Question:
I've had some poor health recently, and the neurologist I went to see
said it was anxiety, and prescribed paxil. I'd like to describe my
symptoms to you in case those of you who know about this could comment.
I am in the last year of Grad school, and basically have periods of
very high stress broken up with periods of very little (when I leave
town and stay with my parents). Most of the time am with my parents
and so have very little stress and anxiety (I think!), however, even so
the conditions I describe below seem to slowly be getting worse.
Answer:
Here is my story:
Starting two summers ago I started to have low back/hip problems (due
maybe to a tense muscle injury) that eventually grew into a bursitis
like condition in my hip last spring. I could no longer sit down at that
time, and it felt like I had a severe inflammatory condition in my hip.
It was at about this time that the symptoms described below started. The
hip has progressively but slowly been getting better (although I still
do not sit much-6 months later, and there is no agreed diagnosis), but
the symptoms below seem to be spreading in some way.
I began to experience various strange sensations at the beginning of
last summer when my hip was at its worst. It started at about the same
time in my left hand and right foot. The hand felt arthritic in about
two of the knuckles and had localized burning, and the foot had tingling
sensations when I laid down at night.
Since then I went through a hand phase where both of my hands would
burn, with the burning being aggravated by any use such as typing on a
keyboard. I took to single finger typing soon thereafter. The burning
eventually receeded after I stopped using my hands altogether for about
a week or two. Right now the hands are sore, feel a little hot over the
skin, but the situation is better than in the summer (although I don't
type with two hands anymore).
The feet still tingle a little, but they are not painful when I lie
down. When I walk around, if I walk for more than an hour, say, they
start to burn from my toes to my heel. Eventually I have to stop. It
seems much like my hands, and like the hands also, it takes the feet a
while to calm down. It may be a few days before they go back to their
usual low level of tingling/burning.
Recently, during a stressful episode, the hand tingling (which had since
moved to the wrist), seemed to move up my arms into my shoulder. The
right arm is affected more than the left, but I figure this is due to
the use of a mouse, which requires that I click a button and somehow use
or tense muscles up to my shoulder. Burning/itching also can happen in
the bicep when I hold my arm up, and also seems to be both inside and on
the surface of the right shoulder (like sunburn, occasionally).
The tingling/burning has also spread to the front of my thighs, and if I
lie in bed on my back with knees up, eventually there will be burning in
the front of my thigh. Sometimes I can't sleep on my stomach because the
pressure makes my thighs or shoulders burn.
That's the situation right now. I've had all standard blood tests (plus
TSH and B12), urinalysis, full body bone scan (last week, with
concentration on hands and hip, apparently negative), MRI of lower back,
right hip, neck (checking for MS due to brief numbness I had around
ulnar region both sides), and all are negative. Exception is high
monocyte count in blood test, but that might be due to a rash on the
inside of my left leg that I am on antibiotics for. This rash started
about 2 months ago and felt(and looked) alot like poison ivy at the
time. However, it didn't go away like it should and a broad red itchy
rash. I recently started antibiotics for it (clarithromycin) but it is
too early to tell if the drugs will fix it.
I've seen a neurologist, and he did the basic neurological exam (pin
sensation, tuning fork, strength test, eye exam), and all were negative.
He said that I don't have a neurological condition. I asked about
peripheral neuropathy and he said no because I should be experiencing
strength loss.
Does anxiety/stress cause these symptoms? I'd like to believe
that but the symptoms (esp. burning in response to use) don't seem to be
mentioned in the articles I can find about health effects of stress.
Burning, tingling sensations of the anterior thighs can be due to
pinched nerves at the waist line due to obesity or a tight belt. The
condition is called meralgia paresthetica. I suspect the neurologist
would have picked it up if it was present and you described these
sensations to him.
I think it is incorrect to say there is no peripheral neuropathy because
your muscle strength is normal. It is possible to have a sensory
neuropathy in which only the sensory fibers are affected. An example of
this would be diabetic peripheral neuropathy with associated numbess or
tingling, but no loss of strength. However you said the neurologist
tested for pinprick and vibratory sensation (tuning fork), so I assume
he did this in the legs and this would tend to rule out a sensory
neuropathy.
It sounds like you sit at a computer and type alot as a grad student.
This can result in various muscle aches and pains, and possibly some
overuse syndromes in various parts of the body. Such musculo-tendinous
problems could result in an assortment of pains and strange sensations
throughout the body.
Your neurological system is probably normal. Ever consider seeing an
orthopedist to rule out any musculo-skeletal problems? If he also says
all is OK, I would think there is no serious (or objective) physical
illness in you.
Are you experiecing an unusual amount of anxiety? Do you have any reason
to feel all these symptoms you describe are related to anxiety?
I had lower back MRIs, they were all clear. Right now I'm more
concerned about sensory neuropathy since it largely matches my symptoms.
I really wonder, thiugh, why the neuro wrote it off so quickly as
stress/anxiety. Based on the responses so far, it seems that these
conditions are rarely anxiety related, if ever.
