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What Causes Numbness And Tingling Sensation In The Arms And Shoulders?

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Posted on Fri, 14 Oct 2016
Question: I have had 2 occasions when both my arms, shoulders have been totally numb and tingling, almost painful. I may have had a stroke? I am on blood pressure meds and low dose aspirin... the episodes have only lasted about 15 or 20 minutes. If I know what this is caused from, that's always half the battle.
doctor
Answered by Dr. Olsi Taka (58 minutes later)
Brief Answer:
Stroke unlikely.

Detailed Answer:
I read your question carefully and I understand your concern.

That would be a very unlikely manifestation for a stroke. Stroke usually produces symptoms involving one half of the face and body, meaning the upper and lower limb on one side, sparing the other side. So having both upper limbs affected sparing the lower ones would be unlikely to be caused by stroke.
There is a very rare type of stroke who might cause involvement of both upper limbs, it would be due to low blood pressure leading to low blood flow between at the bordering zone of the anterior and middle cerebral artery, where the areas responsible for the shoulder girdle are....but it is very very rare, more in the form of weakness then tingling (called man in the barrel syndrome) and I think it is very unlikely really. I am mentioning it more as a theoretical possibility since you ask about stroke, not because I think it is the case at all.

One more common possibility would be cervical spine issues, like disc herniation leading to compression of spinal cord or nerve roots. A spinal neck MRI would be the best means to diagnose that.

Metabolic issues like low calcium, high thyroid function, vitamin B12 deficiency may also cause similar abnormal sensations, so a routine blood panel for their levels is also advised.

Another possibility which is also pretty common would actually be anxiety, which may manifest with many different symptoms, abnormal sensations in the upper limbs are a very common manner of manifestation.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (36 minutes later)
I have been tested for thyroid and that's ok, no mention about a B12 deficiency but low calcium is also an issue. I take a Caltrate equivalent with vitamin D. However, I do have arthritis in my neck. I wear a neck collar at night to avoid scrunching my shoulders up which seems to help. What questions should I ask my doctor? I have some dizziness (I think due to the blood pressure meds). Other than that, I'm in relatively good health. Should I be looking for any other symptoms to explain to my doctor in order to help a diagnosis?
doctor
Answered by Dr. Olsi Taka (50 minutes later)
Brief Answer:
Read below.

Detailed Answer:
Thank you for the additional information.

I am not sure that the dizziness is necessarily related to the blood pressure medication, if your blood pressure is well controlled, neither too high nor too low, and your heart rate as well then there is no reason it should be the cause.
Other causes should be considered. Spinal issues may well be a cause, several possible mechanisms like compression of upper nerve roots which are involved in balance, cord compression, compression of vertebral arteries which supply the posterior part of the brain.

Other symptoms to look at would be weakness of the limbs and gait abnormalities. From the possibility of stroke perspective it would be also symptoms like double vision, vision loss, confusion behavior changes. Afterwards it is up to the doctors exam, he should test sensibility, muscle strength, reflexes, gait, balance and coordination - according to the findings it should be discussed whether there are signs of spinal cord compression warranting a neck MRI or of brain lesions warranting an MRI of the brain and the supplying blood vessels.

Let me know if I can further assist you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (24 minutes later)
Um, what is TIA? That shows up on my reports. I should have asked last week but I get nervous in a doctor's office. I have been tested for all the symptoms you describe and am showing negative results. My next appt is in a couple of weeks and I will ask about an MRI...what is TIA?
doctor
Answered by Dr. Olsi Taka (24 minutes later)
Brief Answer:
Read below.

Detailed Answer:
A TIA is an acronym which stands for transient ischemic attack. Meaning a transitory lack of blood flow to the brain manifesting with transitory stroke symptoms, but which are reversed and there are no symptoms left and no brain lesions on brain imaging. Typically symptoms regress in less than a hour.

It is not always a straightforward diagnosis. There are clinically clear cut TIAs, clear neurological deficits, like say loss of speech and weakness of the limbs on one side (by the way I forgot to mention speech issues among the symptoms to watch before). But there are episodes which are less clear, because the symptoms are not clear cut, they do not correspond to a brain area supplied by a certain vessel, and symptoms may have other origin like migraine aura, anxiety, spinal issues etc. Your episodes as I said in my first answer are not typical for TIA or stroke judging from the distribution.

If your doctor thinks your episodes constitute a TIA though (as I said I have my doubts about that) then they should be managed just as if they were a stroke, in order to avoid a stroke in the future. By that I mean that a patient with TIAs, (repeated ones in this case), is to have brain imaging (CT or preferably MRI), imaging of the vessels (by Doppler ultrasound, Angio CT or Angio MRI), a heart evaluation for arrhythmia or valvular issues as well as blood screening for diabetes, high cholesterol etc. All that is done to find the source in order to prevent a stroke in the future. Common sources are cardiac causes and atherosclerotic plaques in the vessels. Aspirin is already a good preventive drug, but if there is a cardiac cause other types of blood thinners would be needed.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka (33 minutes later)
OK..informative. Thanks... All the more reason I should probably deal with an MRI.
I'll let you know in couple of weeks how I made out. Do you want go know any results?
doctor
Answered by Dr. Olsi Taka (5 minutes later)
Brief Answer:
Yes, thank you.

Detailed Answer:
Yes of course, Whether right or wrong one learns from every patient.

Looking forward to hearing from you again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3674 Questions

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What Causes Numbness And Tingling Sensation In The Arms And Shoulders?

Brief Answer: Stroke unlikely. Detailed Answer: I read your question carefully and I understand your concern. That would be a very unlikely manifestation for a stroke. Stroke usually produces symptoms involving one half of the face and body, meaning the upper and lower limb on one side, sparing the other side. So having both upper limbs affected sparing the lower ones would be unlikely to be caused by stroke. There is a very rare type of stroke who might cause involvement of both upper limbs, it would be due to low blood pressure leading to low blood flow between at the bordering zone of the anterior and middle cerebral artery, where the areas responsible for the shoulder girdle are....but it is very very rare, more in the form of weakness then tingling (called man in the barrel syndrome) and I think it is very unlikely really. I am mentioning it more as a theoretical possibility since you ask about stroke, not because I think it is the case at all. One more common possibility would be cervical spine issues, like disc herniation leading to compression of spinal cord or nerve roots. A spinal neck MRI would be the best means to diagnose that. Metabolic issues like low calcium, high thyroid function, vitamin B12 deficiency may also cause similar abnormal sensations, so a routine blood panel for their levels is also advised. Another possibility which is also pretty common would actually be anxiety, which may manifest with many different symptoms, abnormal sensations in the upper limbs are a very common manner of manifestation. I remain at your disposal for other questions.