Q. I have constant twitches in my upper arm. Could it be an early sign of ALS?

Answered by
Dr. Ashok Kumar Choudhary
and medically reviewed by iCliniq medical review team.

Hi doctor,

I am a 38 year old male, and I have been feeling twitches in my arm. I started feeling this constant twitch about six weeks ago. I did not experience any weakness in that arm or anywhere else in the body. The twitches lasted for about a week and then went away.

The twitches have now appeared four weeks later in the same area (upper arm). Again, there is no apparent weakness, which I have tested by lifting weights at the gym and both my upper and lower body strength seems to be fine.

What is worrying me to death is, could these twitches be an early sign of ALS? Is it possible that weakness will follow even though I do not have it now? Do ALS twitches go away for four weeks at a time and reappear?

If I started to experience constant twitches six weeks ago, if this was ALS should not I have experienced some weakness by now? Is the fact that the twitches are localized to the same place a bad thing?

Do you have a question on Muscle Twitching or Anxiety?

Ask a Doctor Now

Dr. Ashok Kumar Choudhary

Andrology Geriatrics Psychiatry Psychologist/ Counsellor Psychotherapy Sexology


Welcome to icliniq.com.

I have read your query and understand your concerns.

First of all, I will suggest you consider other possibilities before jumping to conclusions. There are a number of conditions which can present with twitches without any disease, and ALS (amyotrophic lateral sclerosis) is one of the remotest possibility for a 38 year old young male.

The commonest cause for twitches is simple worry or anxiety. I know at least 100 individuals with anxiety, who presented with simple twitches and no other symptoms. In my opinion, you need to see whether these twitches have any relationship with your anxiety level.

The another common conditions which present with twitches is endocrine abnormalities, such as thyroid and parathyroid disorders. In case the stress level is not able to explain the twitches, an evaluation for endocrine abnormality is indicated. The list may go on in a similar fashion.

Find the answers to your questions below:

  1. Yes, ALS can be a possibility, but it is very low considering your age and no weakness or stiffness of muscles.
  2. I do not think weakness will follow in your case.
  3. ALS is progressive and spontaneous, and remissions are rare.
  4. If it is ALS, two months is enough to develop weakness.
  5. Treatment of twitches depends on the etiology. If they are stress-related, then there is nothing bad, as they are indicating something correctable.

I hope this helps you. If you have more questions, feel free to write back.

For further queries consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

Hi doctor,

Thank you for your answer. I do have one more question. My neck muscles are stiff and hurt when I turn my neck left, which is the same side where the arm twitches. Could this stiffness be related to ALS when looked at in combination with the twitches? To be clear, the neck stiffness feels like a muscle pull and hurts.

Dr. Ashok Kumar Choudhary

Andrology Geriatrics Psychiatry Psychologist/ Counsellor Psychotherapy Sexology


Welcome back to icliniq.com.

Thanks for reverting with a valuable piece of information.

If we look at them together, the cause of twitches is much clear, as both things are related. If there is stiffness in the neck it could lead to compression over some unimportant nerve fibers, leading to twitching.

I need to reassure you again that at your age, with no family history of ALS and no weakness, the possibility of ALS is remotest, and I do not think this need to be considered among differential diagnosis while evaluating the problem.

I hope this helps you further. Thanks and regards.

For more information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

Related Questions & Answers

Can thyroid problem cause excessive hair fall?
Query: Hi doctor, I have thyroid issues for the past three years. I got this when I was pregnant. I am taking Thyronorm 75 mcg tablet for the last three months. Recently, I have done the thyroid test and my T3 and T4 are normal and TSH is very low. It shows less than 0.01. What does it indicate? First, I w...  Read Full »
Dr. Geeta Priyadarsini Kamminana
Internal Medicine Physician

Answer: Hi, Welcome to icliniq.com. This appears to be due to over treatment or iatrogenic hyperthyroidism. Here is a list of symptoms experienced due to over treatment. They are tachycardia, palpitations, nervousness, tiredness, headache, excitability, sleeplessness, tremors, anxiety and heat intolerance. ...  Read Full »
Can anxiety and stress cause frequent urination?
Query: Hello doctor, I am a 34 year old male. I had anxiety issues since childhood. I have been jumping from one idea to another for a long time but it has been three years I have an issue with frequent urination. It started in a bad time for me when I was obsessing that I have HIV. No burning, just sligh...  Read Full »
Dr. Ashok Kumar Choudhary

Answer: Hello, Welcome to icliniq.com. I read your query and understand your concerns. First of all, I like to state that the stress and anxiety can affect almost every organ of the body and polyuria is not an exception. In other words, yes the stress can cause almost all the symptoms narrated in your qu...  Read Full »
Does thyroid problem delay pregnancy?
Query: Hi doctor, I am a 27 year old unmarried female. Before six months, I was diagnosed with hypothyroidism. I have been taking Thyronorm 100 mcg. Recently, I had TSH test and the level was 0.47 U/mL, which is considered as hyperthyroid. When my doctor asked me the previous dosage, by mistake I told her...  Read Full »
Dr. Swaraj S W

Answer: Hi, Welcome to icliniq.com. I suggest you follow the same dose as you are not a hyperthyroid yet. Also, if you are planning for your marriage and pregnancy, then this TSH value is normal.  If the TSH (thyroid stimulating hormone) value is less than 0.3 U/mL, then the dosage of tablet has to be red...  Read Full »


Ask your health query to a doctor online?

Ask a Doctor Now

* guaranteed answer within 4 hours.
Enter Your Health Query
You can upload files and images in the next step.