Does fatigue, muscle weakness, and aching arms indicate ALS?

Question

Hi doctor,

I recently had covid and suffered from headaches, muscle aches, fever, and fatigue. I have tested negative after four days but still suffer from severe fatigue, muscle weakness (heaviness), and aching in both arms and legs. In the last 2 to 3 days, I have also developed muscle twitches (mostly in both legs and my arms and neck). There is no obvious muscle wasting, and my grip is fine. However, daily tasks are very tiring, and my arms easily become tired when trying to dry my hair, etc. I have had blood tests and chest x-ray, which came back normal for B12, iron, etc. I am concerned these may be early symptoms of ALS. My younger sister was diagnosed with MS last year.

Answer 1

Hello,

Welcome to icliniq.com.

Thanks for providing a detailed history. The timeline of covid infection followed by fatigue and muscle pain is a well-established complication of Covid (coronavirus disease) infection and, in the majority of cases, will settle down in a few days, mostly an average period of 7 to 10 days, and almost all patients become ok after 2 to 3 weeks.

The fear of ALS (amyotrophic lateral sclerosis) is troubling you but let me assure you that the symptoms you have, like muscle fasciculations, do not always mean ALS. You have severe fatigue and pain in the muscles, meaning there was inflammation in the muscles due to covid. The fasciculations are an uncoordinated contraction of the fibers of the muscles and manifest as twitching. Your symptoms fit in with Covid induces myalgia and fatigue. There is no evidence of ALS. In fact, pain is not a part of ALS. So please do not worry, you will be fine soon. I suggest taking a tablet of Paracetamol for fatigue and pain.

Regards.