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Suggest Treatment For Burning Sensation On The Thighs And Buttocks

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Posted on Mon, 6 Jul 2015
Question: I am having strong burning in my thighs and top of my buttocks. When I try to move around in bed my muscles are continuing to move on their own for a few minutes after. I have constant feeling of near-cramping in my forearms and calves. It keeps me too warm at night. I saw a neurologist about two years ago about numbness in my hands and feet. It was temporary. They found I had myotonic potentials at the time and pursued DM1 and DM2 dna testing and it was negative. I did not have these new symptoms at the time. I am awake at nearly 3am because of the pain and I am sweating. These symptoms seem to have come on after a 3 month period of missed aerobic exercise. Over the last 3 weeks they have gotten much worse.

Almost all of my testing is available to me online so I can submit anything you would like.
doctor
Answered by Dr. Dr. Erion Spaho (50 minutes later)
Brief Answer:
More information needed.

Detailed Answer:
Hello and thanks for using HCM.

I have read your query and understand your concerns.

About your symptoms, are there positions or activities that worsen or improve them?

What is the symptoms duration and frequency?

If you have done a spinal MRI and nerve conduction study ( ENMG) can you upload it?

Can you share more information about medications you used?

Also blood electrolytes levels are assessed?

Avaiting for more information....

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Erion Spaho (40 minutes later)
Sodium     132 - 144 mEq/L     145
Potassium     3.5 - 5.1 mEq/L     4.3
Chloride     98 - 107 mEq/L     106
CO2     22 - 29 mEq/L     27
Anion Gap     7 - 13 mEq/L     12
Glucose     74 - 109 mg/dL     90
BUN     6 - 20 mg/dL     9
Creatinine     0.70 - 1.20 mg/dL     0.78
GFR Non-African XXXXXXX >60     >60.0
>60 mL/min/1.73m2 EGFR, calc. for ages 18 and older using the
MDRD formula (not corrected for weight), is valid for stable
renal function.
GFR XXXXXXX XXXXXXX >60     >60.0
>60 mL/min/1.73m2 EGFR, calc. for ages 18 and older using the
MDRD formula (not corrected for weight), is valid for stable
renal function.
Calcium     8.6 - 10.2 mg/dL     10.0
Total Protein     6.4 - 8.1 g/dL     5.7
Albumin     3.9 - 4.9 g/dL     4.1
Bilirubin     0.0 - 1.2 mg/dL     0.7
Alk Phos     35 - 104 U/L     63
ALT     0 - 41 U/L     133
AST     0 - 40 U/L     56
Globulin     2.3 - 3.5 g/dL     1.6

Extensive electrodiagnostic examination of the left lower and
upper extremities, related paraspinal muscles, and thoracic
paraspinal muscles (T10) reveals:

1. Normal sensory and motor responses. Compared with the prior
study dated 3/8/2013, nearly all amplitudes are modestly lower
likely due to technical factors.

2. Increased insertional activity affecting distal > proximal
muscles of the lower and upper extremities, and all sampled
paraspinal muscles (including thoracic paraspinal muscles).
Although the configuration of observed spontaneous activity is
consistent with positive sharp wave potentials, prolonged
observation reveals a waxing and waning pattern consistent with
myotonic potentials. No definite myopathic motor unit potential
changes are identified. Compared with the prior study dated
3/8/2013, insertional activity remains present in a similar
distribution but is now more consistent with myotonic potentials.

XXXX, MD
Staff, Neuromuscular Center XXXXXXX Clinic Neurological Institute

Done two weeks ago.

Total CK 0 - 190 U/L 87
CRP 0.0 - 5.0 mg/L 1.4
Folate 7.3 - 26.1 ng/mL 17.

My only recent MRI was of my left leg. I have not had an MRI of my spine or brain in 5 years

The EMG was performed 2013

My symptoms at first seemed to mostly come on when I'm not moving. Then I would get up and experience pain. I did not ride my recumbent bike yesterday and it seems things have gotten worse. I am hurting constantly this evening and now morning. I rode especially long the day before. When the pain first started my quads, triceps and biceps were weak, but my calves and forearms were very tight and felt like they were constantly about to cramp. Now I have less weakness in my biceps, but my triceps, calves and quads plus upper buttocks are in constant pain since evening.
doctor
Answered by Dr. Dr. Erion Spaho (7 hours later)
Brief Answer:
Myotonic conditions should be evaluated.

Detailed Answer:
Welcome back and thanks for the clarifications.

After the prescription of tests reports, and more information about your symptoms, in my opinion yours is the case of Myotonic dystrophy, a condition usually inherited, but in some cases related to periodic increase of potassium blood levels.

This is supported by clinical distribution of proximal muscles weakness, distal muscles tightness, and EMG findings of myotonic potential.

So, if there's is not known inheritance of dystrophies, the most possible cause is periodic increase of blood potassium levels.

This possibility should be assessed by periodic measurement of potassium and other electrolytes blood levels, especially when you experience worsening of symptoms.

Other possible differential diagnoses are Paramyotonia and a deficiency of an enzyme called acid maltase.

These conditions are evaluated by EMG study characteristics and genetic testing.

I suggest you to discuss with your treating Doctor about above mentioned possibilities and tests needed to confirm/exclude them.

Hope I've been of help. I remain at your disposal for further questions and clarifications.

Best regards.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4494 Questions

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Suggest Treatment For Burning Sensation On The Thighs And Buttocks

Brief Answer: More information needed. Detailed Answer: Hello and thanks for using HCM. I have read your query and understand your concerns. About your symptoms, are there positions or activities that worsen or improve them? What is the symptoms duration and frequency? If you have done a spinal MRI and nerve conduction study ( ENMG) can you upload it? Can you share more information about medications you used? Also blood electrolytes levels are assessed? Avaiting for more information....