Possible Nerve Damage, Carpal Tunnel Syndrome

[NATURAL ANKLING]

I returned from a week long tour, every thing was ok till I got home and no longer cycling.

I have had pain and tingling even weakness before after events like off road or even on road motorcycling.
But that just lasted days say three max.
I have had loss of strength to the extent that I need two hands to cut my toe nails, cut bread clean my teeth, as my index fingers are weak, both hands but right (right handed) is weaker now than before I rode.
Thumb, index and middle are weak tingle a bit and slightly numb.
Saw gp and it appears that that it is an indication (three fingers) that it s carpal nerve problem.
Both feet are affected too, the right worse but I put that down to poor circulation in right foot.
Big toe and most of the others on right foot are numb tingling and my balance twisting and getting up are also affected.
Base of both feet are numb too.
No change for the last ten days.

GP has put me on max dose of naproxen for two weeks, to see if ant-inflammatory will help.

I suppose the shock to me is that its lasted so long, might be my age at 60 now.
Look on the net for any exercise that will help.
Feet I did not expect to be affected that bad.
I had a certain amount of walking whilst away too, maybe that's a reason, though my feet on two days were hurting so bad in balls of feet I had to stop for 10-15 mins before continuing.

Any one had permanent numbness etc.
No lasting pain since I finished.

[SimonCelsa]

I think you just have to understand that you are getting older and learn to slow down a bit!!

You can't be invincible your whole life.

Take up a more passive hobby like smoking a pipe, watching telly, wearing slippers......

[Vorpal]

Feet numb is more likely to be a sciatic problem?

Though there are other issues that can result in numbness in extremities, including some medications, insect bites, inadequate levels of some vitamins & minerals, herniated disc(s) in your spine, underactive thyroid, and various other things.

I strongly recommend that you get the GP to check it out thoroughly.

[531colin]

......I strongly recommend that you get the GP to check it out thoroughly.

...GP has put me on max dose of naproxen for two weeks, to see if ant-inflammatory will help.....

......….I'm not sure that counts as "thoroughly", though.
There is a thread in "too good to lose" with some good stuff in it https://forum.cyclinguk.org/viewtopic.php?f=1&t=35438
Contribution from "Richard Yorkshire" suggests specialist knowledge.
The distribution of the tingling in your hands tells you which nerve is involved. The nerves are susceptible to direct pressure, and also pressure where they go through "pinch points" eg in the joints. I would be looking at bike set up for the hand tingling....too much weight on your hands, or wrist held at an unhelpful angle for example. And yeah, it all changes as you get older, I'm 12 years ahead of you.
Don't assume the damage is permanent; I have had tingly feet for (I think) months after getting really really cold all day, and it eventually went away. The nerve cell bodies are situated well out of harm's way in the spinal cord or the dorsal root ganglia (getting a bit vague on the specifics) and you won't have damaged them; they need to repair the damage to their axons, the long, long processes from the cells to your hands/feet.....think of it as new copper wire growing down the insulation from the fusebox to every light in the house.
Sharp pain in the balls of your feet can be caused by collapsed arches, and there are plenty of exercises for that. You can collapse your arches by tightening up those ratchets on ski boots or cycling shoes....ask me how I know. To curl your feet and raise the arches, you have to get your weight on the outside of your foot, to do this stand up and rotate your pelvis back (tighten abdominal muscles and glutes) and watch in a mirror as your knees rotate....without doing that I couldn't raise my arches.
And, mate, slow down a bit, yeah? I know at 60 I thought I should be able to do what I used to do at 40 or 50, but it ain't always like that.
....if you think 60 is a tough gig, wait till you pass 70...thats a tough gig, but you have to just re-set your targets a bit, I still love to get out on the bike, thats the main thing.

[531colin]

Feet numb is more likely to be a sciatic problem?

Though there are other issues that can result in numbness in extremities, including some medications, insect bites, inadequate levels of some vitamins & minerals, herniated disc(s) in your spine, underactive thyroid, and various other things.

I strongly recommend that you get the GP to check it out thoroughly.

B12?

[Vorpal]

Feet numb is more likely to be a sciatic problem?

Though there are other issues that can result in numbness in extremities, including some medications, insect bites, inadequate levels of some vitamins & minerals, herniated disc(s) in your spine, underactive thyroid, and various other things.

I strongly recommend that you get the GP to check it out thoroughly.

B12?

Yes; that's the most common. Potassium and Magnesium deficiency can also cause it.

