Twitching muscles in the fingers can have some people fearing they have ALS, that incurable fatal disease that causes muscles to waste away.

People with twitching muscles who think they have ALS are prone to relentlessly performing muscle strength tests.

People with muscle twitching are often never satisfied, however, if they “pass” one of their invented strength tests.

A certain percentage of people invariably google those key words, twitching muscles, which then brings them to ALS links.

The person may then start panicking he or she has ALS. However, ALS muscle twitching comes after muscle weakness, not before. So the person then starts imagining he or she has muscle weakness. — “perceived muscle weakness.”

In ALS, it’s called “clinical muscle weakness.”  The strength testing can become obsessive, and unknown to those closest to the person.

So as a personal trainer, I have come up with strength tests that, if you pass, you should have no reason to obsess about ALS.

Finger muscle strength test

Piano and guitar playing, if you already play these instruments. “If someone has ALS affecting the fingers, this would likely affect his or her ability to play a piano or guitar,” says Bonnie Gerecke, MD, director of the Neurology Center at Mercy in Baltimore; board certified neurologist with a special interest in neuromuscular disorders, ALS and EMG.

So if you can get through your most difficult songs without a hitch, you should be reassured. Though this requires no strength in the true sense, it still demands a degree of neurological skills that would be absent in ALS.

Index finger and thumb strength test

You’ll use a bottle of white-out (correction fluid) or nail polish. The cap’s diameter is perfect for this strength test.

Using only your suspected thumb and index finger, screw cap on as tightly as you can. A neurologically impaired finger will struggle.

This test does not apply to those who’ve historically had trouble with tight cap screwing.

Now, with just thumb and index finger, unscrew this tight cap. If you’re having trouble unscrewing it, don’t fret, because this means you were strong enough to screw it on so tightly in the first place!

Additional Strength Tests

Screwing on lids of various food jars can be a good strength test if you, historically, have no problem unscrewing tight jar lids (some healthy people have always struggled with tight jar lids); so screw them on as tightly as possible. An ALS weakness will prevent you from doing this. Now, unscrew them.

If you have difficulty unscrewing a lid that you just tightly screwed on, this does NOT mean muscle weakness; it means muscle strength that was applied to tightly screwing the lid on.

Find a very thick encyclopedia or two moderately thick books. Place book(s) end-up on the floor.

With thumb on one side and fingers on the other, pick them up, without palm touching.

Clinical weakness will prevent you from doing this, or, if you’re able to despite actual ALS clinical weakness, you will immediately feel an uncharacteristic gripping deficit that’s very new to you.

“Patients with ALS who have hand weakness often have trouble picking up objects with their hands,” says Dr. Gerecke.

“When there is weakness in the thumb muscles, patients often have difficulty opposing their thumbs and other digits (grasping objects).  They usually have difficulty holding objects in their hands.”

Use hand grip strength devices – and compare hands. If you have clinical weakness, the affected hand/fingers will be dramatically weaker (when previously they were not), not slightly weaker.

Source: mayoclinic.com/health/amyotrophic-lateral-sclerosis/DS00359

Click on the body part that’s been twitching: