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Suffering From Random Tingling And Pain In Left Arm. Pain In Ankles And Finger Tips. What Is The Issue? Further Tests?

Posted on Sun, 29 Sep 2013

Question: Hello doctor I have been suffering from random tingling & pain in the left hand (lower part) & left leg (low part) for more than 6 months. Here are my symtopms:
- Pain in the left ankle (sharp pain)
- Heavy/Tight hands esp in the middle joints(third) of left
- Sharp pain in the left ankle and moved to the knee
- Tingling in straight line if rubbed in nearby wrist
- sharp pain in the left finger tips (last for few seconds) > pain in ankle > mild pain in the finger tips > sharp pain in the ankle
- Putting hands on the table, kind of straigt line sensation passing through ring finger
- Twitching in the right biceps and lasted only for few seconds
- Numbness around the little finger line
Note all symtopms are random and last only for few seconds and relocates.

I have done all kinds of test like uric acid, MRI (cervical, throraric), blood test for Rheumotoids, NVC nerve test etc.
And only thing found so far are high uric acid (for this using allopurional 100mg), a bit low calcium & vitamin b12 levels.
My Queries are:
What can be this issue?
What are the further test required to diagonize?
Which doctor to refer to (neurologist, orthopedics or else)?

Additionally, I am under medication of allopurinol 100mg & gabapentin, neurobion & vitamin d capsules. But nothing is making much difference.

Answered by Dr. Moustafa Saeed (1 hour later)

Hi,

I have read your question and I understand you have already done extensive number of investigations and the only abnormality so far is high uric acid which can give joint pain and inflammation but does not cause the tingling.
The low calcium however can give such symptoms of tingling in the limbs or even in the face and also can cause muscle cramps.

If the MRI scan and nerve studies are normal then orthopaedic surgeon cannot help you.

My advice is to increase intake of food with high calcium such as milk and its products and take oral supplement of calcium (daily requirement only you can buy it easily) for four weeks and then repeat your calcium level in blood. If symptoms does not settle and bloods still abnormal you can see endocrinologist to find the cause of abnormal calcium.

Consider checking vitamin D level as well

If levels are normal and still have the symptoms then neurologist review will be helpful

Kind regards

Dr AL-SAEED

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Moustafa Saeed (4 hours later)

Dear Doctor,

I have uploaded all the test reports which can help to diagnose .
This health problem is killing me.

Also would like to mention, I am a computer developer by profession.

let me know if you have any queries for me.

Waiting forward for the reply.

Regards

Answered by Dr. Moustafa Saeed (2 days later)

Brief Answer:
Kindly re-upload the reports

Detailed Answer:
Hi,

Thanks for your query.

According to these reports you do not have low calcium as I thought according to your first question.

The reports showed slightly low vitamin D but you are already started taking supplement for it.

The MRI scan of your cervical spine (neck) showed bulging disc but it is mild and not causing pressure on the nerves.

I suggest that you upload the MRI scan itself on the clouds and send me link to it so I can review it myself.

The NCV report did not open with me but I trust it is normal. You can try to upload it again if possible.

Having read your reports and if everything normal then neurologist opinion will be recommended.

Kind regards

Dr. AL-SAEED

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Moustafa Saeed (11 hours later)

Dear Doctor,

I have re-uploaded the NCV report. Please check once.
Just want to add more:
As per test there is some issue with the left leg near knee (NCV test). And issue in neck(MRI test). And doctor told me to do some isometric exercises and having gabapentin.

I do have MRI softcopy which i try to upload and let you know.
Thanks a lot in advance. Your advice means a lot to me.
I am so worried due to my health problem :(

Waiting forward for the reply.
Regards

Answered by Dr. Moustafa Saeed (5 hours later)

Brief Answer:
further to your query

Detailed Answer:

The NCV test of upper and lower limbs still does not explain your symptoms.

Having said that I do not believe that surgery is going to help your transient symptoms.

I am happy to review your MRI scan film if you manage to upload them and send me link if possible.

Exercises and physiotherapy may help.

Try to adjust your setting habits on PC during work and see if you are putting pressure on specific area of your arms or legs or even neck and back posture.

Regards

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vaishalee Punj