Are tingling in hands and legs due to carpal tunnel or ALS?

Q. Does tingling in my hands and legs mean carpal tunnel syndrome or ALS?

Answered by
Dr. Anshul Varshney
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 18, 2018 and last reviewed on: Aug 29, 2023

Hello doctor,

I have tingling in my hands for a few years, and now I am feeling tingling off and on in my feet and legs with occasional inner tremors. I had all my blood work done to test for diabetes, thyroid, vitamin deficiency, comprehensive metabolic panel (CMP) and complete blood count (CBC) all came back normal. I had an magnetic resonance imaging (MRI) of the brain that came back normal and an electromyography (EMG)/NCV (nerve conduction velocity) that showed severe carpal tunnel in both hands. I am currently on Metoprolol and Metformin. I also suffer from anxiety. My question is could these be a sign of amyotrophic lateral sclerosis (ALS)? I am terrified of that. Could this EMG report show carpal tunnel to be mistaken for ALS? Would ALS show on this test? I also have my report to include the EMG test.



Welcome to These symptoms do not look like ALS (amyotrophic lateral sclerosis). Moreover, carpal tunnel syndrome (CTS) has been established in your reports. Anxiety and CTS are more than enough to cause these symptoms. So, my recommendation is that you should start on Pregabalin 75 mg along with Nortriptyline 10 mg once at night time for two weeks.The response to medicine would confirm the diagnosis. I hope it helps you. If you have any further query, please ask me.

Thank you doctor,

Would amyotrophic lateral sclerosis (ALS) show in these reports as the carpal tunnel? When you look at the results could it mistakenly say carpal tunnel, but be ALS or does ALS present itself differently on the electromyography (EMG)? Also, what about the legs and feet tingling? What could that be caused by? What nerves affect the legs and feet and where is the location? And what causes inner tremors or the entire body to feel shaky? Is this something serious? I am really worried.



Welcome back to No, NCV (nerve conduction velocity) test or EMG (electromyography) will not show carpal tunnel syndrome (CTS) when it is amyotrophic lateral sclerosis (ALS). ALS does not present with symmetrical neuropathy altogether. It mostly involves voluntary muscles like talking, chewing, and walking initially. Moreover, it progresses over the time. So, make it sure I need following details to comment further. Is it progressing? If yes, within how much time? What medicines are you taking? Any problems in chewing or talking? However, I feel it is just CTS and Anxiety, but I need these details to be sure. Hope it helps you. If you have any further query, please ask me.

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