Strange symptoms and my GP can't explain it

[Shittenshite]

For about 5-6 weeks I've had strange sensations in my left hand. It started with pins and needles and intermittent numbness. I also have horrible nerve pain, especially on contact with water - hot, cold or warm, even. Cold water (even brief contact) leaves me unable to feel my hand for at least half an hour after contact.

Weirdly, I have a sensation of pressure under the thumbnail too. No injuries, no damage to the nail or nail bed. No infection or fungal growth etc. My index finger feels similar. Both the 'pads' of the thumb and index finger are almost numb all the time.

Just recently I've developed a new symptom - my left hand occasionally goes into spasm and forms a tight fist which I can't release myself. I have to wait a few minutes for it ease off. Anyone who has suffered the agony of calf cramps in the middle of the night will appreciate the pain and intensity of these spasms. I feel it all down the inside of my wrist and forearm.

I've been referred for a nerve conduction study but it's not for over another 2 months. I'm not complaining - I understand and fully appreciate how stretched the NHS is. I've also had a CT scan of my head which didn't show anything concerning.

I've also had an ECG which was fine. I feel I'm wasting precious resources now.

My GP is perplexed. It is getting very rapidly worse and my GP thinks that carpal tunnel is unlikely given the rapid onset and deterioration.

I have two young children. Tasks I took for granted like changing a nappy or preparing a simple meal are becoming a huge challenge.

If anyone has any thoughts please feel free to add them. I am NOT looking for a diagnosis online but opinions, personal experiences or ideas from health professionals which may point me in a better direction would be great. Thank you!

PS. Please forgive me for highlighting in bold - I don't mean to shout or treat anyone like they're daft. I think it's a TL;DR post and many are likely to skip past that bit and suggest carpal tunnel as a possible explanation. Understandably!

How odd.

I have this apart from the water issue and the pressure under the fingers.

I put mine down to nerve damage, as when the doctor knocked my elbow, I felt the same numb tingling sensation. She said it was likely carpal tunnel but couldn’t be sure.

I also get the scrunching of the hand type cramp but only the last three fingers and only about once a month.

Do you wake up with a numb hand in the morning?

Have you been referred to a specialist hand clinic?
a different issue, but an elderly relative of mine went 2hrs away to the Pulvertaft Clinic in the Royal Derby Hospital and they managed to save a finger.

Do they turn white/paler?
What do you do for a living, is your hand in one position for hours on end?

DH has Raynaud's and similar symptoms. His had goes completely dead at times.

I have been having issues with numbness and pain in my hands and forearms and for a while. It has improved significantly since I stopped playing candy crush! I think I'm starting to have joint issues due to perimenopause, but it's definitely aggravated by repetitive strain injury from phone games.

It sounds a bit weird, almost potentially like early onset MS. I'd recommend asking a different Dr about the possibility of that xxx

It’s unlikely to be low blood calcium as it’s unilateral, but carpopedal spasms can result from low blood calcium and/or thyroid problems. have you had any blood tests,Op?

I would have concerns about cervical l spondylotic myelopathy. Has your GP asked neurology for advice?

possibly this
https://en.m.wikipedia.org/wiki/Dupuytren's_contracture
with associated tenosynovitis to account for the pain?

I second @Fedupdoc and would query some form of spinal myelopathy. Have you had an MRI?

FWIW I am not clinical but I am the secretary to a spinal injury consultant

I think you need to be referred to a neurologist. Do you still have the fatty pad on your palm, under your thumb on your left hand? Can you see any muscle fasiculations on the underside of your left arm?

The spasms are commonly associated with hyperventilation and anxiety. Which does not mean the other symptoms are caused by anxiety. But it's possible your raised anxiety about the numbness is causing mild but persistent hyperventilation leading to low blood calcium levels and carpopedal spasms.

I agree a neurology referral sounds most useful as whatever the differential is your nerves are involved. But if it will be a while knowing the spasms in your hand whilst really annoying are often benign may help. I am a psychologist and see them a lot in people with severe anxiety - NOTE I am not saying your symptoms don't need proper medical investigation. But hopefully the cause won't be progressive and debilitating.

OP, look up De Quervain syndrome. I note you have little children as you mention changing nappies. My daughter had this after childbirth.

So many replies! I'm very grateful for your thoughts on this.