[fivetoedsloth]

Have you checked out your back for nerve damage? Since it is happening equally on both sides of your body, hands and feet, it sounds like the source could be nerve compression in your spine. Especially since you say it happens after cycling, which can be a strain on your lower back. Also just making sure you don’t have any other ailments like diabetes or reduced kidney function...? Hopefully rest and anti inflammatories will help.

I found that I had a huge problem with numbness and painful joints when menopause hit. Turns out low testosterone was the culprit. You might check out your hormone levels because it is amazing how much of an impact that makes on joint health for both women and men. Extra testosterone was a cure for what ailed me. (And yes, women depend on testosterone too, and it sucks that our US insurance companies don’t cover it for women, believing it to be a male-specific need.)

I get numbness in my hands (thumb, index fingers) when cycling sometimes, like carpal tunnel, and it subsides when I stop. I have attributed that to gripping the handlebars at the same angle for too long. I occasionally get numbness in one foot which I have attributed to my Morton’s neuroma exacerbated by cycling. I also get lower back pain when cycling for long periods, which I attribute to being 52 and not all that flexible. I am hoping that greater fitness, coupled with awareness of my joints and a conscious effort to change positions frequently, will help.

I hope you find a solution and feel better!


I'm a trendy consumer. Just look at my wobbly bog brush using hovercraft full of eels Pro

[NATURAL ANKLING]

Hi,

I think you just have to understand that you are getting older and learn to slow down a bit!!

You can't be invincible your whole life.

Take up a more passive hobby like smoking a pipe, watching telly, wearing slippers......

What do you think I'll be doing the last two weeks

[Tangled Metal]

Waiting for ferry loading at Zeebrugge so first chance to check in for 2 weeks.

I was involved in a very interesting thread on another cycling forum under their health and fitness sub forum that could be relevant. Sorry if that's not allowed under forum rules.

IME carpel tunnel is often the only thing a gp knows for such symptoms. Possibly unfair and inaccurate but they'll only know straight away the protocol for CTS. The first thing my gp did was tell me to buy special wrist supports for sleeping in. Since my issue was worse when sleeping. At £8-15 a pop and the GPs own quick test (from how favourite website) didn't indicate carpel tunnel I decided to not get them.

Second visit I lied and said I tried one on worst hand and no effect. So he redid the test with same negative indication. So he said he was at a loss and all he could recommend was to lie on my back.

On another forum there were medics from A&E and other areas. Two in particular had a very wide experience / area of knowledge. They both indicated a potentially serious condition.

Basically there are more than the carpel nerve. Which fingers tingle indicates which nerve is the cause. Of course there's also vascular vessels running through the wrist and shoulder constriction points. It's quite possible for your tingling hands to be due to any one of a number of constrictions from your wrist to your neck. I don't want to worry you but get it properly checked out. Perhaps it's beyond your GPs experience and needs a referral.

I hope it gets better, good luck with the nhs system!

[birkhead]

After cycling the Highlander 1200 about 5 years ago, i lost the strength in my left thumb. I had to shift chainring with wrong hand for the last day, which was a bit of a challenge.
After stroke specialist was convinced that I had had stroke, I got to see nerve specialist, who determined that it was nerve damage in the hand, sorry can't remember name of nerve. Prescriotion was rest and no recreation, and not to do any silly ultra audaxes again.
My hand recovered within 6 months, so I felt free to indulge in further gentle exercise.
So if this is the same problem,
R & - R
Patience and await recovery
(Shhhhh. Don't tell the dr but keep on cycling cos its good for heart and soul)

[horizon]

You could check out this:

https://www.nhs.uk/conditions/myasthenia-gravis/

[NATURAL ANKLING]

Hi,
Thanks for all your replies.
Plenty for me to think about there.
Worst is any loss in strength which could be permanent, the weakness in my hands especially my fingers and thumb (index & middle), its bad enough at the moment, even writing is hard and my writing is bad.

Several issues-
I have suffered from bad back for twenty years but do daily physio to keep that good, cycling keeps the sciatica type (lower back pelvis upper legs) pain at bay along with phsio.
Sitting around for a week or more will bring on pain in back and legs (mainly left) so I keep cycling, next day is always a bit sensitive.

Never had a long term of hand or feet problems, after coast ride I did have slight hardly noticeable swelling above my toes but you have to look hard to see that, no pain, typing is making hands a bit funny now.

Last month or so I have had chronic lethargy, almost come to a grinding halt at mid afternoon every day, feels like a lead weight on my body and does not disappear lying down for 1/2 to 2 hrs either.
I have no idea how I managed a week long tour feeling like this, exercise makes me feel more awake but performance is well down, I can keep going but its slow.

