Numbness & Tingling in hands and feet
 

It started March 8th - the day after my PT began for neck and back pain. This was after going to a chiropractor for 2 weeks for the neck pain - no success but he did cause sciatica. So the PT was working on that and the pain in the neck. From the day after the first PT I developed the numbness & tingling in hands and feet - so they suspended the neck exercises but continuted manipulations. Then I developed shoulder pain. At this point I decided to go back to my PCP who told me to try a physiatrist. He gave me a steroid shot in the neck and shoulder. Three weeks later, they were a little better but the numbness & tingling is worse and I developed occipital neuralgia. He gave me a steroid shot in the head for that which seemed to help and another one for the shoulder.

He ordered an MRI of cervical area (insurance needs to approve first).

I am 61 years old, not diabetic but I do have a lot of back problems: scoliosis, spinal stenosis, buldging and herniated dics and degenerative joint disease (arthritic changes). I had carpal tunnel surgery on both hands 8 years ago and it was very successful.

So what started out as neck pain, progressed to neck pain, sciatica, shoulder pain, numbness & tingling and occipital neuralgia.

I don't think it's a coincidence that the numbness & tingling started the day after PT started. Didn't have it before.

However, my biggest fear has always been getting MS. I know most people's is getting cancer - but I've already had cancer (breast) and I fear MS more.

Has anyone has a similar problem with numbness & tingling?

Any help would be appreciated.

It's possible that these symptoms are related to something in your spine, but it's possible they are something else. I have those symptoms, and significant spine issues - cervical and lumbar, but the numbness & tingling I have are peripheral neuropathy, which can have many causes - some of which are unknown, but it's common to manifest after age 60.

Would you say the numbness & tingling is the same on both sides or worse on one side than the other?

Doc

Thanks for your reply. I would say that the numbness and tingling is about the same on both sides ( hands and feet), but slightly worse in the right hand (I am right handed).

I don't believe in coincidences in health and medicine and to me, something happened with the PT manipulations that triggered all of this since it started the day after I started PT. But making the connection would be all but impossible.

What is the treatment for peripheral neuropathy? What have you tried that has worked?

Thanks, again.

But you think you may coincidentally be exhibiting/manifesting MS the day after PT? :Hum:

I'm not doubting you, taking sides, or ruling anything out. None of us on this site are doctors; we're just folks like you who are trying to help each other.

I mentioned peripheral neuropathy (PN), because it affects me personally, the numbness/tingling (parasthesia) you describe sounds very much like it, your age, and comparative prevalence with MS.

PN affects at least 20 million people in the US (~7%).
http://www.healthcommunities.com/neu...uropathy.shtml

MS has a prevalence of between 2 and 150 per 100,000 (up to ~1.5%) and its onset usually occurs in young adults.
http://en.wikipedia.org/wiki/Multiple_sclerosis

Having both hands & feet affected also doesn't sound like a cervical injury. Hands - possibly; feet - no, that would more likely be from something in the lumbar/sacral regions.
http://en.wikipedia.org/wiki/Dermatome_(anatomy)

You may have been injured in both the cervical and lumbar/sacral areas at the same time, but that would be a health/medical coincidence.

There are literally dozens of possible causes (diabetes, vitamin deficiency, more), and several kinds, of PN, and still ~30-40% are idiopathic (of unknown cause/origin). Some causes, if found/known, are treatable; with others, only the symptoms can be treated. PN (and possibly its cause) can be DXed by a neurologist by a number of tests:
http://peripheralneuropathycenter.uc...pn/evaluation/

We have a forum here for PN that has much more information:
http://neurotalk.psychcentral.com/forum20.html

My PN was DXed as idiopathic, but so far it has been arrested and I've seen some slight improvement with a change in dietary habits and a regimen of vitamins & supplements.

I am also an intractable pain (IP) patient for many years, and have recently seen improvement there (by about 1/3 to 1/2) by following a diet for IP and adrenal hormone therapy.
http://www.foresttennant.com/pain_ma...self_help.html
http://neurotalk.psychcentral.com/thread156416.html

I'm not saying/suggesting you have PN. I'm just saying that it sounds like it could be, and I think it's worth asking your doctor about and having it checked out. To put your mind at ease, you can be checked out for MS as well.

HTH,

Doc

Doc[/QUOTE]

[QUOTE=Dr. Smith;876419]But you think you may coincidentally be exhibiting/manifesting MS the day after PT? :Hum:

While rational thinking would preclude this conclusion I don't think the medical community has any answers as to what and how PN or MS is triggered.

