What causes pain and weakness in the limbs and shoulder pain?

default
Posted on Mon, 6 Mar 2017 in Brain and Spine
Question: Hi doctor

Iam 37 years old, I am suffering from below symptoms

 

1. Hands and legs pain and weakness.

2. Burning pain in fingers and toes

3. Numbness in hands and legs

4. Inbalance while walking. Feel of falling while walking and when rapid eye movement

5. Neck pain which comes and goes.

6. Shoulder pain which comes and goes.

7. Feeling sleepy, dizzy and weakness

8. Sleepy eyes

 

I have consulted Neurologist and undergone below tests.

1. Vitamin B-12

2. TSH

3. Vitamin D

4. Nerve condunction study for both upper limbs and lower limbs which came normal

5. Brain and Spine MRI scan

 

 

I have attached the reports. Please look and reports and suggest the possible cause of the symptoms. Are these due to vitamin deficiecy ?

Report for Cervical spine says mild loss of hydration at all levels and there are subtle disc bulges at all levels. Is this something to be concerned.

 
doctor
Answered by Dr. Ajay Panwar 1 hour later
Brief Answer:
Vitamin D deficiency can explain pain.

Detailed Answer:
Hi XXXXXXX chowdary,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist, here to answer your query.

I have gone through your reports. Vitamin D levels are very low, almost closing to severe deficiency. Vitamin D supplementation can help improve your pains.


Burning pain and numbness in extremities, may be indicative of neuropathy. Nerve conduction studies may come out to be normal in small fibre neuropathy.

Further, Blood sugar and inflammatory markers should be done like ESR(Erythrocyte sedimentation rate) and CRP(C reactive protein).

Hope that helps.If you have some further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ajay Panwar 15 minutes later
Thank you doctor for the reply.

You mentioned the burning pain and numbness may be indicative of neuropathy. What are the tests to be performed to confirm the neuropathy. What is the treatment for neuropathy. Do we have permanent cure for this ?

Tested the blood sugar fasting and post fasting which came out to normal.

Did you get chance to go over the spine MRI report. My main concern is about the Cervical Spine MRI report which says -
"Mild loss of hydration at all levels and there are subtle disc bulges at all levels." Is this causing the issue ? Will this dehydration and disc bulge progress and cause further complications ?

Please advice.

Thanks,
XXXX

doctor
Answered by Dr. Ajay Panwar 16 hours later
Brief Answer:
No.MRI changes should not cause these issues.

Detailed Answer:
Hi XXXXXXX chowdary,
Thanks for being in follow-up with details.

I have gone through your MRI Spine report. Spine changes are subtle with mild disc bulges.These are unlikely to cause these symptoms.

Neuropathy can be established with clinical examination and Nerve conduction studies (NCS).Sometimes, in early stage, NCS may come out to be normal.

Treatment of neuropathy include antineuralgic medicines(pregabalin, amitriptyline, duloxetine) along with methylcobalamin. Along with the treatment also depends on the cause of neuropathy. The cause should be detected and corrected.

Hope that helps.If you have any further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ajay Panwar 1 hour later
Thank you doctor for the details.

Are the dizziness and sleepy eyes also caused by neuropathy ?

Also as there are mild disc bulges, Will these cause any issues in the feature ? Is there any treatment to reverse these bulges ? Are these bulges progressive? I mean will it bulge more and cause further problems. What are the precautions to be taken to control the bulges.

Thanks in advance.


Thanks,
XXXX

doctor
Answered by Dr. Ajay Panwar 4 hours later
Brief Answer:
Spinal exercises should keep you fit.

Detailed Answer:
Hi XXXXXXX chowdary,
Thanks for being in follow-up.

Neuropathy usually don't cause dizziness and sleepy eyes.

Further, Mild disc bulges are common and may be seen in many middle aged persons.They are not a cause of major concern.However, they are indicative of getting cautious for future.Spinal exercises should be done on a regular basis forever, to keep spine healthy so that these disc bulges don't progress.These are usually not reversible. They can be progress, if one does not take adequate physical measures like spinal exercises.

Precautions- Regular spinal exercises, Sleeping on flat surface, Sitting straight as far as possible and reduce forward bending posture.
You can consult a good physiotherapist.He can tell you spinal exercises and posture training as well,along with other precautions.

Hope that helps.If you have some further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Ajay Panwar 19 hours later
Thanks a lot doctor for taking time and explaining in detail.

I have visited neurologist today for clinical examination. He has gone through the reports and did some clinical examinations like romberg which is positive. He told that the symptoms could be due to vitamin deficiency and prescribed below medicines
1. Felicita OD 1 each day
2. D-Rise sachets 1 every week
3. Prothiaden 25 mg 1 every night for 1 week and 2 after 1 week if no relief in the symptoms.

Asked to get back after 1 month. Hope I am on the right track. Thank you

Regards,
XXXX
doctor
Answered by Dr. Ajay Panwar 2 hours later
Brief Answer:
Yes. Its the right approach.

Detailed Answer:
Hi XXXXXXX chowdary,
Thanks for being in follow-up.

Romberg's positive suggests that it may be neuropathy. The treatment plan as suggested by your neurologist is optimal. You can continue according to the same.

I hope to see you improve.If you have no further questions for now,please close the thread and write a review.

I shall be glad to have you in follow-up if you have any query in future.

Hope that helps.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Ajay Panwar

Neurologist

Practicing since :2007

Answered : 1794 Questions

premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions
Drug/Medication
Lab Tests ,   ,  
Medical Topics

Recent questions on  Neck pain

doctor1 MD

Dr, I have been suffering from Neck pain and pain in the elbow for last 2 years. The neck pain stated about 4 years back on the right side. after...

doctor1 MD

Sir I am 23 years old (male). I have a regular pian in my neck, back, and a stomache pain. back pain and neck pain is severe and unbearable that i...

doctor1 MD

Hi i am suffering from neck pain & it goes toward left & right.sometime pain is very much sharp that i can t sit fine.My xray & mri is ok but my...

doctor1 MD

I m diagnosed with various allergies n for controlling my cough, I had to take prednisone which showed all the side effects in my body. Totally...

doctor1 MD

Regarding XXXX Profile: I have attached the Thyriod report of XXXX. Please have a look and advice us. I had a discussion with general doctor and...

doctor1 MD

Hi I suffer from health anxiety and it's ruining my life. Ive recently had heart test echo, Monitor for 3 days and treadmill test. If I had a...

doctor1 MD

I had PMR and was on Methylprednisolone from May 2, 2016 to my last 1/2 MG April 5th, 2017. I had rotator cuff surgery on my right shoulder XXXXXXX...

Get personalised answers from verified doctor in minutes across 80+ specialties

156 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
backtotop2