I will have to get ready with info when I visit the docs next.
Blood test to day but that's just your normal full bloods for failing organs etc.
Have had many problems with meds as you do with exercise and blood pressure / anti cholesterol meds spanning 20 years.
Three years ago I thought I was shedding some of those meds but now have circulation problem with my right lower leg so back on more stuff.
The problem with my circulation is not bad enough to stop me cycling at a reduced rate say for day rides only shows up with 2-3 hour training.
I will continue on and hope for better days ahead so I can get back to serious training and maybe next year end to end...and back

Old age I have noticed loss of strength and suppleness but on the bike I have had some good rides in the last five years and have not noticed a big decline at all when I am on form.
Not ready to slow down yet till after end to end type of ride which will be a bit easier (if I am fit) than that stupid devon and cornwall coast
I need to do a ride this year and I have done that for my sanity.
We will see what happens.

[531colin]

I'm going to boot some ideas into the air, please feel free to disagree....with reasons, preferably.
This from my daughter;
Crushing fatigue and peripheral nerve anomalies are features of B12 deficiency.
Her GP grudgingly prescribed oral B12, although I believe the NICE guidelines are for intramuscular B12.
She bought, took, and is taking 2 over the counter medications. Floradix tablets which you need for folic acid to aid uptake of B12 and also Better You B12 vitamin spray, which is a sub-lingual preparation (like GTN spray for angina) apparently the absorption by this route is much better than the oral route, comparable with i/m injection but a lot less hassle.
My daughter wasn't particularly anaemic, but she found useful information on the pernicious anaemia society website.
Her improvement with the self-medication has been spectacular.
As far as I'm aware there is no hazard from taking this stuff, I would take it in a heartbeat if I thought I might need it. If nothing else, it will give you a clear idea whether or not supplementing B12 is going to help you. Measuring the blood level of B12 is notoriously unreliable.

The nerves to the arms and to the legs branch off the spinal cord at different points, therefore I don't think a single disc prolapse (for example) can cause tingly hands and feet with no change anywhere else. I found something here https://www.orthopaedicsone.com/display/Clerkship/What+are+the+classic+motor+and+sensory+findings+of+L4+L5+and+S1+compression
which describes the sensory and motor effects of disc herniation at different levels....its quite long, and describes fairly specific things which happen with lesions of particular discs. For example, S1 (sacral 1) prolapse can cause weakness in the gastroc. with sensory loss in the lateral foot and pain down the back of the calf.

[Tangled Metal]

Off topic but I've had various drug delivery methods for migraine medication. Each one was explained as being more effective at getting the drug into the system. Tablets don't work because my stomach stops working. Nasal spray didn't work. Dissolvable wafers were next as the fast method into my blood. Leave it on the tongue and let it fizz and dissolve. Didn't work.

Now I take exactly the same basic drug as all the other options but being a tablet that you hold on your tongue the saliva dissolves it and you get a kind of pooling of saliva under the tongue. I guess this area is better at absorbing chemicals.

I wonder what it is that makes it a good surface for drug delivery? Nasal membrane is thin between blood vessels and outside but it doesn't transmit drugs any faster than the stomach my migraine consultant said.

I think the main thing I take from this thread and other threads I've read about tingling in the fingers / weakness associated with it is there's too many potential causes to accept an initial carpel tunnel syndrome diagnosis from your gp. If it's causing you a problem that's affecting your ability to function as you did before it then it's worth the effort and "playing the system" that's needed to get it completely diagnosed and treated.

[531colin]

Off topic …..I wonder what it is that makes it a good surface for drug delivery? ....

How about there is a good blood supply just beneath the lining, which is wet, thin, and not covered in a layer of mucus to protect it from digestive enzymes or cold dry dusty air? Also the mouth is a relatively benign environment for the medication, unlike the stomach.
I would have expected the fizzy, on the tongue preparation to be as good, perhaps it fizzed enough to encourage you to swallow it?
Personally, I would be happy to buy a couple of over the counter products rather than fight the system, even if doing so only rules out one possible cause.. of course, if it works, happy days!
I used to work with somebody who had a saying which went something like "If you are in County Kerry, and you hear hoof-falls on the road, don't go looking for Zebra." I'm not surprised that a GP goes looking for carpal tunnel syndrome, its probably the most common thing they see....I know enough (sedentary) people who have had the diagnosis and the operation, but that's probably because I know a lot of people over 60.