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Forearms Are Aching, Feeling Tired And Irritating. Undergone Surgery For Both Achilles. Could I Ask A Doctor?

Posted on Thu, 24 Oct 2013

Question: Hi, I have had various pains and problems in my two arms. My current issues is that my forearms (mostly right but also a bit on the left) is acking in the morning - but is ok during working day - but when the weekend comes the acking increase and Sundays I get very tiered and irritable due to this. When i get to work on Monday the problem is much less - this status s the same during the working week. This has been the process the last 4 weeks. I did a test 2 weeks ago being very active during the weekend (i.e. not resting my arms) and then the acking was much less. I am a "desk jockey" - 43 years old - male. One interesting piece of information is that I did surgery on my both Achilles - scraping. In both legs I had to go in and to a second scraping since the "Funnel" was narrow after the late membrane curled up. A situation that happens i 2-3% of all cases - I got in both Achilles! Any idea?

Answered by Dr. Sudhir Kumar (47 hours later)

Brief Answer:
Symptoms are suggestive of peripheral neuropathy

Detailed Answer:
Hi,
Thank you for posting your query.

Your symptoms are suggestive of peripheral neuropathy, a disease of nerves of hands and feet. In this case, it could be entrapment neuropathy, where one or more nerves get entrapped with tissues surrounding the nerve. It is typical for a pain or ache related to nerve disease to get aggravated during sleep or rest, and become less while busy.
Nerve conduction studies have shown abnormalities consistent with peripheral neuropathy. If not done, you could check the blood levels of vitamin B12 and thyroid profile.
For symptom relief, pregabalin or gabapentin would help. Physiotherapy would also help.

I hope it helps. Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (1 hour later)

Dear Dr. XXXXXXX XXXXXXX

thanks for your answer. I have had nerve conduction velocity (is this the same as nerve condition studies?)measured 1,5 years ago and it was found to be decreased in all 4 limbs and a lot of blood sample tests have been done (B12 included), but no conclusions has been drawn. The thyroid profile is that done using the blood and would a neurologist typically ask for that when doing a blood scan?

Br

XXXX

dear Dr. XXXXXXX XXXXXXX

another piece of information that might be of interest to this case.

1) I did a spinal tap September last year. I was sitting when this was done. I fainted during the procedure. It was diagnosed as vasovagal syncope.

2) I had a lot of pains in my back and both legs a few years back. And I undertook surgery based on my description on the problem. A minor spinal stenosis was removed.

So, based on my last to questions I have a feeling that I might have very sensitive nerves as the the data shows small/minor issues (i.e. a minor spinal tap, minor readings on the nerve velocity readings etc.) and what do you suggest I do going forward as I feel that the doctors looking at it has "stopped".
¨Thnaks

XXXX

Answered by Dr. Sudhir Kumar (8 hours later)

Brief Answer:
My replies are below

Detailed Answer:
Thank you for getting back with more details.
I agree most of the work up has been done. Yes, nerve conduction velocity and nerve conduction studies refer to the same test, and the values were suggestive of nerve disease.
Vasovagal syncope is not something to worry about, and it was a situation response to the pain or discomfort of the spinal tap.
Thyroid profile is tested in blood tests.
Going forwards, you can take medications for relief of pain and ache (pregabalin or gabapentin), and also start exercises for arms, legs and back.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar