Can someone please explain the difference between perceived weakness and true weaknes

[wingo22]

I have been racking my brain over this for a year now.

So been a long time health anxiety sufferer. I do plan on going for CBT, however the wait list in my area is quite long. But I feel like it’s a step in the right direction.
Ive been recently worried about MS. Well it started out as an ALS fear, then quickly moved to MS. My right arm for some time (9 months) has felt tired and gets fatigued quite easily when I an doing something with it. Recently I have been feeling dull aches in my right leg as well when climbing stairs or doing whatever. I find myself constantly strength testing my leg by walking.running up stairs, standing on one leg, etc.

I saw my doctor about 6 weeks ago about it. She really focused on my arm issue and kind of pushed aside the leg one. We did a full physical, strength, neuro, reflexes test and blood work. Everything is good. I told her I was super afraid it could be something neurological and feared MS. She responded “I don’t think so” and “MS usually does not present itself that way”.
I felt really relieved on the drive home. I do trust her but am still getting some occasional fears that she misdiagnosed me. She said my nerves and muscles are all responding well, if this is the case should i stop worrying about MS?
30 yr old male btw. I am just super worried that it is only affecting one side of my body (my right arm and leg). My left arm and leg are perfectly fine. I have no tingling, numbness, vision issues, etc. I am still strong as I can walk up stairs, lift weights, but my right arm and leg just "feel" tired and fatigued afterwards.

Can anyone offer some advice please!

[Fishmanpa]

True weakness is about failure—physically being unable to to do things you did before. It is not about these things becoming more difficult. It is about these things being impossible… no matter how hard you try. If you can do normal things, but it is more difficult, you do not have true weakness. If you used to be able to do 100 curls and now one arm can only do 50; that is not true weakness. If you used to run 2 miles and now you can only run 1; that is not true weakness. If you used to run 2 miles and now you can’t lift up one of your feet no matter how hard you try, you may have clinical weakness.

Positive thoughts

[WorryRaptor]

I have been racking my brain over this for a year now.

So been a long time health anxiety sufferer. I do plan on going for CBT, however the wait list in my area is quite long. But I feel like it’s a step in the right direction.
Ive been recently worried about MS. Well it started out as an ALS fear, then quickly moved to MS. My right arm for some time (9 months) has felt tired and gets fatigued quite easily when I an doing something with it. Recently I have been feeling dull aches in my right leg as well when climbing stairs or doing whatever. I find myself constantly strength testing my leg by walking.running up stairs, standing on one leg, etc.

I saw my doctor about 6 weeks ago about it. She really focused on my arm issue and kind of pushed aside the leg one. We did a full physical, strength, neuro, reflexes test and blood work. Everything is good. I told her I was super afraid it could be something neurological and feared MS. She responded “I don’t think so” and “MS usually does not present itself that way”.
I felt really relieved on the drive home. I do trust her but am still getting some occasional fears that she misdiagnosed me. She said my nerves and muscles are all responding well, if this is the case should i stop worrying about MS?
30 yr old male btw. I am just super worried that it is only affecting one side of my body (my right arm and leg). My left arm and leg are perfectly fine. I have no tingling, numbness, vision issues, etc. I am still strong as I can walk up stairs, lift weights, but my right arm and leg just "feel" tired and fatigued afterwards.

Can anyone offer some advice please!

Hey, so I can relate somewhat here, and hopefully help to put your mind at rest. I pretty much have what you have, except mine is on the left side. Arm, and leg on one side feels noticeably weaker than the right. Like you, I feel way more fatigue in that side when exercising, or exerting myself. Actually, even at rest I've had both my arm and leg suddenly go "weak" and even had numb patches on the skin which freaked me out. I was convinced I had MS, or ALS and even my gp was concerned enough to send me to a neurologist. She went through all the reflex tests, muscle strength tests and stuck me in an MRI. No MS, nothing bad at all.

She explained that real weakness is a very obvious absence of strength and function. Perceived weakness is the addition of a sense, or the sense of losing a sensation to be more exact. So, if you wanted to lift your phone off the table and you couldn't at all...like AT ALL, you have clinical weakness. If you can, even though it feels like it's taking more effort, even if that hand trembles a little, even if you feel like your other hand can do it so much easier, its perceived. Anxiety can hyper focus on tiny differences in our bodies and make them so much worse than they really are.

