Left Arm Numbness

Left arm numbness and tingling with or without pain can be indicative of many possible disorders.  Some of the causes include anxiety, heart attack, stroke, cervical spine disease and thoracic outlet syndrome.  This is by no means an exhaustive list, but should be kept in mind when having these symptoms.  In order to differentiate between these conditions the character of the numbness and whether there is pain along with nausea, sweating must be looked at.  Do the symptoms occur at rest or with any activity?  Are there any other symptoms as well?  Is it only in the left arm or is the right arm affected?  Do symptoms remain localized to the arm or do they include other parts of the body like the legs and feet.   Going through each possibility individually will help tease out the true cause.

Anxiety can cause numbness or tingling in not just the left arm but in both arms and legs as well.  In fact you can have that tingly feeling all over.  Usually you will know if this is indeed the cause because of the other psychological factors associated with this.  To be sure you can be administered an anxiolytic like lorazepam or diazepam which is more commonly known as valium.  If the symptoms abate that is a good clue that anxiety or even a panic attack could be the origin of your symptoms.

A heart attack or myocardial infarction is always on everyone’s mind when these symptoms occur.  Especially if you have had a family history or know of others who have had a heart attack before.  Usually pain or numbness in the left arm is accompanied with shortness of breath and maybe either nausea or sweating.  When you are seen you should be given nitroglycerin which acts to dilate your coronary arteries and vessels hence improving blood flow which will relieve symptoms.  Pain, shortness of breath and numbness that is relieved with nitroglycerin is a good sign that the heart is involved.  You should have further testing including a stress test and if positive that means you could have decreased blood flow to the heart.  The only way to know for sure is to undergo a cardiac catheterization or angiogram which is the gold standard and will tell you for sure if there is indeed disease in the coronary arteries of your heart.

Cervical spine disease such as severe arthritis causing blockage of nerves as they exit the cervical vertebral spaces or cervical spinal stenosis can result in numbness, tingling and even pain in the arms.  It could be one sided on the left or right as well as bilateral.  The best test for this would be an MRI of the cervical spine.  If you are claustrophobic ask for an anxiolytic like lorazepam or valium to help you relax as this scan can take upwards of an hour.  While you can opt for an open MRI just know that the magnetic field is not as powerful as a closed MRI which could make for images that are a bit distorted compared to a closed MRI.  However, most of the time the images are good enough to detect disease if present with enough information to formulate a treatment plan.

A stroke can cause these symptoms as well.  In fact if your symptoms affect both your left arm and left leg then the likelihood increases.  Why?  because the brain is crosswired so that when the right side is affected with a stroke or TIA the loss of blood flow manifests as  symptoms on the left side.  It is the same too when the right side has symptoms it would be the left side of the brain that has had the stroke.  What is noteworthy is that the speech centers of our brain our located on the left so that if you have right sided weakness, numbness or tingling with speech trouble even slight then a stroke would be at the top of my list for the cause.  Of course other things like MS or a partial seizure may also be the case.  The best way to determine the cause is an MRI of the brain which can delineate if there is any neuronal cell death or if there is any disease of the brain itself indicative of MS.  An EEG can be done to determine if there is abnormal electrical activity in the brain, but often is only positive in only 20% of cases of actual seizures.  With recurrent symptoms sometimes a 24 hour EEG would help so that the electrical activity of the brain can be recorded at the time of the event.

These are only some causes of left arm numbness, tingling and pain.  A good history is and physical exam is the cornerstone to determining whether the numbness in your arm is truly an emergency or can wait to be assessed


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