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What causes tingling in face,fingers and toes with stiffness in jaw?

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General & Family Physician
Practicing since : 2003
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About 8 weeks ago had a sore throat, went to Dr and was diagnosed with Strep and took medication for it. After 2 weeks still tightness in throat. Started getting tingling in my fingers and toes. About a week later stiffness in jaw, difficulty opening jaw wide, tingling in face. This week my legs mainly my thighs have been sore and my legs feel really heavy when i walk. Also my back has gotten sore as if I have difficulty standing up straight. Also I feel shortness of breath with minimal physical activity.I'm at my desk now feeling like I'm breathing hard. just sitting at my desk. I walked up the street today and could barely breath. I've been to Dr and had EKG, Chest X-Ray, Blood tests to rule out vitamin deficiencies and other common illnesses. Gone to ENT and they put a camera in my throat and didn't find anything. Suggested it could be related to heartburn but I've never had it before and I am not convinced of this being the answer. The past two days extremely weak and feels difficult to take a full breath. If I run even a block I feel extremely winded
Posted Thu, 20 Feb 2014 in General Health
 
 
Answered by Dr. Vaishalee Punj 4 days later
Brief Answer: Maybe myositis Detailed Answer: Hi Thanks for posting your query on XXXXXXX I am sorry to know that are going through a tough phase. From your description it seems that the skeletal muscles in your body are getting affected. It seems like myositis, though it can also be necrotizing fasciitis. Toxic shock syndrome is also possible. It seems to be due to streptococcal infection (Group A streptococcus). A biopsy of muscle will confirm the diagnosis. Since it has been a few weeks, I don't know what treatment you have tried. I also don't know if you are recovering or not. In my opinion you should be managed by an infectious disease specialist and a surgeon. Penicillins may not be of much help. In toxic shock syndrome the treatment is supportive. In case of myositis, treatment depends on severity of symptoms. If the symptoms are mild, then the treatment will be supportive. If large chunks of muscles got destroyed, then those muscles will need to be removed (debrided). Necrotizing fasciitis is more damaging and you do not seem to have it. Ask your doctor to refer you on emergency basis or you consult someone in emergency room for diagnosis and treatment. Take care Dr Vaishalee
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Follow-up: What causes tingling in face,fingers and toes with stiffness in jaw? 3 hours later
Thanks, my dr has referred to a neurologist for further testing. Do you think this is the correct path? He seems to think its all anxiety causing it though is this possible?
 
 
Answered by Dr. Vaishalee Punj 1 hour later
Brief Answer: Anxiety can cause tingling not other symptoms Detailed Answer: Hi again It does not seem to be anxiety. Anxiety causes similar symptoms but milder. Your symptoms are related to muscles and you seem to be unwell. Maybe you discuss the myositis or toxic shock syndrome diagnosis with your doctor. It is a good idea to consult a neurologist to rule out neurological symptoms of these symptoms. A neurologist will like to see a report of CT scan or MRI of head. I think tests like creatinine kinase, myoglobin, etc should help to rule out muscular causes. Biopsy is an invasive test, but if you are not getting better than you can get it done too. Regards Dr Vaishalee
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Follow-up: What causes tingling in face,fingers and toes with stiffness in jaw? 1 hour later
Thanks can this cause the shallow breathing I'm experiencing all day? It feels like I can't take a deep breath all day and some times like I'm grasping for air. I wake up with a tingling feeling all over my face.
 
 
Answered by Dr. Vaishalee Punj 11 minutes later
Brief Answer: Tingling related to shortness of breath Detailed Answer: Hi again The tingling and numbness seem to be related to shortness of breath. Shortness of breath can be caused by both myositis and some neurological condition. For normal and deep breathing, respiratory muscles are brought into action. Since your muscles are getting affected, you take shallow breaths. Anxiety can have similar symptoms but the cause is not muscular but psychiatric. Anxieties usually have a stressor too. To assist with deep breathing, please do some breathing exercises. There are some excellent breathing techniques in Indian yoga like nadi shodhan pranayam and XXXXXXX XXXXXXX You can find nadi shodhan pranayam on internet but to learn XXXXXXX you will need to take a course. Do not over exert at deep breathing though, do it only till the level you can tolerate. Slowly increase the level of deep breathing. Hope it helps. Dr Vaishalee
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Follow-up: What causes tingling in face,fingers and toes with stiffness in jaw? 1 hour later
With breathing muscles involved can this be dangerous? My breathing feels very light but pulse feels normal also not able to sleep well so extremely tired. I went to two PCP doctors and neither seems concerned that this is anything... Is there Any test that can be done to determine actual muscle weakness vs perceived mental weakness?Could this be related to something such as my thyroid levels?
 