Numbness and tingling certainly suggests some type of nerve damage/involvement there does not seem to be a lot of definitive answers - thus the catch all "ideopathic"

I can rule out diabetes and vitamin deficiencies - both have been tested recently and several times.

While I have had extensive and multiple back conditions, they have never caused the numbness & tingling I am experiencing now. Only when I got the herniated disc at the L2/L3 area 8 years ago did I get numbness and occasional tingling in the left thigh that persists to this day - which the neurosurgeon said in January that he couldn't help - the nerves are too damaged over the 8 years. Nor could he help my other back conditions.

Back to the PT - I go in for PT on the neck and back and the next day the numbness and tingling go from 0-10. Again, while no one in the medical community will ever be able to explain why - that leaves me to ponder the reasons, including MS. It's like Indiana Jones's biggest fear always being snakes. That's how I've always felt about MS - it was always my biggest medical fear. And I've faced cancer, lost my husband to cancer (we had it at the same time) and intractable back pain, among other things.

When I get the MRI of the cervical area I am hoping that it can shed some light on this.

Thank you for your reply, insights, links and information. I really appreciate it.

I always watched Lost in Space. One of my favorite shows.

That's why a spinal problem (aside from affecting both hands and feet) sounds unlikely (not impossible). When paresthesia presents from a spinal problem, it is usually unilateral - one side or the other (or predominantly so), handedness notwithstanding. To appear bilaterally and both hands & feet suggests another cause, or as previously mentioned, multiple causes.

The MRI may shed some light on the hands, but if it's just cervical, not the feet. Another possibility for the hands is Thoracic Outlet Syndrome; there's a forum here for that too.
http://neurotalk.psychcentral.com/forum24.html

All I'm suggesting is that a more likely reason than MS is PN (albeit PN can be a symptom of MS), whatever the cause.

Another factor that causes me to question PT as the direct cause is that if inflammation/swelling or impingement had occured during that session, I would think the paresthesia would have manifested much sooner, from immediately to minutes to a couple hours - not 24 hours, but a neurologist would have more knowledge/experience about that. I DO have personal experience with that; I had a session that caused a migraine, but I had the migraine before I left the office. Other therapists have warned me about possible increases in pain/soreness, and I've had that too, but again, within a very short time, if not immediately.

You might try searching the archives here - go to the main page and use the search button along the top solid bar (that will catch ALL forums), or google: physical therapy causing paresthesia

Doc

i have the same thing tightness,numb tingling im left handed have it in my trigger finger,frm Diabetis.im new will gt back to you.its terrible unless u really have this

When I woke up one day in June 2003, I had this very intense and unusual pain in my buttocks, unlike anything I had before. It was difficult to walk or sit. I went to a chiropractor who did some adjustments and it got worse. It was a few days later that I noticed some numbness and tingling in my left thigh than got worse and included pain. Then the whole thing just got too painful and I went to the ER and was admitted and they did an MRI and found the herniated disc. I remained in the hospital for a week, had epidural steroid injections and was on vicodin and neurontin, but what mostly helped was time. The nerve damage is permanent as is the numbness and tingling in thigh (but I have lived with this for 8 years - it is tolerable).

So, in this case - there was elapsed time from the herniation to the numbness/tingling.

The MRI is the next step, although before it is scheduled I am going to ask why it isn't being done to my lower back to address the foot issue.

Thanks, again, for your thoughtful response and links.

Let us know what the MRI turns up. Not just the technical jargon; we can try to interpret that, but it tends to lead to a lot more speculation, which can lead to unwarranted fear, and I don't know how helpful that is. IMO, it's more helpful when accompained by the interpretation and results of your follow-up, but that's your call.

Before seeing another chiropractor, please google: chiropractic stroke

Take care,

Doc

I should mention--
 

--that any impingment of the spinal cord itself, as opposed to one of the foraminal nerve roots, may cause symptoms at multiple levels, depending on which tract is being compressed (or stretched). Symptoms can occur from the approximate level of the injury to any level lower.

So it is possible that physical therapy, especially if done brusquely, could have caused something to be moved enough to impinge something and cause symptoms at multiple levels. I imagine, though, that an MRI of the neck would likely show such an impingment if the symptoms came on that acutely--it would be similar to symptoms caused by a sudden trauma.