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Have mild hypertension, had herniated disk. Woke up with pain and numbness in body. Treat anxiety first?

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I am 56, male, 173 cm, 85 Kg. I have mild hypertension and take a calcium blocker and beta blocker to control it. Other than orthopedic issues, lower back herniated disk 9 years ago, dislocated right bicep shoulder tendon, I am healthy. I also suffer from hyperchondria anxiety.. 3 months ago I woke up to terrible pain in right arm, numbness in part of my right hand I also could not sit. After a week I also had occasional numbness between my big and 2nd toe on my right foot. After 5 weeks of rest and PT I was pain free, the numbness was reduced dramatically and I was left with an inability to lift my right index finger. Now I have occasional numbness in both hands, have frequent numbness in my right foot (between the same toes) and sometimes in the left as well. The numbness generally disappears when I lie down. I also get what feels like pockets (circles) of jumping electricity, mostly in my left leg but in other parts of my body as well. The "electricity"almost never happens when I lie down, walk or exercise (I go to a gym 3 days a week) and it mostly occurs when I sit. I also get occasional XXXXXXX twitches, my body does not usually move involuntarily. I went to a neurologist 2 weeks ago and my neurological exam was ok except for the weakness in my right hand. A CT of my neck showed small bulges in c3-c4 and c4-c5. An EMG showed chronic reinveration problems in all muscles tested in both arms, with the right arm being worse than the left. No neuropathy was detected. The EMG was one month ago and all the leg symptoms except for the numbness in the right foot, started after the EMG doctor asked if I have issues with my legs. I have scheduled an MRI on my neck for next week and was told to have another EMG in January. I am very anxious and noted that some of the symptoms, left leg numbness, "electricity, occasional twitching started after I was asked if I have them. Today a couple of hours after my aerobic (treadmill) workout, my legs felt shaky. I do have any problems walking or standing. The neurologist told me to come back after 3 months and the orthopedist said to return with the MRI results. Although I think these phenomena are real, I have also decided to consult a therapist to control my anxiety. Any other ideas how to manage this?
Posted Thu, 19 Apr 2012 in Brain and Spine
Answered by Dr. Shiva Kumar R 16 hours later
Hello and thanks for the query.

Weakness of arms, pain and the sensory symptoms looks like you are suffering from problem in the roots exiting the spinal cord. Most common cause for this is Spondylosis. Tomography) scan is good for seeing the problems in the bony structures. MRI (Magnetic Resonant Imaging) is the best investigating tool for spinal cord and the exiting roots. Till you get your MRI done, you can reduce the pain with medications like Gabapentin, Pregabalin or Tryptomer. These are prescription drugs; you need your doctor’s prescription for the same. Physiotherapy is required to strengthen your muscles of the hand to prevent wasting.

I do agree with the neurologist for a repeat EMG after the MRI for confirming the diagnosis. The numbness in the legs may be due to lumbar Spondylosis. Rarely compression of the spinal cord in the neck can also cause sensory symptoms and sometimes shaky legs during the exercise.

This is a very difficult time for you, I am sure. The bottom line is that I think you need to talk to your General Physician and get yourself started on the medications and physiotherapy till you XXXXXXX your Neurologist.

I thank you again for submitting your query. I hope my response was both helpful and adequate. If you have any additional questions I would be happy to address them.


Dr Shiva Kumar R
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