Knee pain and muscle twitching

[Flynn77]

Quick question relating to twitching and stiffness in the knee joints, and ankles. I am 40 years old and have been experiencing muscle twitches all over my body for about 3+ months. They are all over (15-20 or so a day), but most common in my eyelids, right chest, biceps, jaw and upper abdomen. Most of them are fluttering twitches and are really rapid. Also, and even more distessingly, I've recently developed deep recurrent stiffness of the knees - specifically, under the kneecap, on inner side of the knee and in the back of the knee. Sometimes it feels as though my right knee is going to give out from beneath me. It will stiffen up in the back and momentarily buckle. (I also notice a far milder but similar sensation in my ankes as in my knees.) It tends to vary in severity, but is worse when I sit for long periods and when squatting, kneeling, and running up stairs. I may experience stiffness in one knee and not the other for a couple of hours to an entire day and then vice versa. I tore my right MCL about 20 years ago, and somehow wrenched my left knee six months ago, which resolved itself 2-3 weeks later. All these new pains seem to have occured out of the blue. So my question is: How likely is this type of knee pain a neurological problem rather than an arthritic type problem (especially when combined with symptoms of twitching)? Could the old knee injuries have anything to do with this? Or does this sound like a form of arthritis, and would any such condition affect both knees at the same time? Thank you for your time and effort.

[Kevin Pho, MD]

It is difficult to give a definitive answer without examination.  Both neurological disease or arthritis are possible.  

There are various neurological diseases that can result in muscle twitching.  This can include:
    
* Chronic denervation of muscle due to disc compression of nerve exiting the spinal cord
* ALS (Lou Gehrig's disease)
* Spinal muscular atrophy
* Muscular dystrophy
* Myopathy

I would consider a few tests to further evaluate the neurological causes.  This would include an MRI as well as electrodiagnostic testing.  Blood tests look evaluate the muscle enzymes for various forms of myopathy can also be considered.

If the neurological workup is non-revealing, you can consider an orthopedic referral to evaluate whether there is an arthritic component.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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