What can add to this feeling of weakness, is the fact you have a dominant side of your body, and could be subconsciously relying on that, or over-relying, which puts a lot of strain on your back muscles, and those in the limbs on your dominant side, or vice versa. After all my in depth tests, they're guessing my back is doing way too much work and I'm constantly overcompensating for fatigued muscles (not clinically weak ones!) and I'm over correcting my posture. This could be causing upper back spasms which then put pressure on my lower back, and next thing I know I'm having weeks of weird one sided feelings. My anxiety amplifies all of that 1000 times and I used to be convinced it was MS or some terrible neurological disorder. It wasn't, of course.

I hope this was of some help. Just thought I'd leave a wall of text as I've had such similar feelings. I hope you feel better soon, and do let us know how you're getting on :)

[wingo22]

Hey, so I can relate somewhat here, and hopefully help to put your mind at rest. I pretty much have what you have, except mine is on the left side. Arm, and leg on one side feels noticeably weaker than the right. Like you, I feel way more fatigue in that side when exercising, or exerting myself. Actually, even at rest I've had both my arm and leg suddenly go "weak" and even had numb patches on the skin which freaked me out. I was convinced I had MS, or ALS and even my gp was concerned enough to send me to a neurologist. She went through all the reflex tests, muscle strength tests and stuck me in an MRI. No MS, nothing bad at all.

She explained that real weakness is a very obvious absence of strength and function. Perceived weakness is the addition of a sense, or the sense of losing a sensation to be more exact. So, if you wanted to lift your phone off the table and you couldn't at all...like AT ALL, you have clinical weakness. If you can, even though it feels like it's taking more effort, even if that hand trembles a little, even if you feel like your other hand can do it so much easier, its perceived. Anxiety can hyper focus on tiny differences in our bodies and make them so much worse than they really are.

What can add to this feeling of weakness, is the fact you have a dominant side of your body, and could be subconsciously relying on that, or over-relying, which puts a lot of strain on your back muscles, and those in the limbs on your dominant side, or vice versa. After all my in depth tests, they're guessing my back is doing way too much work and I'm constantly overcompensating for fatigued muscles (not clinically weak ones!) and I'm over correcting my posture. This could be causing upper back spasms which then put pressure on my lower back, and next thing I know I'm having weeks of weird one sided feelings. My anxiety amplifies all of that 1000 times and I used to be convinced it was MS or some terrible neurological disorder. It wasn't, of course.

I hope this was of some help. Just thought I'd leave a wall of text as I've had such similar feelings. I hope you feel better soon, and do let us know how you're getting on :)



THank you for both of those answers, it does make me feel better. So are you saying that this feeling of perceived weakness is all in your head? It’s so weird, I can still do everything normally, but it seems my mind gets in the way. Every time I have to climb stairs at home or work my mind directly focused on my right let to see what kind of feeling I will have once I am done.

Is this still an issue for you? How can we stop it?

[WorryRaptor]

It's still an issue at times, yes, but I've been less worried about it as I'm more able to accept that anxiety can really do a number on your nervous system and cause all kinds of sensations, real and imagined.

To answer your question about perceived weakness, I feel it's both in my mind, but real at the same time, just extremely amplified because of anxiety. It was hard for me to believe that anxiety could have that much of an effect. I used to tell myself that other people's "symptoms" were probably not as bad as mine, so easily attributable to "something in their minds". Thing is, anxiety isn't just mental, it has a physiological impact too, so some things can feel genuinely real. It's a big stress on the nervous system, hormonal balance,digestion etc to be perpetually anxious, so it can product a LOT of pretty scary sensations that can mimic scary conditions. Anxiety by its very nature tries to make us catastrophize anything slightly wrong, so we end up convinced that it's something terrible, rather than one of the most common causes...anxiety.

As for stopping it, you mentioned you would be doing CBT soon, which should really help. In the meantime, as there's a long wait for you, try looking into relaxation techniques, stretching, and good nutrition. I know they all sound generic, and perhaps you're already doing all the good stuff, but I find it really helps the body to relax and feel good. Often, that has a knock on effect with the mind. Yoga and meditation have helped me a lot when I'm feeling "symptoms". And it goes without saying...don't google! Oh, and there's also a really good book I read called The Worry Cure by Dr Robert Leahy, which deals with so many aspects of anxiety, and how to break the cycle. I found it really helpful :)