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Neurology (Expert Forum)
Arm spasm/spasticity?
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Arm spasm/spasticity?
by Kylie__0__0, Dec 25, 1998 12:00AM
I have a recurring problem with pain, stiffness and heaviness in the left arm (have been diagnosed 6 months, with most problems on left side, particularly sensory). The pain is deep, to the bone and sharp at times, mostly present during the day, but starting this time to hit more at night. It tends to fluctuate in and out, in about a 3-4 week cycle, and becomes almost unbearable at its worst. I have also had occasions of similar pain in the legs, but of shorter duration and less severity.
My neuro tried me out on zanaflex (ramped up to 6mg/day), but I found it made me very groggy and left me with poor balance, with little amelioration of the pain, so I chose to stop taking it. I have also been diagnosed with thoracic outlet syndrome in the left arm (positive occlusion of arteries on testing), but no-one seems to be able to differentiate what is causing what.
I have 2 questions. The first is, does this sound like spasticity?
And do you have any further recommendations for medications, preferably ones which will allow me to keep working without falling asleep or falling down. I have an appointment shortly with my neurologist and like to go into our sessions with good information and questions to ask of him.
Many thanks.
Dear Kylie:
Without examining you, I can't tell if you have spasticity. Since you are writing under MS, I assume that is what you are describing. Usually, pain is not the major issue with spasticity, although as it gets really bad, there is pain involved. It sounds like the pain part is the major problem. One medication to think about is neurontin. It has few side effects, and if started slowly the sleepy part is very reduced and likely would not be a problem. The anti-spasmodic medications are often given with good success for the spasticity part of MS. Usually, the dosing has to be gradually increased to avoid the side effect such as you described. Good luck and let us know if we can help, I'm not sure I helped much.
Sincerely,
CCF Neuro[P] MD