I do have thyroid problems (historic but very well controlled currently). My mum has myasthenia gravis, and another relative (not immediate family) has MND. I've been very worried, but the possibility of MS has run through my mind too. I'm no stranger to neuropathic pain - I have nerve damage in my legs and feet from prolonged stay in ICU (ventilated) over 5 years ago. This hand and wrist pain and altered sensations is very new.

@Fedupdoc CSM is a possibility, definitely. My chiropractor mentioned something to a similar effect last December. No idea where to go from here.

Has your GP seen you face to face and examined?
My next port of call would be neurology/neurosurgical advice and urgent referral. You need secondary care assessment and MRI of neck. The rapid nature of your symptoms makes things like MND/MS much less likely and you need urgent assessment

Vitamin B12 deficiency!
I had all those symptoms + facial nerve numbness, tingling.
Used to wake up unable to feel hands.
Saw private neurologist as convinced it was MS.
My B12 levels were only tiny bit low.

I struggle with supplements as they make me sick, so I use B12 patches (via Amazon) which I apply daily.
Resolved all symptoms. Loads more energy & better concentration.

This might not be your issue, but literally changed my life!

Could it be tennis elbow?

I had this last year. Mentioned it when at hospital for something else ( they asked if I had any change in health) examined by a dr there —- flummoxed. Told to see GP, not a clue, see how it goes ( her answer to everything)
Then I realised it was holding my phone and iPad. I was bored out of my mind and spending far too long online and it was holding the phone particularly that had caused all the symptoms ( right down to the thumb numbness)
Switched to propping screen up on a cushion and everything disappeared after a week or so. Suppose it’s like repetitive strain injury.

Thoracic outlet syndrome. Your first rib or even an extra rib could be causing compression.

I had similar after I’d given birth. Lasted about a year then resolved itself. Read something later about a vitamin deficiency and it clicked into place. Have since forgotten what that deficiency was but could have been what the pp above suggests - b12.

I had tingling and numbness, still unexplained. When I looked into it, it said that these symptoms are some of the hardest to diagnose, so you are not alone.

As it is on one hand, this may well be something up with the nerves on one side of your body and might be ‘wear and tear’, a temporary thing or some damage like arthritis.

Mine has mostly gone, and I think it was related to menopause, fluctuating hormones and lack of Vit D and B12.

You need to be referred to a neurologist if it’s ongoing.

I do have thyroid problems (historic but very well controlled currently)

Is your thyroid issue autoimmune related (such as Hashimoto's)? B12 deficiency can be caused by autoimmune disease and it's common to have more than one, unfortunately.

It's probably worthwhile having your B12 tested; simple, inexpensive blood test.

Some useful input here. One possibility, while you are waiting, is to perhaps find a good physiotherapist. If it is related to musculoskeletal, they might have insight. I had damaged muscles in my arm which were basically refusing to release and clamping down on nerves. Loss of grip strength, control, dexterity, pain, numbness were my main symptoms.

I would explore it being potentially autoimmune related. Perhaps you could start with an ANA blood test and see what comes back? I had this issue for a year and it very occasionally flares up 7 years later. The rheumatologist said it's Raynaulds but I also have other autoimmune problems too (Scleroderma) as they are often linked together (now in remission)

Hey OP maybe just take a list of what everyone’s said and run through them with your doc - even just for your peace of mind, so you know they’re looking at it from every angle - you need a referral though so would call tomorrow first thing and press quite honestly.

I know someone with myotonic dystrophy and one of her first symptom was hand gripping and not releasing. Not sure about any numbness/tingling though.

It’s probably more likely to be a trapped nerve or similar though! Hoping you find answers soon

From your description I wondered about complex regional pain syndrome, especially if some minor trauma happened to the arm before this started. Used to be called sympathetic regional dystrophy - there’s a good description here https://www.ninds.nih.gov/health-information/disorders/complex-regional-pain-syndrome
I think the suggestions above about looking for nerve damage in the nerve roots and shoulder area are sensible but this might be something to consider if you don’t find anything there. B12, folate deficiencies are all easy to check for but as a general rule toxic and deficiency causes of neuropathy affect the longest nerves first ie feet then hands, and are a bit less localized. There are always exceptions though!
whatever it is I hope you get an answer soon