diagnosis of muscle inflammation is secured, You may take simple analgesics like paracetamol, ibuprofen etc. Try to avoid steroid till the condition is diagnosed or your neurologist has examined you

Please note that the causes of leg pain are many. If you have fasciculation along with pain, it is worth repeating an MRI of the spine. Further guidance can be obtained by electromyography test as I have discussed above. Fasiculations can be seen without any reasons called as benign fasciculations. If there are other neurological signs like severe cramps along with fasiculaitions, neurological cause like nerve compression should be ruled out. I also recommend you to test for thyroid, blood sugar, calcium, creatinine as abnormality in these can cause cramps, fasciculations and so on.

Hope this clarifies
Please get back to me if you are not clear with further questions
I will be happy to help you
Best wishes

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gopal Krishna Dash (11 hours later)

Dear Dr. Dash,

Thanks for the information about inflammation. Is it possible for the inflammation to last 7 weeks as it would have done in my case?

Would it be helpful for me to upload my EMG, Nerve study results for your examination. They were taken two weeks after my muscle twitching started. I am not sure if only an electrophysiologist may interpret the results.

Thanks.

Answered by Dr. Gopal Krishna Dash (12 hours later)

Hello,

Thanks for the feed back

Inflammation may last up to 7 weeks or even longer depending upon the cause.

Please up load your EMG reports. In India, the training is such that neurologists interpret the EMG data.

Best wishes

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gopal Krishna Dash (10 hours later)

Dear Dr. Dash,

Thankyou. I have attached the results of the emg and symptoms of right calf twitching (5th Feb 2013) WWW.WWWW.WW
2) Muscle vibrations and trembling in legs can be seen if hairs on legs are observed (9th Feb 2013)
WWW.WWWW.WW
3) Recent leg muscle twitching (24 March 2013)
WWW.WWWW.WW

Thankyou.

Answered by Dr. Gopal Krishna Dash (13 hours later)

Hello,

Thanks for the feed back

I regret to inform you that I could not see the video, probably related to some soft ware issue. If you want, please sent to my email. I have gone through all your EMG and Nerve conduction reports. The good news is that all these studies are normal and hence it rules out neurological illness as of now. I think that you should stay relaxed and go for physiotherapy and regular exercise along with relaxation techniques. In some problem, we have to study all the abnormal site and in some one site is ok. I assure you again that you do not have any thing serious. Please check your blood sugar, thyroid, calcium etc.

Hope this helps
Please let me know if you have other questions
Best wishes

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gopal Krishna Dash (2 days later)

Dear Dr. Dash,

Thanks again. If you have an e-mail address, then I could forward the video address as I think they are helpful in pointing out the location and nature of twitching and might rule out conditions like spondylosis.

Thanks.

Answered by Dr. Gopal Krishna Dash (1 minute later)

My email address: YYYY@YYYY and YYYY@YYYY

Best wishes

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gopal Krishna Dash (2 days later)

Dear Dr. Dash,

Thanks for viewing the videos and getting back to me regarding the causes which could be either nervous tension or electrolyte imbalance. I will continue to monitor the situation.

I have seen a neurologist who believes these conditions can continue for many months, even years and that they may always return. He also believes that nervous tension can cause the problem to be more likely. He has arranged another emg and nerve conduction in a while just to rule out peripheral neuropathy (I am not sure which peripheral neuropathies can cause the twitching and vibrating) but he expects it to be normal.

Thanks for your information and assistance.
Best regards.

Answered by Dr. Gopal Krishna Dash (1 hour later)

Hello Sir,

Thanks for the feed back

I respect your doctor's decision. I personally feel that yo do not need any repeat study as of now. How ever, You may repeat it and let me know. I strongly feel that it will be normal. I also feel that you need to look the various aspects of your personal life which may be the cause of stress.

I am always there with you. You may contact me directly through my personal email. I generally respond within 24 hours

My best wishes to you
Let me know if I can help you in any way any time...

Take care

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar