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Neurology (Expert Forum)
ALS genetically in the family, concerned about pain
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ALS genetically in the family, concerned about pain
by laurajh, Sep 01, 2005 12:00AM
I'm worried about my father in law. His family history is known to have ALS (3 generations affected), and I've been worried about leg problems my FIL has been having. In Feb/05 he started having what he describes as sciatic pain, throbbing pain in the back of his calf going up the back of his thigh (even though doctors haven't used the word "sciatica.") He had physical therapy (no help), electrical stimulation (no help), MRI & some kind of nerve testing (doesn't know what the test was called but whatever it was made his leg jump involuntarily). They never found a cause. MRI showed some scar tissue, but they didn't seem to have much opinion about that (isn't "sclerosis" scarring??) They ended up giving him 3 epidural shots in the spine, and it worked wonders, giving him 4 months of relief. But now, the same pain has returned. He can't sit in a chair for long and has to get up and move around which helps. He has no other symptoms other than pain, which I know doesn't suggest ALS but the family history worries me nontheless. Could ALS be possible even though there are no "typical" symptoms or changes within 6 months time? He's 75 years old and active. He didn't do anything to injure himself. And he's already used up his limit of 3 epidurals so the only thing he knows will help he can't have done again. I've also been reading that there are findings inflammation can be a contributor to ALS. If the spinal epidurals eased the pain obviously steroids reduce inflammation. If it wore off the inflammation must be back. Is this reason for concern? Could a chiropracter be of help?
Doctor's Answer
by CCF-Neuro-M.D.-PW, Sep 06, 2005 12:00AM
Despite his family history of ALS, other causes of those symptoms in old age are much more common, like osteoarthitis, pinched nerve roots, muscle pain etc. To be fit at 75 years does not suggest ALS. Pain as a sole presentation in ALS is highly unusual, although muscle cramps can occur. Inflammationa and ALS is a purely hypothetical theory at the moment - the pain being steroid responsive does not give any further indication that ALS is present. Steroids are probably more likely to be respponsive in the inflammation caused by arthritis. Chiropracty should be used with caution, as bony manipulation can be complicated by arterial tears and if potential joint instability is present
Good luck
Good luck
He's also had leg and foot surgeries for reasons such as improving poor circulation and to release tendons.
I am wondering if Neuromyelitis Optica is a condition related to ALS or could be mis-diagnosed ALS if similar?
I am 35 and hoping to start family with wife (also 35) but having second thoughts, if ALS in family not sure I want to burden a child with that knowlingly.
Can someone put this into some sort of perspective for me?