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Avatar universal

Random Paresthesia which feels like nerve pain and Muscle Twitching

On 23rd June, I woke up with a pain in my right hand palm which felt different compared to all the pain I experienced before. It doesn't looked like some bone pain or pain after cramp. It felt like the pain was coming from inside the body and to be precise it felt like it was coming from Nerve itself. I woke up to investigate what was going on, but it vanished.

The next day, the same kind of pain again came on right palm, and then it radiated from right palm to mid-arm and came and went for few minutes. I ignored it, but the same week, I started developing higher intensity of same pain which on one day used to stay on left arm, radiating whole arm and next day changing place to next arm. It was not stationary nor there was any pattern for the pain. I had a bit stressful weekend as I work for tech industry so it usually involves lot of typing. So I assumed it was due to that. So the next week I de-stressed a bit, but the strange pain which was generally in arm. Now I could feel the same behind the head (occipital part) , neck and back as well.

I went to the doctor and they prescribed me a anti-inflammatory pain killer but nothing happened. The pain had one characteristic : If it was paining in one part, it didn't pained in any other part. So one body part at a time. The sensations were generally Pins and needle, Burning like fire & Electric shocks. I did a cervical X-Ray which turned out to be normal.

In July, the pain intensity decreased compared to June's but the area increased. Now, I could feel that same kind of come and go pain in chest and legs. That means my whole body was now paining. Then, I did tests like
ANA Titer, CPR, CBC, Vitamin B12, Typhoid, Vitamin D, Hepatitis, West Nile Virus, CMP, TSH, HIV etc. It generally took 7 days to get the result. Meanwhile, I finished ECG & Doppler; both came normal. So I was relieved that it wasn't heart related.

MRI of brain, spine, cervical was done and it was normal as well except few swelling in Cervical Spine which doctor said was minor. Then, I was referred to Neurologist who conducted NCV/NCS and it was perfectly normal.

Then the blood tests report came, The only two which stood out was
Vitamin D = 13.5 ( Range 32-100 )
Salmonella H b,d = Positive

I was stoked to see 3/5 Anti-gens in Typhoid test being positive. I had no viral symptoms like Fever, cold, chills, Cough, Vomit, Nausea. So, I did Widal Test again after few days and it came out Negative. Very confusing.

So, it's Mid-August and still my symptoms are persisting. I changed many doctors because some doctors are very quick to say this is anxiety but it is not. The pain and suffering is real and I am very positive thinker, I don't get anxious quickly. So this is for sure not anxiety or depression related.

I also noted, that my weight before this thing started was 145 pounds and now it is 139 pounds after 2-ish months. Also, the most pain I feel is when I wake up from sleep. One Neuro told me this is fibromyalgia. As per the Internet, Fibromyalgia is a debatable term. Nobody knows if it's real and it means end of diagnosis. So, I won't buy that.

So, my questions are:
1.) What do you guys think, all these symptoms are related to ? Is it due to Vitamin D deficiency or cervical swelling is the culprit?
2.) If someone is diagnosed with Fibro, can they please see if I fall under that category ? I am yet to see rheumatologist.
3.) Is this something serious going on ? Because I have constant Muscle twitching and pain that strikes every 2-3 hours and goes. Also, I am experiencing sleep issues as well. Couldn't sleep more than 3 hours =(

I am so confused, HELP
7 Responses
20841821 tn?1547946564
The good news is that you have had a very thorough work up. Did your doctor discuss trying some PT for your cervical pain? I am curious about your C Spine MRI. Did it mention soft tissue swelling or a disc bulge? You can try some simple home stretches that can be found on YouTube or other sites. Has your healthcare provider tried any medications like Lyrica to see if that provided you with relief? Sleep deprivation is going to exacerbate all of your symptoms. Seeing a rheumatologist sounds like the next logical step.
2 Comments
The Neuro just told swelling when he received report from Radiologist. I am yet to see him formally. Today is my scheduled appointment. So, I will go and ask him in depth about MRI Reports more importantly C-Spine MRI.