 
Answered by Dr. Vaishalee Punj 13 hours later
Brief Answer: Need to be tested Detailed Answer: Hi again, It is always better to get tested if suspecting anything. You have shortness of breath, muscle weakness, pains, etc. These definitely make you a candidate for all basic tests including thyroid profile, complete blood count, creatinine kinase, myoglobin levels, etc. Hypothyroidism is known to cause myopathy in some cases. Thus similar symptoms can happen in thyroid disorders. An infection can affect thyroid. Breathing muscles involved may cause shallow breathing. Your blood gas levels need to be checked and pulmonary function tests also need to be done. Blood gas analysis is done in emergency room. It is better to be taken care in a hospital setting where all tests are available at hand. Muscle weakness is usually done manually. It is called as manual muscle testing. Neurologists and internal medicine specialists do it more frequently than other physicians. Electromyogram is another test that can be done. In your case it is of acute onset (after a streptococcal infection) and goes in the direction of an organic cause rather than perceived muscle weakness. Hope it helps. Dr Vaishalee
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Follow-up: What causes tingling in face,fingers and toes with stiffness in jaw? 4 hours later
Thank you so much it feels like I can't take a deep breath using my diophram. I can't sleep for a week because of this. My vision is getting blurry as well
 
 
Answered by Dr. Vaishalee Punj 3 hours later
Brief Answer: Visit ER Detailed Answer: Hi again, Vision getting blurry is not a good sign and may suggest optic nerve involvement. Thus I will suggest that you visit emergency room at the earliest to rule out something ominous. A general rule about medical care is to keep looking for a doctor until you are in good hands. Please do not ignore this. Take care of your self. Dr Vaishalee
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Follow-up: What causes tingling in face,fingers and toes with stiffness in jaw? 28 minutes later
Is it possible for anxiety caused all this
 
 
Answered by Dr. Vaishalee Punj 14 minutes later
Brief Answer: Anxieties happen in attacks Detailed Answer: Hi again Anxieties are of many types like panic disorder, generalised anxiety disorder and phobias ie fear of something for example fear of heights. In panic disorder the patient typically has hyperventilation, chest tightening, sweating and feeling of impending doom. All tests including ECG come back normal and then the patient is labelled as having an anxiety attack. It does not last for more than a few days. A stressor is usually present. This is a presentation for panic disorder. Generalized anxiety disorder people keep worrying for some thing like relationships, etc. Symptoms include restlessness, fatigue, irritability, sleep anomalies, muscular tension, difficulty in concentration. These symptoms should be present for atleast 6 months for the diagnosis to be made. Though some of the symptoms overlap, but do not entirely fit the scenario of anxieties. Dr Vaishalee
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Follow-up: What causes tingling in face,fingers and toes with stiffness in jaw? 28 hours later
Thanks for your response it appears like I cant breathe properly. im breathing through my mouth all night instead of my nose. any suggustions for this?
 
 
Answered by Dr. Vaishalee Punj 13 hours later
Brief Answer: Could be two reasons Detailed Answer: Hi again There could be two reasons for this. Either your nose is blocked or you may be gasping for air. In nose blockage, nasal sprays can be taken. When you are trying to get in extra air, you may breathe through your mouth. Breathing exercises should help in later case. Dr Vaishalee
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Follow-up: What causes tingling in face,fingers and toes with stiffness in jaw? 6 hours later
What kind of breathing exercises? feels as if I cant breathe through my diaphram properly
 
