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Q. I feel tired and sick after waking up and get numbness in arms and legs on lying down. Why?

Answered by
Dr. Basuki Nath Bhagat
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on Aug 26, 2021

Hi doctor,

I am a 28-year-old female. I am obese with a weight of 288 lbs. I am not under any medication and do not have any illness. Recently, I am getting numbness in my arms, thighs radiating to my feet, and my face feels odd whenever I lie down or wake up from sleep. My vision is blurred, I have a headache on the side that I lie down, and neck pain. After waking up, I always feel tired, sick, and lightheaded. I also have pain in my right lower back that runs down my thigh. I consulted a doctor today, he said that everything is fine and advised some blood investigations. I feel anxious and cannot get enough sleep.

Kindly help.

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#

Hello,

Welcome to icliniq.com.

I feel sorry about the problems you are facing.

Kindly answer me the following to guide you.

1) Is it exactly numbness or a weakness misinterpreted as numbness?

2) Since how many days are you having these complaints, and is it increasing in severity?

3) Do you feel similar complaints in your day-to-day activity?

4) Do you have any shortness of breath?

5) Are you getting tired quickly?

6) Are you getting enough and sound sleep?

7) Is there any recent onset of low grade or mild depression or anxiety?

The above questions I asked you are to rule out anemia and mild depression or anxiety as a cause of your symptoms. Your symptoms specify 'on lying down,' which makes me wonder what it could be.

I suggest you check your BP (blood pressure), suspecting the lower side of BP as one of the reasons for your illness. But usually, BP tends to be normal as the gravity pool of blood is eliminated on lying down, and your symptoms should go away rather than aggravated.

I hope this helps and guides you through figuring out the problem.

Get the tests done next week as advised by your doctor, and try to get enough sleep and focus on meditation if you are getting mentally exhausted.

Take care.

Thanks.

Hi doctor,

Thanks for your reply.

It is numbness. As I touch my skin, it feels numb, like dulled sensation. It starts to go away once I stand up or sit. I probably feel a little weak for the last five days. I would say all my complaints are getting worse. Today, I seem to have numbness around the back passage. I do not get numbness through day-to-day activity, but I feel sick all the time and also have a headache. I feel tired, but that is because I cannot sleep because of the issue with lying down. I was not anxious or depressed before, but I am now worried about my health.

The numbness is felt only when I lie down. My BP is slightly high. It is impossible to get much sleep. I feel awful when I lie down.

Kindly help.

#

Hello,

Welcome back to icliniq.com.

I have read your reply up and down many times and trying to figure out what is going on as it is an unusual presentation.

Why it is unusual to me because:

  • The issue is acute in onset with only five days duration.
  • You have only numbness without pain or imbalance.
  • The numbness goes away quickly once you stand up or sit.
  • You have headaches and blurred eyesight during numbness.

Collectively above reasons make it an unusual presentation to me.

Since the main complaint is numbness, I would suggest doing tests related to peripheral sensory neuropathy, and then the likely reason or cause of it can be known. It is advisable to take an electrodiagnostic evaluation for suspected peripheral neuropathy, consisting of NCS (nerve conduction study) and EMG (electromyography). And also, check your serum vitamin B12 level.

Visit your doctor and ask him about these tests, whether to be done or not, as the attending doctor can do a physical examination that helps the clinician choose appropriate tests likely to yield results and narrow down the differential diagnosis.

I hope it helps you.

Do not worry and take care.

Thanks.

Hello doctor,

Thanks for the reply.

If it helps, I am experiencing lower back pain this morning, along with pain in the right side buttock radiating down to my right thigh, stomach aching when I lie down, numbness along thighs and forearm when sitting, feeling lightheaded and sick.

I am not sure about all the tests advised by my doctor, but vitamin B12 was included.

Thanks.

#

Hi,

Welcome back to icliniq.com.

From your statement, pain in the right side buttock down to the right thigh along with numbness likely points toward nerve pathology.

