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Suggest treatment for cervical dystonia and arthritis

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Posted on Sat, 31 Jan 2015
Question: I have been diagnosed with cervical dystonia. I also have arthritis throughout my cervical spine. Last night when I was looking at my hands I noticed both pinkie fingers twitching. What could this be?
doctor
Answered by Dr. Mukesh Chugh (34 minutes later)
Brief Answer:
Stretching of muscle will help

Detailed Answer:
Hi,

Thanks for posting

The Cramps(twitching) are caused by hyper excitability of the nerves that stimulate the muscles. Cramps at rest are very common, especially in older adults, but may be experienced at any age, including childhood. Rest cramps often occur during the night.

While not life threatening, night cramps (commonly known as nocturnal cramps) can be painful, disruptive of sleep, and they can recur frequently (that is, many times a night, and/or many nights each week). The actual cause of night cramps is unknown.

The cause of cramps is as following-
1. Low blood levels of either calcium or magnesium directly increase the excitability of both the nerve endings and the muscles they stimulate. This may be a predisposing factor for the spontaneous true cramps experienced by many adults.
2. On drugs which causes excessive urination. Leading to low calcium, Magnesium, potassium level. Drugs given for asthma, angina and Parkinsonism also lead to cramps. Cholesterol lowering drugs like statin also cause cramps on chronic use.
3. Several vitamin deficiency states may directly or indirectly lead to muscle cramps. These include deficiencies of thiamine (B1), pantothenic acid (B5), and pyridoxine (B6).

Most cramps can be stopped if the muscle can be stretched. Gently massaging the muscle will often help it to relax, as will applying warmth from a heating pad or hot soak.

A simple way to prevent night cramp is stretch muscle before going to bed 3-4 times and each time holding for 10-15 seconds. Quinine water tonic is also useful to prevent night cramps before going to bed.

I hope this information will be helpful to prevent night cramps. If you have further query I shall be glad to answer.
Take care
Regards
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Follow up: Dr. Mukesh Chugh (46 minutes later)
I do not have cramps and they are not only at night, I have twitching of the little fingers. Please answer the question as to the twitching of the little fingers at any time of the day. What can this be?
doctor
Answered by Dr. Mukesh Chugh (43 minutes later)
Brief Answer:
Cervical nerve irritation/stimulation is the cause

Detailed Answer:
Hello
I have gone through your reply carefully and the cause of twitching is irritation/stimulation of cervical spine secondary to arthritis.These are usually treated by shots/pills of vitamin B12 and by drug Gabapentin/Pregablin along with neck muscle strengthening exercises..Get it prescribed by your local doctor.
Hope this answers your query.
Regards

Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Mukesh Chugh (31 minutes later)
I am trying to work with my cervical dystonia diagnosis but find I am very tired every day and can hardly work at my job for a half day. Does this exhaustion come with cervical dystonia which is a NEUROLOGICAL disorder or does it sound like something else is going on too? I was on disability home for almost two months and tried going out to walk to build up my strength and then returned to work Dec22 and 23 and 29 30 and 31 and could barely make it through the half day.
doctor
Answered by Dr. Mukesh Chugh (15 hours later)
Brief Answer:
As follows

Detailed Answer:
Hello
I have gone through the whole discussion till now and early fatigue is a know symptom of dystonia .
My suggestions are-
1.Keep a positive attitude and try to do regular exercises and have balanced diet especially vitamin B12 supplements.
2.Drugs which helps in cervical dystonia and twitchings are Gabapentin/pregablin.Get them prescribed by your doctor.
3.In cervical dystonia not responding to above treatment,injection therapy in form of botox may be considered.
4.A visit to neurologist is highly recommended.
Hope this suffices.
Regards and wishing you best of health in new year.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Mukesh Chugh

Orthopaedic Surgeon, Joint Replacement

Practicing since :1997

Answered : 1619 Questions

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Suggest treatment for cervical dystonia and arthritis

Brief Answer: Stretching of muscle will help Detailed Answer: Hi, Thanks for posting The Cramps(twitching) are caused by hyper excitability of the nerves that stimulate the muscles. Cramps at rest are very common, especially in older adults, but may be experienced at any age, including childhood. Rest cramps often occur during the night. While not life threatening, night cramps (commonly known as nocturnal cramps) can be painful, disruptive of sleep, and they can recur frequently (that is, many times a night, and/or many nights each week). The actual cause of night cramps is unknown. The cause of cramps is as following- 1. Low blood levels of either calcium or magnesium directly increase the excitability of both the nerve endings and the muscles they stimulate. This may be a predisposing factor for the spontaneous true cramps experienced by many adults. 2. On drugs which causes excessive urination. Leading to low calcium, Magnesium, potassium level. Drugs given for asthma, angina and Parkinsonism also lead to cramps. Cholesterol lowering drugs like statin also cause cramps on chronic use. 3. Several vitamin deficiency states may directly or indirectly lead to muscle cramps. These include deficiencies of thiamine (B1), pantothenic acid (B5), and pyridoxine (B6). Most cramps can be stopped if the muscle can be stretched. Gently massaging the muscle will often help it to relax, as will applying warmth from a heating pad or hot soak. A simple way to prevent night cramp is stretch muscle before going to bed 3-4 times and each time holding for 10-15 seconds. Quinine water tonic is also useful to prevent night cramps before going to bed. I hope this information will be helpful to prevent night cramps. If you have further query I shall be glad to answer. Take care Regards