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Have Nerve Pain, Muscle Spasms And Numbness With Chest Pain. Imaging Test Negative. Cause And Treatment?

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Posted on Wed, 9 Oct 2013
Question: Hi I am 31 year old male named XXXXX. I continue to have inexplicable symptoms that are progressive in nature. Two primary symptoms are universal nerve pains with muscle spasms and numbness/tingling as well, and chest pain that is upper chest and comes in waves with exertion and or stress. The chest pain has lead me to multiple imaging tests and all were negative. As these neurological symptoms progress and more muscles twitch and I have more flashing nerve pain I have begun to believe I should be looking into infectious diseases that could attack the nervous system as a whole and could be at the same time affecting bronchial in chest. Any suggestions I have an appointment with neuro in a month but getting worse by the day.
doctor
Answered by Dr. Ram Choudhary (5 hours later)
Brief Answer:
unlikely infection, the investigation may help

Detailed Answer:
Hi XXXXXXX

Based on your description, I do not believe you have an infection. There is no infection that will affect nerves and bronchi and leave you otherwise mobilised. Further your negative radiological scans also suggest against infection.

The pain and other group of symptoms might be due to Fibromyalgia. If you been having depressive thoughts the pain may be secondary to chronic depression. If I were to be your treating doctor, I would order blood investigations - Complete blood counts, ESR, CRP, vitaminB12 levels to rule out neuropathy of deficiency state and an XRay chest. If test are negative, I would seriously consider the aforementioned two conditions and refer you to the respective specialist for further evaluation.

I hope the advise would be informative and useful for you.
Take Care!
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ram Choudhary (4 hours later)
Let's not talk about depression as a possible cause of widespread nerve pain and muscle spasms, that is not a satisfactory answer. And neither is stress. I have read all over about mds wanting to pin these kind of symptoms that are difficult to diagnose as "Secondary" to simple stress or emotions. That being said, I will respect the notion that it is not an infection, so where does that leave me. I have tested thyroid and b12 in blood, and have had ncv test on peripherals. I am wanting to get emg done with neuro. Chest pain seems to be closer to outside of chest wall and higher up than heart but FYI I also had echo that showed healthy. If I am unwilling at this point to simply write this off as bfs and hope I get better, would you think that mri of brain or back would be most cost effective? Along with emg. I am someone who never visited a doc before and now need to decide If expensive scan of those areas are worth it because now I of course have this high deductible plan which is costing me my rear to explore these problems.
doctor
Answered by Dr. Ram Choudhary (44 hours later)
Brief Answer:
have a relook.

Detailed Answer:
Hi XXXXXXX

Mostly such pains are either musculoskeletal in origin or as I mentioned due to fibromyalgia. I did not want to offend you or write you off attributing to depression alone; but I just wanted you to be aware that depression per se can also cause similar symptoms. If you have been to an MD and after examination he is in favor of the diagnosis of depr...... related pain then there is no harm accepting it and undergoing suitable treatment.

At this point, I do not seem to find any serious XXXXXXX pathology. You can consider Chest MRI; but I do not find any reasons for ordering brain MRI - that may be unnecessary.
Please get the advised work up. Vit.B12 you have already done and is normal.

If your MD hasn't found any significant abnormality to detect the cause of your problems, you may consider discussing about fibromyalgia. Rheumatologist referral may be necessary.

Hope this helps.

Regards
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Ram Choudhary

Internal Medicine Specialist

Practicing since :2001

Answered : 2270 Questions

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Have Nerve Pain, Muscle Spasms And Numbness With Chest Pain. Imaging Test Negative. Cause And Treatment?

Brief Answer:
unlikely infection, the investigation may help

Detailed Answer:
Hi XXXXXXX

Based on your description, I do not believe you have an infection. There is no infection that will affect nerves and bronchi and leave you otherwise mobilised. Further your negative radiological scans also suggest against infection.

The pain and other group of symptoms might be due to Fibromyalgia. If you been having depressive thoughts the pain may be secondary to chronic depression. If I were to be your treating doctor, I would order blood investigations - Complete blood counts, ESR, CRP, vitaminB12 levels to rule out neuropathy of deficiency state and an XRay chest. If test are negative, I would seriously consider the aforementioned two conditions and refer you to the respective specialist for further evaluation.

I hope the advise would be informative and useful for you.
Take Care!