The doctor has not recommended me to any Physio-Therapist yet. But I will raise that today and also about Fibromyalgia detection from a Rheumatologist. My neuro's area of expertise is in Multiple Sclerosis (MS). I have heard Melatonin 2mg-5mg are good natural pills for sleeping. Not sure about that though.

The healthcare provider has not provided me Lyrica yet. But I am on Nexto LS (https://www.lybrate.com/medicine/nexito-ls-tablet), Anti-Acidity pill and 1 Anti-Depressent pill.

He must have thought this pain is related to anxiety. But it doesn't look like. The pain strikes just like any other pain during any activity I am doing no matter what I am thinking. So, it's not in my mind but a real pain

I am experiencing almost the same exact symptoms with no answers from the doctors. Please keep us updated of your progress.
1530171 tn?1448133193
You need to correct your vitamin D3 deficiency before you move on to any other investigations.
Adequate vitamin D3  will help reduce inflammation and pain.
Low vitamin D3  might also be related to your poor quality sleep.
There are many other potentially serious implications of vitamin D3 deficiency, since D3 has to do with hundreds of important functions and biochemical reactions in the body.
So please do not overlook the OBVIOUS.
You do not need to megadose. 5000 IU -1000 IU daily along with Vitamin K2 (very important as K2 is a "smart"  calcium transporter) is much safer and efficient than 100.000 IU some doctors prescribe.
Best wishes,
Niko
1 Comments
Thanks for your answer,
Sounds reasonable. I have an appointment with Neurologist today and I will show him my Vitamin D Blood Test results. I am planning to start One a Day Multivitamin. It says 700 IU Vitamin D on the label, and Vitamin K as 20 mcg. I have no idea if that will be enough. A separate pill for Vitamin D and K sounds like a better option as of now. What do you suggest ? Should I kick on with One a day Multivitamin and then continue it with Vit. D and K supplements as well ?
1530171 tn?1448133193
Personally I'm not a fan of multivitamins. I prefer getting  most of my nutrition from fresh and organic when possible foods (pastured meat, wild fish with low heavy metals etc.)
I would suggest you take D3 on its own with K2.
They are available separately or the 2 in one.
The minimum would be 2000 UI taken separately every day, but because you are very deficient
you should consider at least 5000UI daily. Take with food containing good quality fats.
Both these vitamins are fat soluble. Taking also supplemental vitamin A as well would help avoid any toxicity issues
In the event you have vitamin D resistance  (due toVDR gene polymorhism, obesity...) the upper dosage   range would apply, however if you have the opportunity to sunbathe  AND consume vitamin D rich foods, the 5000 IU should be sufficient.
I personally take Life Extension super K (not an endorsement) which is 2600 mcg every other day
, 1-2 hours of sun exposure daily (175 Lbs, M , live 7 months out of the year in "sunny" climates) and follow a very healthy Mediterranean nutrient dense diet.
As far as your meds go, I'd be cautious with the anti acid pills, specially if high acid levels have not been confirmed by testing.. If taken for symptom relief when acid levels are low, your ability to digest and absorb will be diminished, leading to numerous deficiencies, some of which don;t show up necessarily.
Are you taking Nexito for panic attacks or seizures and what med are you taking for depression?
When was this prescribed in relation to the Nexito and anti-acid meds?
Best wishes,
Niko
Niko
7 Comments
It takes a few months to get up your Vitamin D to the proper level, btw. There is no need to take D with food, so it is different than most vitamins. You can take it with or without food.

J Acad Nutr Diet. 2015 Feb;115(2):225-30. doi: 10.1016/j.jand.2014.09.014. Epub 2014 Nov 17.

"Dietary fat increases vitamin D-3 absorption."
I see that you are right, however it is still absorbed maybe 70% with a fat free meal. I also saw a study saying too much fat meal makes the D less absorbed, so that one said to eat a moderate meal.
Too much fat in the meal might make  the  vitamin D too soluble to function properly.
Moderation is  the best approach.
Adequate sun exposure can provide much of the vitamin D our bodies need without going through this
absorption process.

