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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Muscle Twitching, Fatigue And Weakness

Hello Doctor, I am a fairly healthy 36 year old woman. I take pantoprazole 40mg once a day for issues with gastritis (which has since resolved) and acid reflux. I also take 2.5mg of pisoprolol 2.5mg once a day for inappropriate sinus node tachycardia (benign condition). Last year, I had pain in my left hip and right shoulder. We don t have a car, so I do a LOT of walking and tend to carry bags on my right shoulder. After x-rays and MRI s, it was found that I have tendinosis (tendinopathy) of the left hip. No imaging was done for the right shoulder. It was also found that my t4-t5 vertebrae were fused together since birth. My father has ankylosing spondylitis, but I tested negative and all my other back and x-rays and MRI of neck and spine were clean. My right shoulder pain never really went away, but my primary doctor made it seem that I had overworked it by carrying heavy bags and that it would take a long time to resolve heal. I still have the pain and recently started having muscle weakness in my upper arm and forearm and fatigue (especially after carrying bags, writing or stirring). Sometimes my arm shakes after carrying something heavy. Holding my phone in front of me sometimes fatigues my arms as well. I also have tenderness on the side of both hips. A couple of months ago I started having issues with my left shoulder as well. Similar to my right, but to a lesser degree. I was also having tender pressure points in my deltoid muscles and felt constantly stiff and in pain. I started developing jaw pain and my jaw started popping. I went to my primary, who prescribed muscle relaxants for the evening and xanax .25mg as needed during the day to relax. I was also told to take 1000mg of Tylenol for the pain. The deltoid pain went away, but the jaw pain comes and goes. I was sent to a rheumatologist who did a bunch of bloodwork, which all came back normal. He made me do some stretches, and he said that I have hypermobility joint syndrome. He didn t really elaborate too much on what that was. I asked him about Fibromyalgia (I have a friend who has it and some of the symptoms seem to fit), he said I could but he is not one of those doctors who doesn t really believes in Fibro. Because of the muscle weakness, he said we might as well just try and do an EMG. He wrote on the EMG ( Myopathy? ) My EMG isn t for another month. What has me really concerned is the fact that I also have muscle twitching in my hands, arms and legs (which I told him about and he said was normal). Bilateral pain, muscle weakness/fatigue and muscle twitches all over....I am terrified that it might be ALS. I wanted to think it might be Fibro, (since I have TMJ/TMD issues as well), but the muscle twitches have really started to scare me. Does Hypermobility Joint Syndrome fit what I am experiencing? Any insight you could provide would be greatly appreciated.
Thu, 7 Jan 2021
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Physical Therapist or Physiotherapist 's  Response
Hi,

Twitching is very common in weak and atrophic muscles. You already mentioned weakness in muscles hence please don't freak out over twitches. The weakness most probably sounds to be resulting from the underlying shoulder pathology which I suppose should be scanned for tendinopathy similar to your hip. Fibromyalgia might also coexist, but the weakness of your arm doesn't sound to be related to it.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Sonia Dhawan, Physical Therapist or Physiotherapist
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Suggest Treatment For Muscle Twitching, Fatigue And Weakness

Hi, Twitching is very common in weak and atrophic muscles. You already mentioned weakness in muscles hence please don t freak out over twitches. The weakness most probably sounds to be resulting from the underlying shoulder pathology which I suppose should be scanned for tendinopathy similar to your hip. Fibromyalgia might also coexist, but the weakness of your arm doesn t sound to be related to it. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Sonia Dhawan, Physical Therapist or Physiotherapist