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Started Having Muscle Twitching On Leg And Arm. Related To Coffee Intake Or Exercise?

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Posted on Wed, 27 Feb 2013
Question: Hi,
I started having muscle twitches on my right lower leg about 5 days ago. There was also some twitching of the left leg at the time. The twitching then spread to the thigh on the right and also left. Now, it seems to have changed to more of a tremor or trembling sensation where when I place my feet on the ground, I can feel the legs trembling. However, if I put my left lower leg crossed on top of my right knee with the leg muscle pressed against the knee, then it can induce twitching in the left leg again, which does seem to also increase the muscle activity on the right leg. The right upper arm also twitches sometimes. I can also sometimes can sharp pins on the legs and other areas, they last a short time. What are the possible causes of these symptoms and should they be investigated further?
Possibly related is caffeine intake although that was stopped 5 days ago and leg exercises done in the gym about 4 days before onset.
How is it possible to rule out something serious such as ALS or other neurological issues, what sort of tests are needed if this problem continues?
doctor
Answered by Dr. Krishna Kumar (46 minutes later)
Hello
thank you for sharing your problem.
First of all your age rules out ALS as it affects elderly people with profound muscle weakness, wasting and breathing difficulties.
Caffeine and exercise can cause muscle twitching due to electrolyte imbalance (sodium, pottassiumetc)
As you do not have weakness or numbness most likely it would resolve.
But you may undergo tests such as blood for electrolytes, Thyroid function.Other optiond are EMG,NCV tests which has to be recommended only after examination by a doctor.
Anxiety can worsen tremor too.
So have adequate rest and salt in your diet and if you do not improve please XXXXXXX your physician
I hope I had cleared your doubts
Please get back to me if you have any queries
thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Krishna Kumar (6 hours later)
Hi,
Thanks for the information. Would you recommend any supplements for potassium? What is a good source?
Would the sodium mainly just come from salt?
Also, does the transition towards more continuous trembling from occasional twitching mean there is an improvement in the condition or worsening?

Lastly, I understand ALS can affect anyone and usually starts with the twitching of muscles so that is why it needs to be ruled out.
doctor
Answered by Dr. Krishna Kumar (5 hours later)
Hi, thank you for getting back to me.
Sodium is obtained from table salt and fruits (oranges), milk, meat are good sources of potassium. So include fruits in your diet.

Transition towards more continuous trembling from occasional twitching mean there is an improvement in the condition or worsening?
Well, that means worsening of the condition.

As far as ALS is concerned, you could rule it out with EMG, NCV and MRI .
If you do not improve with diet modification, please consult your physician.
Thank you

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Krishna Kumar (1 hour later)
Hi,
Thanks for the information. My physician has prescribed for the time being Centrum (a multivitamin) and Norgesic (muscle relaxant).
Would you agree with taking these supplements and relaxants?
Would taking supplements for magnesium also help and for electrolytes could the drinking of sports drinks be of any benefit?


Thanks.
doctor
Answered by Dr. Krishna Kumar (22 hours later)
Hi,

I agree with the treatment

Magnesium is present in vegetables and almonds and nuts. Let these be part of your diet.

Yes, you may try the sports drink as well.

Hope I answered all your queries. Please close this discussion if you have no other concerns.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Krishna Kumar (2 hours later)
Thanks for the opinion and I will continue the treatment to see how it goes.
I believe I have one follow-up with you left.
Is it possible that the symptoms could be caused by allergy?
Norgesic is said to be a calcium and magnesium channel blocker, does this mean that it negates the effects of taking calcium and magnesium supplements?
Could the trembling be caused by continued twitching of the muscles closer to the skeleton, as the trembling can definitely be felt but is difficult to see.
I am sometimes getting twitching of the hands and movement, such as fingers contracting. Could these be due to the continued twitching causing other muscles to twitch or is it more signficant?
I hope to get a neurologist opinion within a week if the symptoms do no resolve.
doctor
Answered by Dr. Krishna Kumar (7 minutes later)
Hi,

Thanks for the follow up.

Calcium channel blockers do not cause depletion of calcium or magnesium. But please continue your vitamins. Your symptoms do not seem to be due to allergy.

The recurrent twitching and muscle contraction needs to be evaluated properly. It is always better to get your condition examined by a neurologist and get EMG/NCV as per his/her order.

Hope I have cleared all your doubts.

Thank you

Regards
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Krishna Kumar (5 hours later)
Ok thanks, I will investigate the issue further if it does not resolve soon. Is there any possibility though that the condition could be something serious which would benefit from quick investigation as it might be treatable?

I do have a closely related uncle with Guillaun-Barre disease but my symptoms are not similar to that condition but perhaps there could be a similar neurological connection.
doctor
Answered by Dr. Krishna Kumar (3 hours later)
Hi,
I do not think that your condition is serious.
So you could complete the present medicines and please consult a neurologist later if symptomatic.
GBS has no connection with your present symptoms.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
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Dr. Krishna Kumar

Spine Surgeon

Practicing since :2002

Answered : 102 Questions

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Started Having Muscle Twitching On Leg And Arm. Related To Coffee Intake Or Exercise?

Hello
thank you for sharing your problem.
First of all your age rules out ALS as it affects elderly people with profound muscle weakness, wasting and breathing difficulties.
Caffeine and exercise can cause muscle twitching due to electrolyte imbalance (sodium, pottassiumetc)
As you do not have weakness or numbness most likely it would resolve.
But you may undergo tests such as blood for electrolytes, Thyroid function.Other optiond are EMG,NCV tests which has to be recommended only after examination by a doctor.
Anxiety can worsen tremor too.
So have adequate rest and salt in your diet and if you do not improve please XXXXXXX your physician
I hope I had cleared your doubts
Please get back to me if you have any queries
thank you