Physically you are obese. An increase in body weight can stress your spine and contribute to spinal changes triggering this kind of nerve pathology. Since no test has been done so far, it is just speculation. Lightheadedness may be due to lack of sleep as you lack sleep for four to five days.

I suggest you get your tests done by next week and do visit the doctor. Do not worry. Let the test report come, and the doctor will correlate it to arrive at a diagnosis.

Meanwhile, try to get some sound sleep and do some light exercise. But be cautious in back pain as it should not get increase by doing exercise.

I hope it helps you.

Thanks.

Hi doctor,

Thanks for the reply.

Are there any new symptoms I should look out for that would turn this into an emergency?

I am still worrying.

Thank you.

#

Hello,

Welcome back to icliniq.com.

Kindly lookout for any sudden severe back pain radiating to the right lower limb and severity in numbness. Also, watch out for giddiness and lightheadedness interfering with the regular activity.

I do not think it would turn into an emergency, but be aware of the above and any new symptoms that make you feel sick. And you could talk on the phone to your doctor you visited yesterday if it helps calm you.

I deduced possible peripheral neuropathy based on the above symptoms, but a proper conclusion should be made after the tests reports.

Relax and calm your mind. Do your everyday routine and try to get sleep. Kindly get the tests done as suggested by your doctor and share test reports if you find them necessary.

Take care.

Thanks.

Hello doctor,

Thanks for the response.

I have given the blood sample for the tests, and it takes a couple of days for the results.

I had an awful night, I woke up to skin numbness all over my lower body involving the groin, but it faded when I got up. I feel some numbness in my lower legs, starting from my knees, and a tingling sensation in my feet while sitting and standing during the day. The pain in the lower right back and buttock got worse today. I feel sick and have a headache. I had an odd experience yesterday like my lips, gums, teeth, and tongue felt numb and not working right, and I had to stop eating. I do not think this is just anxiety.

I saw another doctor yesterday, and he examines for the signs of stroke, but it was fine, and again did not have any answers about the numbness. He also insisted on waiting until the blood results come.

I am worried.

Please help.

#

Hi,

Welcome back to icliniq.com.

I feel sorry to read that your symptoms are the same as before.

Your symptoms are confined below the lumbar spine involving both legs and right back. And your symptoms are going away when you got up indicates stroke, but your doctor examined about stroke and did not find any signs related to it. I would suggest you visit a neurologist as he would best address your issue.

Have you done any imaging tests like MRI (magnetic resonance imaging) spine done today? I think an MRI spine would give some clues and help find any pathology in the lumbar area causing such symptoms.

The numbness around the oral cavity which you had yesterday is the new symptom. Is it present today also? Kindly check vitamin B12, serum calcium, and vitamin D, along with other blood tests, since low serum calcium can cause such numbness around the oral cavity.

I understand this is worrying you, but do not get scared. Ring your doctor tomorrow or get a neurologist appointment at the earliest.

Thanks.

Hi doctor,

Thanks for the reply.

I thought I would update you. My blood test results came back, and the only low thing was Vitamin D. Vitamin B12 was fine, and my doctor said my iron was normal but on the more downside.

I just finished talking to my doctor on the phone again, explaining how I felt, back pain, numbness still, headache. And he said perhaps I have a viral bug, or the low vitamin D could cause some numbness. He added that my examinations never showed any neurological issues. He advised me to get an eye test for my headaches and insisted on waiting for a week or two to see the betterment.

I feel especially awful today with my headache, and I am exhausted too.

Thank you very much for each reply. I hope I feel better soon.

Thanks.

#

Hello,

Welcome back to icliniq.com.

It is good to read that all your blood parameters tested came back normal except for low vitamin D and lower side serum iron. Low vitamin D can cause low calcium, which manifests as circumoral numbness as one of its clinical symptoms. Since vitamin D is low, start taking weekly or daily vitamin D3 supplements. But still, the cause of numbness in your leg with pain on the right side has to be found out. I suspected peripheral neuropathy and suggested investigation accordingly, but physical examination done by your doctor showed no neurological issues. Also, vitamin B12 came as normal, so vitamin B12 associated neuropathy is now ruled out.

