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Numbness and Weakness of Extremities

Numbness of Extremities

Numbness in and extremity, always signals that there is a problem with a neural structure in the body. Most commonly the individual with numbness has a pinched nerve in the extremity or spine. A very small percentage of patients with numbness in extremities have problems arising from the brain or spinal cord. A careful history and physical examination including a detailed neurological examination usually allows for a diagnosis.

Electrodiagnostic testing (EMG), which is an extension of the neurological examination is often very helpful in determining the source of numbness. This test involves studying nerve conduction velocities through administration of electrical shocks in the extremity in addition to the electromyographic examination of muscles by inserting very fine needles. The test is associated with a very minimal risk of injury, and is usually mildly uncomfortable.

Imaging via MRI or ultrasound and blood work also can assist in determining the source of numbness.

Although there are numerous possible reasons for numbness in an upper extremity, the most common reasons are carpal tunnel syndrome (compression of the median nerve in the wrist), and cervical radiculopathy (pinched nerve in the neck). The most common reasons for numbness in a lower extremity are polyneuropathy (generalized nerve dysfunction) and lumbar radiculopathy (pinched nerve in the back).

Weakness of Extremities

Weakness of extremities can be the result of a multitude of problems, including deconditioning, localized atrophy from an orthopedic problem, muscle diseases, compression of nerves, a general nerve disorder, spinal cord, problems, and illnesses that affect the brain. Most commonly, the source of weakness is benign and reversible.

As above, a thorough history and physical examination, including a neurological cause emanation, is the most important part of a patient’s evaluation. Electrodiagnostic testing and imaging as well as bloodwork can be helpful as well.

Numbness and, or weakness can result in functional problems for the patient. Determining the specific diagnosis often allows for a specific treatment which can often eliminate the problem altogether. Practically all patients benefit from treatment, including physical or occupational therapy, orthotics, injections, medication, and at times surgery.


Rehabilitation Institute

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