Altered sensation or weakness in the limbs
Altered sensation in the limbs is often described as numbness, pins and needles (‘paraesthesiae’), cold or hot sensations. Painful or unpleasant sensations may be felt, such as shooting pains, burning pain, or increased sensitivity to touch (dysaesthesia). There may be a precipitating cause, such as after trauma, or exacerbating features.
The distribution of the sensory symptoms, and any associated pain (such as radicular pain, back pain or neck pain) can help to determine the cause.
Muscle weakness (loss of power) may occur in specific muscles or muscle groups.
· It should be differentiated from general symptoms of weakness such as fatigue.
· Muscle weakness due to lack of use develops rapidly, for example in the legs due to a painful hip or following surgery or a debilitating illness.
· Distribution of the weakness, onset and any associated pain, e.g. back pain may point to a cause.
Although formal assessment of muscle weakness takes place in the examination, certain questions to assess the functional ability of the patient are required:
· Can you carry and lift objects as you could before? (assesses hand and upper limb power).
· Can you get up from a chair easily? Do you need to use your arms to help you get up from a chair or to climb up stairs? (assesses lower limb power).