By reading your earlier replies, I do not think you are a hypochondriac. And you replied spontaneously, it suggests you are suffering from the above symptoms and not exaggerating it. Please wait for a week or two as suggested by your doctor, and I hope and wish you to get better every day and get relief from the above symptoms.

I tried to guide you with my medical knowledge about your symptoms and pondered what could be the reason.

Take care of your health and get better soon.

Thanks.

Hello doctor,

Thanks for the reply.

I have been struggling with the symptoms. I do not know if I can wait for a week until I speak to another doctor, so I want to read your opinion on it. The symptoms have changed a bit, and it is mostly numbness, tingling and headache that is now worrying me. My headache gets worse when I lie down on one side. I have numbness and weakness when I lie down. It feels all over. My legs go numb to touch, my arms, my face, my mouth and teeth feels odd too. It gets better when I move or get up. I noticed some genital numbness also. The feeling of weakness all over is strange and hard to explain. Pain in my back, buttock, and thigh is actually getting better. I have noticed tingling in legs, feet, genital area throughout the day which is on and off. I have not noticed any issues in using the bathroom. The headache and feeling of weakness and numbness has been making it hard to sleep still. Have you heard of headaches getting worse when lying down? Or the weakness or numbness happening on lying down?

I am just anxious.

Kindly help.

Thank you

#

Hello,

Welcome back to icliniq.com.

Sorry to read that now the headache is troubling you along with other symptoms.

Around a week back, the patient started to have symptoms like numbness of the lower limb with pain more on the right side buttock and thigh. She had a headache, neck pain, blurred vision. These symptoms are more pronounced when she is lying down or supine and get better when she moves or gets up. She also feels a little nauseous but has no vomiting. And around two to three days back, she felt numbness around the oral cavity in the gums, lips, teeth, and tongue, and she had to stop eating. She also feels numbness in the upper arms.

She got blood tests were done, which revealed low vitamin D and normal vitamin B12 levels. Physically she is obese, weight around 288lbs, with no past medication history or similar complaint. She needs medical attention as the headache has increased on lying down with a tingling sensation over the legs and feet.

Differential diagnosis could be IIH (idiopathic intracranial hypertension) but let your doctor investigate or work up to about it and come to the diagnosis.

I have compiled the complaints you mentioned in the previous chats as a summary and hope the attending doctor finds it useful. You should seek a neurologist's medical attention without delay. And I wish for the earliest diagnosis and treatment of your health condition.

Take care.

Thanks.

Thank you doctor,

Hello, I saw another doctor who advised me to do some more blood tests. I had no explanation for my headache or numbness once again after checking. There was no neurological cause. I think the blood tests were done to check for some infection or glandular fever. But I have not heard the results back. I am not feeling great but a bit better. I do not feel lightheaded when doing things, however, I am still getting head pain as soon as I lie down usually on the left side of my head. I have on and off tingling on my lower body, legs, and feet. I have weird genital tingling which is uncomfortable to share but I wonder whether it is a symptom that could be concerning. I still have some slight numbness or tingling in my hands. I wonder to see doctors for no reason. As I am not symptom-free hundred percent and so I am not sure what to think. I will contact the doctor next week and see what she says and if the blood test result comes back with anything. I thought you might be curious about an update. Thanks.

#

Hi,

Welcome back to icliniq.com.

I read your update. I do not know what to reply to you. The best or ideal way to practice medicine or exercise medical knowledge is to see the patient, taking an elaborate medical history of the present illness, looking for any sign that could help a physician to arrive at a diagnosis along with necessary medical investigations. In your case, you have met a doctor in the clinic, and they have not found any reason for the headache or numbness but it is good that some more blood investigations have been done. I just hope that the results of blood tests done help the attending doctor to narrow down the possible causes which the doctor is thinking about it.

