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What Causes Severe Pain In All Four Limbs?
Question: In ALS does initial symptoms effect all 4 limbs at the same time or just 1 limb to start? I have shocking pain in all 4 limbs and am worried it's ALS.
Brief Answer:
ALS very unlikely in this situation... pain is not a general characteristic of ALS
Detailed Answer:
I read your query and I understand your concern.
Pain in general is not a characteristic of ALS or any other motor neuron disease, main feature is progressive weakness.Even weakness doesn't start in all four limbs, it's an insidious progressive process which starts in one limb, other limbs are affected over the course of many months.
So it's not ALS.
For further hypotheses more data are needed like:
other medical conditions
medication,
time of pain onset
character (throbbing, continuous, intermitent)
intensity
precise location
evolution in time
aggravating factors
other signs you might have noticed
I am at your disposal for further questions.
ALS very unlikely in this situation... pain is not a general characteristic of ALS
Detailed Answer:
I read your query and I understand your concern.
Pain in general is not a characteristic of ALS or any other motor neuron disease, main feature is progressive weakness.Even weakness doesn't start in all four limbs, it's an insidious progressive process which starts in one limb, other limbs are affected over the course of many months.
So it's not ALS.
For further hypotheses more data are needed like:
other medical conditions
medication,
time of pain onset
character (throbbing, continuous, intermitent)
intensity
precise location
evolution in time
aggravating factors
other signs you might have noticed
I am at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
celiac disease XXXXXXX Valve Prolapse
Fibromyalgia
Low Folic Acid
Low Vitamin D
constipation
Zoloft, chlomifine
45 days ago
intermintent - shooting pain
fingers, toes, hands, feet
Fibromyalgia
Low Folic Acid
Low Vitamin D
constipation
Zoloft, chlomifine
45 days ago
intermintent - shooting pain
fingers, toes, hands, feet
Brief Answer:
Peripheral neuropathy, EMG necessary
Detailed Answer:
Thank you for providing some more information.
The peripheral distribution of your pain indicates a peripheral neuropathy. Since all limbs are involved nerve compression is not to be blamed and a systemic cause is to be found.
There is a long list of possible causes like diabetes, alcohol, nutritional, toxins, endocrine diseases etc.
The main test for the diagnosis is the EMG with nerve conduction studies (NCS).
Usually it is associated with other tests to find the cause like blood glucose with HbA1c, electrolytes, Vit B12, erythrosedimentation rate, antinuclear antibodies. The list of possible tests is long, they are not necessarily all done at the same time, it is usually started with the common causes continuing with rarer ones if negative.
There is a percentage of cases when with all tests being done, still there is no cause to be found.
In your case though, you do have a potential cause which is celiac disease. Like many autoimmune diseases it has been associated with several types of peripheral neuropathy, not always improved by a gluten free diet.
However Electromyography (EMG)/Nerve conduction studies NCS has to be performed before blaming it on celiac disease, along with testing for other more common causes.
Zoloft also can cause burning and tingling feeling in the extremities, but it is a rare side effect (only 2%), less likely.
I hope to have been of help.
Peripheral neuropathy, EMG necessary
Detailed Answer:
Thank you for providing some more information.
The peripheral distribution of your pain indicates a peripheral neuropathy. Since all limbs are involved nerve compression is not to be blamed and a systemic cause is to be found.
There is a long list of possible causes like diabetes, alcohol, nutritional, toxins, endocrine diseases etc.
The main test for the diagnosis is the EMG with nerve conduction studies (NCS).
Usually it is associated with other tests to find the cause like blood glucose with HbA1c, electrolytes, Vit B12, erythrosedimentation rate, antinuclear antibodies. The list of possible tests is long, they are not necessarily all done at the same time, it is usually started with the common causes continuing with rarer ones if negative.
There is a percentage of cases when with all tests being done, still there is no cause to be found.
In your case though, you do have a potential cause which is celiac disease. Like many autoimmune diseases it has been associated with several types of peripheral neuropathy, not always improved by a gluten free diet.
However Electromyography (EMG)/Nerve conduction studies NCS has to be performed before blaming it on celiac disease, along with testing for other more common causes.
Zoloft also can cause burning and tingling feeling in the extremities, but it is a rare side effect (only 2%), less likely.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Raju A.T
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