OpenHealth Q&A

Seeking Guidance on Numbness and Pain in Arms and Fingers Upon Waking

I’m reaching out for insights regarding some troubling symptoms that have drastically affected my life. Any suggestions on what I might discuss with my physician would be greatly appreciated. I am a 38-year-old female with a somewhat complicated medical history including episodes of tachycardia, shingles in 2018, and potential flare-ups from last summer. Post-childbirth in 2016, I developed peripheral neuropathy and carpal tunnel syndrome, along with sporadic instances of hyperhidrosis. Additionally, I have battled severe anorexia and bulimia, coupled with alcoholism, which left me critically underweight, around 50 pounds lighter than my required weight, resulting in frequent gastrointestinal complications, including uncontrollable vomiting—particularly exacerbated since starting my recovery journey in February 2023. I suspect gastroparesis but haven't undergone testing yet. Considering I have been sober for nearly six months, it’s important to note that the nerve pain began long before my struggles with alcohol. The aforementioned malnutrition and alcoholism also led to seizures and episodes of near-fainting due to low blood pressure and potassium levels, not to mention several minor concussions and extreme insomnia characterized by nights without sleep, hallucinations, and PTSD related to trauma during the onset of my eating disorder. Fortunately, my health has stabilized after recovering from these issues six months ago, although I do experience fatigue, which I believe is typical given the distress my body has endured over the years. I’ve been diligently maintaining my vitamin intake and hydration for about eight months, and overall, I’ve been feeling well. However, in October 2024, I awoke to numbness in the last three fingers of my right hand, as if I had slept awkwardly on it. This sensation worsened, appearing nightly and spreading to both hands and up to my elbows, often waking me in tears from the burning pain. Interestingly, it sometimes strikes while I'm simply sitting, compelling me to move. Recalling that I felt better on a strict keto diet years ago, I resumed it in January of this year. Within a fortnight, the pain nearly vanished. Nevertheless, adherence is crucial; I must restrict my net carbohydrate intake to 20-30 grams daily. Even slight deviations, such as consuming a bit too much watermelon, trigger a return of the pain, especially after periods of sitting or lying down. Recently, I've also experienced heightened fatigue and episodes of hyperhidrosis, particularly on my palms. So, what could be happening? Despite numerous diabetes tests over the years returning negative results, I believe it’s time for updated blood work and possibly an examination of my neck and back. What specific tests should I request? I've heard from some that my symptoms might align with MS, although previous checks for lesions proved negative. What could be causing such a severe reaction to carbohydrates? After years of struggling, I've finally achieved a healthier relationship with food, but it feels cruel to think I may need to adhere to a strict diet indefinitely. Some speculate that I'm unwittingly trying to revert to anorexia, but I assure you that’s not the case. I’m just barely under a “normal” BMI by two pounds, a stable weight I’ve maintained for the past year and a half. Please, shed some light on potential solutions for this dilemma; I long for the chance to eat more freely again. Thank you!

Answers (1)

3/31/2025, 4:50:40 AM

OpenHealth AI

Your symptoms of numbness and pain in your arms and fingers are concerning but not uncommon, especially given your medical history. There are several potential causes, including peripheral neuropathy, carpal tunnel syndrome, or even issues related to your diet and metabolic health. Let's break this down:

Main Points:

1. Symptoms Overview: Your numbness and pain seem to relate to nerve issues, potentially aggravated by dietary changes or past medical conditions.
2. Next Steps: Focus on specific testing and management strategies to address your symptoms without compromising your recovery.

Explanation:

The numbness in your fingers and hands, especially worsening at night or with certain positions, suggests you might be experiencing nerve compression (like carpal tunnel syndrome) or peripheral neuropathy, which could be exacerbated by your dietary choices, body mechanics, previous malnutrition, and even anxiety-related responses. It's crucial to rule out other conditions, including those related to your spine (like cervical radiculopathy) and systemic conditions affecting nerves and muscles (like autoimmune disorders).

Prioritized Next Steps:

1. Consult Your Physician: Discuss your current symptoms and emphasize the following points:

   • The sudden onset of numbness and pain pattern.
   • Your ketogenic diet's impact on your symptoms.
   • Your complicated medical history including prior diagnoses (peripheral neuropathy, carpal tunnel syndrome) and current recovery from eating disorders.

2. Request Specific Tests:

   • Blood Work: Request a comprehensive metabolic panel, including vitamin B12, folate, and electrolyte levels to assess for deficiencies or metabolic issues.
   • Nerve Conduction Studies: To evaluate for peripheral neuropathy or carpal tunnel syndrome.
   • Imaging: Consider an MRI or X-ray of your cervical spine to check for any spine-related nerve compression.

3. Track Symptoms: Start a diary to note when symptoms occur, any related activities, and dietary intake. This information can help your physician better understand triggers.

4. Dietary Adjustments: If the ketogenic diet alleviates symptoms but feels restrictive, work with a nutritionist to slowly introduce other foods while maintaining awareness of how they affect you. You could try variations of low-carb diets that allow for more flexibility.

5. Manage Stress and Fatigue: Since fatigue and hyperhidrosis are present, ensure you're incorporating stress management techniques. Gentle exercises like yoga or mindfulness practices might be beneficial.

6. Physical Activity: Regular, gentle movement can also help improve blood flow and reduce nerve pain. You might consider low-impact activities that suit your comfort level.

By following these steps, you'll be better equipped to understand your condition and explore ways to manage it effectively. Remember, it's crucial to communicate openly with your healthcare provider throughout this process to ensure a safe and supportive recovery. Don't hesitate to seek help whenever you need to adjust your dietary plan or symptom management strategies.