 
Answered by Dr. Vaishalee Punj 1 hour later
Brief Answer: Diaphragm muscle maybe weak Detailed Answer: Hi again, The treatment for diaphragmatic muscle weakening depends on the cause and treatment of the cause. The cause may be myositis or myopathy in your case, though neurologic causes are more often seen. If your blood gas analysis shows abnormal blood gases and increasing carbon dioxide levels, then ventilatory support will be needed. I am not sure if you have already visited the neurologist or emergency room. Breathing exercises are available in Indian yoga or in Chinese traditional therapy. In Indian yoga, breathing exercises are pranayam (many types) and XXXXXXX XXXXXXX (controlled breathing). These should help strengthen the respiratory muscles. I am hopeful that these will help you. These are taught as a course by "art of living" organisation and some of them are also available on internet. Dr Vaishalee
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Follow-up: What causes tingling in face,fingers and toes with stiffness in jaw? 4 minutes later
Thanks, everyone thinks its just anxiety. I've seen a neurologist and he said all looks normal. I've been to ER and urgent care 3x and they don't find anything wrong. Can anxiety really cause all of this? I haven't slept in a week as a result.
 
 
Answered by Dr. Vaishalee Punj 45 minutes later
Brief Answer: Anxiety does not seem to be the culprit Detailed Answer: Hi I am really sorry that you are going through all this. I really wish some doctor would have thought it as a muscular weakness and investigated in this direction. Since I am not able to examine you and treat you, I have to give my diagnosis based on your description of symptoms. If you tell me the reports that you have gotten done and blood gas analysis results, I will be better able to help you. I would also like to know about the neurologist's report. You have the feature to upload the reports from your dashboard. You can also send them at YYYY@YYYY and address it to my name: Dr Vaishalee Punj. If you feel that your symptoms are getting better, then recovery is happening. Otherwise you need to find appropriate medical help. I still believe that it is not anxiety. It is easier to blame mental health when finding a cause is tedious. Moreover you are getting typical symptoms of diaphragmatic disorder. Waiting for your response. Dr Vaishalee
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Follow-up: What causes tingling in face,fingers and toes with stiffness in jaw? 52 minutes later
Thanks, I had PFT testing and they all turned out normal. I'll have to contact hte hospital to get the blood gas test results. Neurologist did a neurological exam and reported that all of my neurological functions were working okay. Per him it doesn't seem to be a neurological issue that required any further testing.All of my muscles feel very weak as well. Is there any test they could do for diaphragmatic issues? My face feels rubbery and very weak. My blood oxygen levels seem to be okay when testing. Always 95 or higher. I have a home pulse oxymeter that I've been using to test it. No one seems to believe anything is going on besides an anxiety issue. If I go back to ER will they be of any help?
 
 
Answered by Dr. Vaishalee Punj 22 hours later
Brief Answer: At least PFT is normal Detailed Answer: Hi again, I think if your PFT is normal, then you are able to expand your lungs to the full (maybe with extra effort). With breathing exercises, etc you will be able to develop your muscular strength back to normal. Please get the blood gas results (even if verbally) and let me know. Regarding neurological exam, did the neurologist check the strengths in individual muscles of legs and arms? For example bicep muscle strength test, tricep muscle strength test, etc. If these tests were within normal limits, then the weakness may be mild. Though your symptoms are not going with the tests. For diaphragmatic weakness, there are other tests like chest X-ray or CT scan of chest that may check for diaphragmatic paralysis. Other tests are there but are not done in routine. These tests include phrenic nerve stimulation/diaphragm electromyography, maximum inspiratory and expiratory pressures (MIP and MEP) sustained during one second against near complete occlusion and Sniff nasal inspiratory pressure (SNIP). I think you may recover, since your tests are coming back normal. It means that the muscles got affected but not to the extent of causing lot of damage to function. I am not sure if the ER doctors will help you. Another visit to the neurologist may be of more help, if you can convince him that your muscles are weak and that he tests you further for it. Dr Vaishalee
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Follow-up: What causes tingling in face,fingers and toes with stiffness in jaw? 5 hours later
neuroligist seemed to be very good and assured no neurological issues. I had a chest xray in urgent care a month ago and all showed up normal. I'll check on blood gas testing results and report back
 
 
Answered by Dr. Vaishalee Punj 18 hours later
Brief Answer: negative test reports are reassuring Detailed Answer: Hi again It is good that the test reports are coming back negative. I will wait for the blood gas analysis too. Dr Vaishalee
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