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I’m 47 And (with Exception To A 5 Year Period

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Posted on Tue, 16 Jul 2019
Question: I’m 47 and (with exception to a 5 year period of heavy alcohol and drugs) have always been athletic, healthy, fit. No major injuries or health issues. Worked-out regularly, muscular in an athletic sense. Fairly good diet, supplements. About 2.5 years ago (age 45) my hips, lower back and upper buttocks began to hurt, ache. My back completely locked-up twice in a 6 month period and had to be taken to emergency clinic. It was uncomfortable to sit on a sofa and lay on my side when sleeping. As this problem progressed, I had to cease working-out. Over the course of the next 12 months, by back (lower and upper), shoulders, neck area, hips, buttocks were in constant state of tightness, tender, painful. There was no method of relief. None. I began to take Tizanidine about 12 months ago in an attempt to get everything loose. Over the course of the following 6 months, my muscles relaxed significantly and situation improved greatly, yet not completely. I’d say I improved by 80%. Hips remained tender to the touch and had to use a ultra thick foam mattress topper. I ceased my Tizanidine use completely. However, over the course of the last 6 months, my muscle mass and tone have decreased significantly and drastically. I have mild and prolonged spasms in legs, buttocks, back and shoulders. Sometimes one area will spasm for weeks. The spasms are mild and not typically the top layer of muscle. The spasms tend to be deep or the underside of the muscle and sometimes just a section or strip of the muscle. The loss of muscle tone and mass has obviously decrease my strength. I also have soreness in my ankles, right shoulder and right tricep. I realize this could all be due to a number of things: ALS, Muscular Dystrophy, etc. Could these issues be the result of the Tizanidine use? Could they be the result of an organ issue? If I need to see a physician, should I see a general or specialized physician?
doctor
Answered by Dr. Dr. Antoneta Zotaj (2 hours later)
Brief Answer:
Tizanidine is unlikely to be the cause - further explanations below

Detailed Answer:
Hello and welcome to 'Ask a Doctor' service,

I carefully read your query and understand your concern. The symptoms you are having is very unlikely to be due to tizanidine. Other conditions should be considered and proper examinations were done.

I would recommend you to see your local doctor first and have a thorough physical examination first. According to the findings, your local doctor decides on further specialist referral or needed tests and examinations.

Very likely you will need the following:
- CBC and ERS, electrolytes in blood (especially calcium and magnesium levels), RF, ANA test, to rule out electrolyte problems and also some autoimmune conditions
- EMG and NCT are tests that will determine if your symptoms are due to the nerves or due to a musculoskeletal condition (polymyalgia rheumatica, rheumatoid diseases) or the neurological conditions that you were already mentioning and others (Multiple sclerosis).
- sometimes MRI of brain and spine may be ordered (not all patients need these).

To conclude:
- there are many conditions that might cause your symptoms from neurologic to rheumatoid diseases and electrolyte disbalances.
- it is less likely tizanidine is the cause, it actually helps with your symptoms
- it might be better to see your local doctor, have a thorough examination and probably some tests and then it will be more clear which specialist to visit (rheumatologist or neurologist)

I hope this is helpful. I remain at your disposal in case further medical assistance is needed.

Regards
Dr. Antoneta Zotaj,
General and Family Physician


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (16 minutes later)
I forgot to mention: I've had three bouts of constipation within the last 5-6 months, too. Won't go for a few days. Extremely painful. Need tons of fiber and softeners to get things moving. Then fine for a month or two before a re-occurrence. Constipation has NEVER been an issue for me. Additionally, on a scale of 1 to 10, my libido is now at 0.
doctor
Answered by Dr. Dr. Antoneta Zotaj (11 hours later)
Brief Answer:
Further advices below

Detailed Answer:
Hello and welcome back,

I would advise you to have a TSH check to rule out thyroid problems as well. Thyroid may cause constipation, mood changes and in some cases even muscular problems.
Meanwhile you can use movicol2-3 sachets a day when you are constipated and 1-2 a day when you are not. It is advisable to take movicol regularly even when you are not constipated as to prevent severe constipation.

I hope this answers your query and is helpful.
I remain at your disposal in case further medical assistance is needed.

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

Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
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Dr. Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 4435 Questions

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I’m 47 And (with Exception To A 5 Year Period

Brief Answer: Tizanidine is unlikely to be the cause - further explanations below Detailed Answer: Hello and welcome to 'Ask a Doctor' service, I carefully read your query and understand your concern. The symptoms you are having is very unlikely to be due to tizanidine. Other conditions should be considered and proper examinations were done. I would recommend you to see your local doctor first and have a thorough physical examination first. According to the findings, your local doctor decides on further specialist referral or needed tests and examinations. Very likely you will need the following: - CBC and ERS, electrolytes in blood (especially calcium and magnesium levels), RF, ANA test, to rule out electrolyte problems and also some autoimmune conditions - EMG and NCT are tests that will determine if your symptoms are due to the nerves or due to a musculoskeletal condition (polymyalgia rheumatica, rheumatoid diseases) or the neurological conditions that you were already mentioning and others (Multiple sclerosis). - sometimes MRI of brain and spine may be ordered (not all patients need these). To conclude: - there are many conditions that might cause your symptoms from neurologic to rheumatoid diseases and electrolyte disbalances. - it is less likely tizanidine is the cause, it actually helps with your symptoms - it might be better to see your local doctor, have a thorough examination and probably some tests and then it will be more clear which specialist to visit (rheumatologist or neurologist) I hope this is helpful. I remain at your disposal in case further medical assistance is needed. Regards Dr. Antoneta Zotaj, General and Family Physician