
My Hand, Forearm And Calf Seem To Be Experiencing “weakness”.

Question: My hand, forearm and calf seem to be experiencing “weakness”. I can do all tests normally, run and lift. I can zip zipper and open bottle tops and am only occasionally clumsy. My thumb pad gives some resistance when I circle my thumb around in circles and my forearm burns and feels fatigued very very quickly. I can stand on my toes and walk on my heels but the right calf just fatigues faster. I have no cramping and while I do have twitches they aren’t too noticeable or out of control. It follows exercise. My knee sometimes hyper extends while running on that side. The feeling is more of fatigue. I’ve experienced this now for exactly 30 days. Could this be a sign or als/ms or other mnd? It’s been occupying my thoughts a lot. I have not yet had an emg - should I?

Can als begin in a forearm or wrist? If it did it would be painless correct and I would be unable to do tasks? As it stands, I can summon the strength to do anything. It just fatigues faster on my right side.
Brief Answer:
Further examinations are necessary.
Detailed Answer:
Hello and welcome to "Ask a Doctor " service.
I have read your query and here is my advice.
Weakness is a prominent early sign of ALS or MND with limb involvement, so, since there is no weakness, I don't think it's ALS.
ALS may start in wrist or leg, but with weakness.
There are a number of other conditions that may cause such symptoms such as pinched nerve(s), cervical spine spondylosis, impaired blood flow etc.
Multiple sclerosis also may result in unconventional symptoms.
Fatigue after physical activity in one limb may indicate also problems with the blood supply such as in cases of peripheral artery disease.
In all the scenarios, in my opinion, neurological examination and tests such as brain and spine MRI, nerve conditions study, Doppler ultrasound, etc. are necessary for a correct diagnosis.
Please discuss with your Doctor about these issues.
Hope you found the answer helpful.
Let me know if I can assist you further.
Further examinations are necessary.
Detailed Answer:
Hello and welcome to "Ask a Doctor " service.
I have read your query and here is my advice.
Weakness is a prominent early sign of ALS or MND with limb involvement, so, since there is no weakness, I don't think it's ALS.
ALS may start in wrist or leg, but with weakness.
There are a number of other conditions that may cause such symptoms such as pinched nerve(s), cervical spine spondylosis, impaired blood flow etc.
Multiple sclerosis also may result in unconventional symptoms.
Fatigue after physical activity in one limb may indicate also problems with the blood supply such as in cases of peripheral artery disease.
In all the scenarios, in my opinion, neurological examination and tests such as brain and spine MRI, nerve conditions study, Doppler ultrasound, etc. are necessary for a correct diagnosis.
Please discuss with your Doctor about these issues.
Hope you found the answer helpful.
Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee


I have seen a neurologist and passed all of the reflex tests and she didn’t seem concerned although she offered an emg. But my symptoms have gotten I think worse. Perhaps from anxiety. I regularly rest my fingers and arm strength which may lead to the fatigue, but I test both sides. My leg though, seems like a different issue. I am in full control of it... it doesn’t buckle and I don’t have spasticity. I do not have blurred vision, heat intolerance, numbing or anything like that. Would that point to vascular? I have been having a hard time letting als go since it was planted in my brain but it’s true, when push comes to shove I do not have clinical weakness. Just fatigue but I can still do all activities symmetrically. The symptoms are specifically confined to around my knee and calf/shin forearm and wrist. My fingers are sore and strained I think from me messing with them.
If you believe this is not ALS or another mnd - do you think these symptoms seem urgent or indicative of something fatal/degenerative?
Do you feel this has progressed to quickly (30 days) to be als?
Both a pcp and neuro have both told me not to worry about it - If both of them, and yourself say that, I should let als totally go right?
I am fit, never been in a car accident, never had prior history. Not sure where this would have come from out of the blue. But I have a son, so naturally I’m concerned. Thanks!
If you believe this is not ALS or another mnd - do you think these symptoms seem urgent or indicative of something fatal/degenerative?
Do you feel this has progressed to quickly (30 days) to be als?
Both a pcp and neuro have both told me not to worry about it - If both of them, and yourself say that, I should let als totally go right?
I am fit, never been in a car accident, never had prior history. Not sure where this would have come from out of the blue. But I have a son, so naturally I’m concerned. Thanks!
Brief Answer:
Your questions answered below.
Detailed Answer:
Welcome back.
Symptoms and concerns you describe, in my opinion, are not typical for MND.
There are simple conditions that I mentioned before that may explain your symptoms.
It is visible that anxiety is playing a role in your symptoms too.
I agree with the opinion of your Doctors, their word is more reassuring since they had the possibility to examine you.
MND usually progresses gradually in time, not in days.
To ease your mind, I think you should have done the tests asked by your Doctor.
Hope I helped you.
Feel free to discuss with me about your health issues.
Your questions answered below.
Detailed Answer:
Welcome back.
Symptoms and concerns you describe, in my opinion, are not typical for MND.
There are simple conditions that I mentioned before that may explain your symptoms.
It is visible that anxiety is playing a role in your symptoms too.
I agree with the opinion of your Doctors, their word is more reassuring since they had the possibility to examine you.
MND usually progresses gradually in time, not in days.
To ease your mind, I think you should have done the tests asked by your Doctor.
Hope I helped you.
Feel free to discuss with me about your health issues.
Above answer was peer-reviewed by :
Dr. Yogesh D

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