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Severe leg cramps, pain in both legs with weakness, numbness, tingling and muscle twitches. On Vyvance, Cymbalta. What to do ?

Hello I am a 30yr old female who has been having problems with my legs. I have severe leg cramps and pain in both legs with weakness, numbness, tingling and muscle twitches that are getting worse. I also have electrical type feeling impulses that pulsate or radiate in both. If you tap on my reflex area under the patella when my legs are flat eg. while sitting in beg with legs out infront of me they have an over reaction where they do not only jerk like they should but also twitch. The best way to describe it would be in to comparison of a fish out of water that also has parkisons disease. I had an increased ESR but no other lab finding but I was also sick when they did the labs so maybe that s what caused the ESR. I was also diagnosed with fibromyalgia recently.I have had a pelvic MRI, a bone scan, and EMG . EMG findings showed increased insertional activity and positive fibrulation potentials. I have mild to moderate arthritis in the S1 and L5 spinal facets. I also have an inlarged lynphnode on the right side of my neck, not by the clavicular line but more twords my thyroid. I also wake up at night soaked in sweat and have to change everything I m wearing because its so bad. I m a nursing student and my legs cause me so much pain its getting hard to be able to do ADL s as usual. I m at a loss. It seems all of my doctors are unsure and just pass me back and forth. Any advice would be greatly appreciated. I currently take: 70mg Vyvance 60mg cymbalts 75mg Lyrica 3x a day Ortho Evra patch and Zanaflex 4mg at night
Asked On : Fri, 22 Feb 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Jul 2013
Hi, thanks for writing to HCM.

All your symptoms of pain in both legs, weakness, numbness with tingling typically points to a Lumbar disc disease with radiculopathy.

An MRI scan of the lumbar spine is needed to establish the diagnosis.

The conservative management of the condition is as follows -

* avoid lifting heavy weights as it imparts more strain on your back
* avoid forward bending activities as it will worsen the disc protrusion
* Use a lumbosacral back support to augment your spinal muscles
* Intermittent pelvic traction to cause a regression of disc
* Maintain optimum body weight,if you are obese
* Physiotherapy to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided.
* Judicious use of analgesics and muscle relaxants

If your symptoms are not improving with the above measures, you may need a surgical decompression.

Hope this information is helpful. Good day
Answered: Thu, 29 Aug 2013
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