I've been having this very strong tingling and throbbing sensation in my feet for almost a month and a half now. This has also been accompanied by muscle spasms and a single big twitch that jumps all over my body. This morning I woke up to a constant twitch in my left pinky finger and palm. I'm also feeling this "pulling/stretching" pain behind my knees and in my left tricep muscle. I suffer from anxiety and panic disorder so worrying about this has been causing me non-stop panic attacks. I am just wondering if this is a sign of worse things to come such as Parkinsons or something of the sort or if this could be just damaged nerves in my back. Any feedback is greatly appreciated. Thank you.
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.
It must be emphasized that most of the cases of muscle twitches are benign meaning that they are of no consequence and are not resulting from a serious cause. In such cases, the twitches may be related to anxiety/stress, caffeine, and often occur after recent strenuous activity or muscle over-use. It is important in such cases to reduce stress/anxiety levels and to reduce caffeine intake. Tremors of the hands can be physiological that is exacerbated by stress/anxiety and caffeine.
Benign fasciculation syndrome (BFS) is a condition in which there are involuntary twitches of various muscle groups, most commonly the legs but also the face, arms, eyes, and tongue. If the diagnosis is confirmed and other causes are excluded, it can be safely said that the likelihood of progression or occurrence of a serious neurologic condition is low.
When BFS is present but not particularly bothersome or disabling, treatment is not necessary. If severe and it requires treatment, there are a few medication options though this condition is not very common, and the research that has been done on its treatment is limited. Minimizing caffeine and stress, and treating anxiety if it is present, will improve your symptoms.
However in general (and please understand I am not trying to imply I feel this is the case in you), when fasciculations occur 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. In general the symptoms would not be episodic and triggered by certain things but would be more constant/frequent without consistent triggers. The location of the problem could be the anterior horn cells, the area where the nerves that supply motor innervation to our body comes from. These are the cells that give off the nerves that allow us to voluntarily contract our muscles. The diseases that might affect the anterior horn cells include ALS (also called Lou Gherig's disease), a condition called spinal muscular atrophy, polio-like viruses, west nile virus, and other infections.
Another nervous system problem, neuropathy, may also lead to fasciculations. There will again be associated weakness or sensory changes. These diagnoses include but are not limited to most commonly diabetes, vitamin deficiencies, autoimmune disorders such as lupus or a disease called Sjogren's, certain types of neoplasm, and certain toxins (such as lead), genetic, metabolic, and hereditary disorders.
Since the symptoms are migratory (or in different areas), seizures, migraine disorder or metabolic problems such as low calcium should be considered.
Often these symptoms may reflect emotional/psychiatric problems related to stress (what is called somatization disorder). The latter is a true medical condition whereby instead of a patient experiencing depression or anxiety, they experience physical symptoms, and once the stress is addressed, the symptoms resolve.
I suggest follow up with your primary doctor and you may benefit from evaluation by a neurologist as your primary doctor feels fit. As you can see, there are many differentials for muscle twitches.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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