Yes, I am curious about the cause of your present symptoms but unfortunately, I am not helping you much either to get to the root of your problem. I do not feel comfortable as I am not able to guide you properly or help you with your symptoms. Whatever I deduced from the history of your symptoms is not the cause or diagnosis of your complaint as the attending doctor has ruled out a neurological cause. It is comforting to read that you are a bit better now. Sometimes, we have to see two to three doctors as they do not come up with diagnoses.

I just wish this attending doctor comes up with something and helps you to restore your health. I think that your doctor is thinking, infectious origin as a cause of your present symptoms. I have noted your symptoms and if I come up with some other explanation, I will message you back. You just take care of your health. Follow up with your attending doctor and ask the cause of the symptoms. Hope your attending doctor gets a diagnosis, start your treatment at the earliest. Thanks.

Thank you doctor,

I do not have any diagnosis. Right now, I still have a constant headache on the left side that seems to get worse when lying down. I still feel a bit weak and lightheaded whenever I am up and doing anything. I have back aching and aching down my buttock and thigh. But it is not like a sharp shooting pain. Just ache. Aches when lying down gets worse on the right side. The numbness are on and off. I had a bad episode after waking up two nights ago but not since. I definitely do not feel right. I spoke to the doctor. But she said the same thing. My symptoms are probably caused by a viral bug. When I checked previously, there were no neurological issues and my symptoms were atypical. I was offered an appointment to be seen but I have been made to feel that I am making a fuss over nothing. I am just seen as anxious. I am advised to get an eye test within 10 days. I keep getting some double vision when reading or some object slightly too (up close and further away). So I am waiting another 2 weeks to see if I get any better before bothering the doctor again. I just hope it is not anything serious and I just kept being dismissed.

#

Hi,

Welcome back to icliniq.com.

Ok. I thought that the diagnosis has been made. Anyways, you are under the guidance of a doctor now. Please tell me about your tests done. Kindly say whether it is normal. Kindly update your parent's views about your health. It is so late in doing an eye test (in 10 days). Hope your doctor has started some medicine for your symptoms. Your symptoms have changed somewhat, in the sense that it has become less severe. I just hope that you should get better and be in the guidance and touch of your treating doctor. In another two weeks, your symptoms should go away. Thanks.

Thank you doctor,

Thanks for the reply. I am feeling better than what I was. I have a question though, as I am still experiencing numbness. I noticed it right now as I was laying down on my left side, and on my right thigh starting from hip downwards. What could possibly cause this? If a patient came to you complaining of it happening, what would you think or tests should be done? I am unsure whether I will contact the doctor again unless things get much worse.

#

Hi,

Welcome back to icliniq.com.

It is comforting to read that you are getting better. I hope that the headache and blurred vision are also getting normal. I have a question though, as I am still experiencing numbness. I noticed right now as I was laying down on my left side, and on my right thigh starting from my hip downwards. What could possibly cause this? If a patient came to you complaining of it happening, what would you think/tests you think should be done?

Answer: First of all, I would suspect Peripheral neuropathy with the above limited medical information. To know the cause of neuropathy, I would do blood tests like vitamin B12 and vitamin D. The electrodiagnostic evaluation is done in suspected peripheral neuropathy which consists of nerve conduction study (NCS) and EMG (electromyogram). Other important medical histories should be asked along with a physical examination of the patient. Since you had back pain along the right thigh, I advise you do an MRI spine (also as you are obese since you mentioned in the query, it can cause stress spine. It can contribute to spinal changes triggering this kind of nerve pathology), so MRI spine would help to find if there is any such pathology.

But you had unusual headaches, blurred vision, numbness around the oral cavity, and upper arm. All these symptoms do not fit with the above initial differential diagnosis. In such a clinical scenario, the patient should visit a doctor. You visited the doctor which is the ideal way because a doctor can ask for important medical history, a physical examination which becomes vital to look for any sign and the doctor may order tests that help the clinician to narrow down the possible differential diagnosis. Anyways you are getting better now that is what the aim is. Be in touch with your local treating doctor. Hope you get completely well and fine soon. Thanks.


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