Unexplained Neuro-muscular Symptoms

Hello- I am a 29 year old female. I had my second baby thirteen weeks ago. Three days after delivery I started having twitching in my calf muscles and feelings like the muscle wants to cramp. It was uncomfortable, but didn't stop me from doing daily activities. Progressively it started to worsen- now I'm at the point that I can not stand, walk, or move my calf muscles without pain. These are my symptoms: twitching in calf muslces and feet, cramp like feelings in calf and feet, stabbing  and pinching pain when trying to walk, extreme muscle stiffness (my muslces are so stiff behind my knees that it takes me a very long time to try and get out of bed in the morining), sometimes the twictching feeels like I'm being shocked, muscle is sore to the touch, random tingling, and some uncontroled muscle movement in the calf and feet. I have been to see a neurologist and they said there is no clinical explination for my symptoms (EMG came back normal). I have had a million blood tests (potassium, magnesium, calcium, etc) and all have come back normal. Every morning I wake up and it is worse. I have to use a wheelchair at work to get to meetings (the building I work in is very large). I can't cook, clean, or take care of my baby or 3 year old. Someone has to always be with us to help.

What is wrong with me? The symptoms all seem Neurological, but the EMG was normal. Where do I go next to try and get help? I don't have a primarycare provider (she moved) and there is a waiting list to get in to see the doctor where I live.

Any help that can be offered would be greatly appreciated. I am very scared. Thank you!

[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.

The pain in the calf is concerning. Have you had an ultrasound of that calf to ensure you do not have a blood clot? I would encourage you to do so.

It is good that you have had an EMG. In the majority of cases 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 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 this condition 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.

Again, I would encourage you to have your calf evaluated for a blood clot and to have it further evaluated by a primary care physician.

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