[42F] With bilateral hand and arm pain, tingling, and weakness

Patient Description

A 42-year-old female presents with severe dull pain in both hands and arms for one week, rated 9/10. Accompanying symptoms include tingling, weakness, swelling, and color changes in the palms and fingers, with symptoms waking her at night. She reports numbness and difficulty with fine motor skills. There is no history of recent injury, repetitive hand movements, or changes in daily activities. Family history is significant for a sister with multiple sclerosis. The patient has a history of myasthenia gravis diagnosed in 2007. She denies any allergies and is currently taking Levothyroxine. No recent infections or illnesses were reported.

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Arora's Assessment

What might be happening

Based on your symptoms, here are some possible explanations:

  • Carpal Tunnel Syndrome: This condition occurs when the median nerve is compressed as it travels through the wrist. It can cause pain, tingling, and weakness in the hands and fingers. Swelling and nighttime symptoms are common.

    • Treatment often includes wrist splints, anti-inflammatory medications, and sometimes corticosteroid injections or surgery.
  • Peripheral Neuropathy: This involves damage to the peripheral nerves and can cause pain, tingling, and weakness. It can be related to conditions like diabetes or autoimmune diseases.

    • Treatment focuses on managing symptoms and addressing the underlying cause.
  • Cervical Radiculopathy: This occurs when a nerve in the neck is compressed or irritated, leading to pain and tingling in the arms and hands.

    • Treatment may include physical therapy, medications, or injections.

Given your history of myasthenia gravis, it's important to consider how this condition might interact with your current symptoms.

What you can do

  • Consult a Healthcare Provider: It's important to see a doctor for a proper diagnosis and treatment plan. They may recommend tests like nerve conduction studies or imaging.
  • Symptom Management: Consider using wrist splints, especially at night, to help alleviate symptoms. Over-the-counter pain relievers may also help.
  • Track Symptoms: Use MDandMe to journal your symptoms, track any changes, and share this information with your healthcare provider.

What you should look out for

  • Seek Immediate Care: If you experience severe weakness, loss of function, or if symptoms rapidly worsen, seek medical attention promptly.
  • Monitor for New Symptoms: Keep an eye out for any new symptoms, such as changes in vision or speech, and report these to your doctor.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment plan.

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3 mo ago

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People Also Ask


What are the common symptoms of carpal tunnel syndrome?

Common symptoms of carpal tunnel syndrome include pain, tingling, and numbness in the thumb, index, and middle fingers, weakness in the hand, and symptoms that often worsen at night.


How does peripheral neuropathy differ from carpal tunnel syndrome?

Peripheral neuropathy involves damage to the peripheral nerves and can cause widespread pain, tingling, and weakness, often affecting both hands and feet, whereas carpal tunnel syndrome specifically affects the median nerve in the wrist.


What is cervical radiculopathy and how is it treated?

Cervical radiculopathy occurs when a nerve in the neck is compressed or irritated, leading to pain, tingling, and weakness in the arms and hands. Treatment may include physical therapy, medications, or injections to relieve symptoms.


How might myasthenia gravis affect symptoms in the hands and arms?

Myasthenia gravis is an autoimmune disorder that causes muscle weakness. It can exacerbate symptoms in the hands and arms by contributing to overall muscle weakness and fatigue, potentially complicating the diagnosis and treatment of other conditions.


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