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Getting stiffness, tightness and pain on leg muscle. What treatment should be done?

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Practicing since : 2001
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Dear Dr. Dash,
I asked you about my leg muscle fasciculations about a month ago, which have now mostly subsided. However, my left leg has now got more stiffness and tightness with pain. The pain is particularly felt in areas where the leg muscles were twitching before.
Are these symptoms to be expected after a period of leg muscle twitching and vibrations?
Posted Sat, 25 May 2013 in Bones, Muscles and Joints
 
 
Answered by Dr. Gopal Krishna Dash 2 hours later
Hello,
Thanks for the query,
I understand your concern
If I remember correctly an extensive evaluation during the last Feb did not yield much in your case including the EMG test.
The current symptoms can be due to

1. Electrolyte imbalance
2. Thyroid related problem
3. Remote possibility of spinal cord problem

Further narrowing down is a bit difficult for me, how ever things will be clear with more discussions with you in follow-up questions. This is mainly because of lack of examination. I feel that you should get the thyroid functions, serum electrolytes initially. If these are normal, please do not hesitate to get re-examined by a local neurologist as this will clarify the picture. A repeat scan may be required if the base line tests which I have told are negative. In the mean time you may try medications like paracetamol, vitamin E supplements for symptomatic management.

Please get back to me in case you have any concern

I will be very happy to help you
Wish you good health
Best regards
Above answer was peer-reviewed by
 
Follow-up: Getting stiffness, tightness and pain on leg muscle. What treatment should be done? 9 hours later
Dear Dr. Dash,

Thankyou. I did get an emg done in February together with clinical examination. Blood tests for electrolyte levels were normal as was the thyroid through blood test.

Is there a possibility of nerve or muscle damage through a disease given that the symptoms now are tightness and pain but not twitching anymore, suggesting that nerve issues may have led to muscle issues or perhaps the two appeared together in the first place. Or is it likely that twitching and muscle vibrations led to a deep strain in the muscles which may manifest as pain and tightness?

I note that the muscle pains and tightness are more obvious after walking and later in the day.

My next emg is due in three weeks' time and I wonder if it will be a good idea to include my results from the previous emg for comparison purposes because I am seeing a different neurologist.


Thankyou.
 
 
Answered by Dr. Gopal Krishna Dash 24 hours later
Hello,
Thanks for the feed back
Please note that the last investigations which included EMG were completely normal suggesting that there was no damage to any of the nerves/muscles etc.Muscle vibration also will not result in such damage.

Muscle pains and tightness are more obvious after walking and later in the day would suggest a possibility of neurogenic claudication. This can be picked up by an MRI of the lumbo-sacral spine as well as neurological examination.
Till you get -re-evaluated please try medications like vitamin E, Gabapentine, pregabaline etc which will relieve your symptoms.

Let me know if I can help in any way
Best wishes
Wish you good health
Regards
Above answer was peer-reviewed by
 
Follow-up: Getting stiffness, tightness and pain on leg muscle. What treatment should be done? 7 hours later
Dear Dr. Dash,

Thankyou. I will certainly mention the possibility of neurogenic claudication to the neurologist. However, sometimes the tightness and pain is also there in the early morning.

The reason for the second emg is to compare to the first because I understand that in many nerve and muscle diseases at an early stage, nothing shows up on the emg.


Regards.
 
 
Answered by Dr. Gopal Krishna Dash 17 hours later
Hello,

Thanks for the feed back

Even though historically it looks like neurogenic claudication, I feel that it could be non-specific pain related to musculo-skeletal problems. Further narrowing down based only upon your history without clinical interview and examination will be a tough task.
Please discuss with your neurologist and if possible get back to me
I will be happy to help you
Wish you good health
Above answer was peer-reviewed by
 
Follow-up: Getting stiffness, tightness and pain on leg muscle. What treatment should be done? 27 hours later
Hi Dr. Dash,

Thankyou. I understand the difficulty in diagnosis based on online feedback alone and I understand that it could be an issue that does not really have a specific diagnosis.
I will first discuss with the neurologist and see what results first.


Regards.


 
 
Answered by Dr. Gopal Krishna Dash 9 minutes later
Thanks for the feed back
I am always with you to help
Wish you good health
Regards
Above answer was peer-reviewed by
 
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