Spasms and weakness

I've had weakness in my left leg for about a year. It doesn't limit me too much, mainly I notice when I'm climbing stairs I have to consciously lift the left leg, and then it's somewhat painful. However last week I had several days of sharp jolts of pain in my back left side in the ribs area, and wondered if they are related (both on the left side). I've been able to calm these back pains somewhat (reducing pain level from 8 to 4) with Tramadol, however I'm worried something serious is going on. My dad died of ALS at the age of 56. I'm 57.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

ALS is typically associated with something called fasciculations, which may be called muscle twitches. This syndrome occurs in the setting of associated symptoms such as progressive loss of sensation, tingling or numbness, weakness, trouble swallowing and other symptoms; the cause may be due to a peripheral nervous system problem or a more central problem. A very detailed neurological examination is needed to diagnose.

Is the weakness of your foot a “foot drop”? If so, the problem could be due to a lesion at a nerve called the peroneal nerve or at the level of the back in the lower lumbar region (which would be much lower than the ribs).

The rib pain may not be related to the foot pain. I would be concerned for muscle strain or even kidney infection if you have severe pain around the rib area.

I would suggest you follow up with your primary physician for diagnosis and management.  

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck!