OpenHealth Q&A

Navigating Arm, Neck, and Grip Challenges with Conflicting EMG and MRI Results

Greetings. I’m a 33-year-old male facing health difficulties, and I want to outline my symptoms along with relevant details that might assist in understanding my situation better. I experience tension in my neck, a persistent claw-like grip, diminished grip strength, reduced strength in my legs, and numbness in my hands and fingers. Additionally, I feel discomfort in my neck, radiating from my shoulders to my arms, tension in my traps, lower back pain, weakness in my legs, and instability while balancing. These symptoms seem to have begun about eight months ago, and initially, I attributed them to general unfitness and clumsiness. Their intensity increased earlier this year while I was moving furniture. I acknowledge that I am not in the best physical condition. Although I have shed 80 pounds, I still need to lose around 30 more. I suspect much of my weight loss might be attributable to muscle mass reduction since I’ve been consuming fewer calories. Generally, I have poor posture from my desk job and tend to hunch over. My orthopedic specialist advised an electromyography (EMG) and nerve conduction velocity (NCV) test for my arms and hands. The results indicated minor to mild cubital and carpal tunnel issues in both arms, along with slight chronic radiculopathy at the C6/C7 level on my right side. He mentioned that I might have previously sustained an injury, which healed unnoticed but has since resurfaced. During the examination, when he pressed on a specific area of my head, I experienced tingling and numbness in my arms. He then referred me to physical therapy, focusing on my neck, shoulders, and arms. The sessions were quite painful, especially in my upper back, where I felt significant discomfort. They utilized a machine that delivers vibrations and electrical impulses (I can't recall the specific name). After physical therapy did not yield improvement, he referred me to a spine specialist who ordered a cervical MRI, which, surprisingly, returned normal results. I have yet to undergo any MRIs for my arms or hands. At the onset of these issues, I began wearing robust wrist braces while sleeping and used lighter carpal tunnel braces at work, adjusting as necessary. I also incorporated a stress ball with some exercises into my daily routine. To counteract a sedentary lifestyle, I now switch to a standing desk every hour, though I occasionally forget. Additionally, I have improved my hydration and adopted a more balanced diet. Since implementing these changes, I’ve noticed some positive developments. My leg strength appears to have increased, likely attributed to weight loss and improved ease in tasks, such as closing my recliner. While my arms experience less pain, they now mostly ache, and the claw grip has resolved, contributing to better flexibility in my fingers and wrists. However, my grip strength remains quite poor. Although lifting items feels somewhat easier now, the act of grasping things continues to pose challenges. My balance is still concerning—I sway while walking, even without pain, leading to frequent tripping. Tightness, discomfort, and popping sensations persist in the left side of my neck, while the right side hurts to a lesser extent. Notably, wearing a neck brace alleviates some discomfort. I continue to have lower back pain, and there is a family history of nerve-related issues in the lower back, with my brother and father both suffering from sciatica. My current focus is on addressing the more pressing symptoms in my hands, forearms, elbows, and neck. The popping and tightness in my neck remain concerning, and I’m anxious about my enduring grip strength. Recently, I’ve noticed pain directly at the C6/C7 region that intensified after my recent furniture-moving incident. Additionally, I experience a burning sensation across both sides of my neck, traps, and upper back, alongside some lower back discomfort. My neck audibly clicks during movement, creating an unsettling sensation. I recently realized I might have a tongue tie, which could potentially impact my posture, causing me to hunch and elevate my shoulders frequently. Using my phone or computer often exacerbates the pain, though I have adjusted my workspace to improve ergonomics. After evaluating my EMG results, my spine specialist concluded that the identified nerve issues are minor and possibly unreliable, given the absence of findings in my MRI. All X-rays of my hands and neck have been unremarkable. He has suggested I see a neurologist for further assessment. Lately, I’ve experienced heightened difficulty in maintaining focus. Although I've dealt with Attention Deficit Disorder (ADD) throughout my life, the effects of my medication, Vyvanse, seem less potent now. When I increase the dosage, I feel more jittery but less focused. I've been struggling to stay present, often daydreaming, which I’m addressing through meditation and conscious focus training. Currently, I plan to consult with a neurologist and will be seeing an ENT this Friday to explore my tongue tie further, as well as my deviated septum, since I often struggle to breathe comfortably. I'm seeking advice on any additional steps I might consider or signs I should be on the lookout for during this journey.

Answers (1)

4/3/2025, 4:50:55 PM

OpenHealth AI

It sounds like you’re dealing with a complex combination of symptoms affecting your neck, arms, and balance, which can indeed be frustrating. Your focus on improving physical health and symptom management is commendable. Here’s a structured approach to help you move forward effectively:

Key Points:

• You have multiple symptoms that might be linked to posture, previous injuries, and potential nerve issues.
• Ongoing evaluation by specialists, including a neurologist and ENT, is essential to address the underlying causes.
• Attention to posture, exercise, and self-care strategies remains crucial.

Explanation:

Your symptoms suggest a possible combination of nerve involvement and muscular tightness, potentially exacerbated by postural habits from your desk job. The EMG findings of cubital and carpal tunnel syndromes, along with radiculopathy, indicate some nerve stress or damage, but normal MRI results might suggest that the damage is minimal or in an early stage. The tightness and clicking in your neck could also contribute to your symptoms, affecting your posture and grip strength.

Next Steps:

1. Continue Physical Therapy: Since your previous therapies were painful but yielded some benefits, inform your therapist about the pain intensity. Request tailored exercises focusing on neck stability, shoulder mobility, and grip strength without exacerbating pain.

2. Posture Correction:

   • Ergonomics: Ensure your desk setup promotes good posture—screen at eye level and keyboard at elbow height.
   • Posture Checks: Set reminders to check your posture frequently throughout the day, especially when sitting or using your phone.

3. Neck and Upper Back Care:

   • Heat Therapy: Use a warm compress on your neck to alleviate tension. Gentle neck stretches can also help.
   • Neck Brace Usage: Continue using your neck brace as needed to alleviate discomfort, but avoid prolonged use that may lead to muscle dependency.

4. Exercise Regimen: Gradually incorporate low-impact strengthening exercises for your arms and legs focusing on balance (such as standing on one leg or using a balance board) and grip (like squeezing a stress ball). It’s crucial to maintain a consistent routine without overexertion.

5. Nutrition and Hydration: Continue focusing on a balanced diet to support overall health and promote muscle recovery. Adequate hydration can also positively impact nerve function.

6. Monitoring and Documentation: Keep a symptom diary, noting any changes in your symptoms, activities, and triggers. This documentation will be valuable for your neurologist and ENT consultations.

7. Address ADD Management: Since you’ve noted concerns with attention and medication effects, discuss these with your prescribing doctor. They might want to explore adjusting your medication or introducing behavioral strategies to support attention.

8. Breathing Issues: At your ENT consultation, express your concerns regarding your deviated septum and tongue tie. Effective breathing can influence your overall posture and energy levels.

Watch for:

• Any new or worsening symptoms, such as significant numbness, weakness, or changes in balance.
• Symptoms like severe headaches or changes in vision that could indicate more serious issues.

It sounds like you're on the right path by engaging healthcare professionals and making lifestyle changes. By taking these steps and remaining vigilant about your health, you can work towards improving your condition. If you need further clarification or support, please reach out again.