I have one last thought I would like to add. While I do not know the specifics of your situation, many people with chronic pain think rest will make them feel better. However, the opposite it true. Walking can safely bring oxygen to your muscles and decrease your pain and stiffness. If you can get in a good 20 to 30 minute walk during daytime hours that could substantially increase your feelings of well being. When you are exposed to the sun, without sunscreen, for roughly 10 minutes, you likely absorb about 10,000 units of natural vitamin D. However, keep in mind that this amount differs from person to person, depending on skin tone. Physical exercise will also improve your sleep. I agree with lightseeker regarding the supplements, but thought you might want add a daily walk. As always, I wish you all the best.
uomeasmile : That's correct. My pain although does not change it's intensity no matter what position I am in. But, walking a bit when it is paining excruciating helps for me. In my region, right now there is no sun. But, I try to walk atleast 6,000 steps a day and would continue the same once the sun is out in a month or two. My doctor gave me 60,000 IU Vitamin D3 with no Vitamin K supplement. He told me that take this Vitamin D3 once a week, and continue for 1 month and then do once a month.  
TheLightSeeker : I will let you know the new sets of medicine the neuro suggested. He thinks this is anxiety related, but I insisted him that it is not. It doesn't matter what I think when the pain comes. My pain strikes me the most when I am half-asleep, does that means I am anxious at that time. I think, he didn't understood the situation correctly.

That rises one more question; I also suffer for Muscle Twitching for no reason and I am not suffering from Anxiety when I get twitches at random position for 5-10 minutes which are noticeable on my body. As per google, They give the reason of Twitching as anxiety and stress. But even when I am not anxious / stressed and even relaxed I get those twitches. So why is that happening? Does that mean I am dehydrated or Electrolyte imbalance ? I did a Urine test yesterday, and it came out Normal.
Avatar universal
TheLightSeeker : I will let you know the new sets of medicine the neuro suggested. He thinks this is anxiety related, but I insisted him that it is not. It doesn't matter what I think when the pain comes. My pain strikes me the most when I am half-asleep, does that means I am anxious at that time. I think, he didn't understood the situation correctly.

That rises one more question; I also suffer for Muscle Twitching for no reason and I am not suffering from Anxiety when I get twitches at random position for 5-10 minutes which are noticeable on my body. As per google, They give the reason of Twitching as anxiety and stress. But even when I am not anxious / stressed and even relaxed I get those twitches. So why is that happening? Does that mean I am dehydrated or Electrolyte imbalance ? I did a Urine test yesterday, and it came out Normal.
1530171 tn?1448133193
You need an RBC electrolyte test. You might be low in magnesium and perhaps others.
Consider drinking ample spring and mineral water.
Please tell me about your meds I asked before.
In  regards to acid blockers you also run a risk of low B12, thus my recommendation for an MMA test for B12 Methylocobalamin.
The physical effects of stress and anxiety  are not necessarily immediate.
Depletion of vitamins and  minerals along with prolonged  need of stress hormones, may eventually cause numerous symptoms and lead to complications.
2 Comments
My doctor prescribed me new sets of medicine

1.) Cyclobenzaprine 15mg
2.) Calcium Citrate, Magnesium, Zinc and Vitamin D3 in one tablet
3.) Rapisone-D SR (https://www.lybrate.com/medicine/rapisone-d-sr-capsule)
Your doctor has prescribed 2 drugs from the same class - muscle relaxants.
Cyclobenzaprine is a muscle relaxant and Rapisone-D SR is a combo of muscle relaxant and antiinflammatory NSAID drug.
I'm surprised at this perhaps aggressive approach.
Personally, I see a starting dose of Rapisone-D SR ONLY, being more reasonable, while waiting for vitamin D levels to rise.
The Calcium Citrate is questionable, when your current calcium is NOT metabolized properly due to your low vitamin D.  Additional unmetabolized calcium would make matters worse  to my opinion.
Also the Calcium/Magnesium ratio will still be out of balance.

Even if I don't have all the information your doctor has,  without vitamin K2 your biggest risk is that
Calcium gets deposited in the soft tissues, causing havoc, while your bones, joints and teeth may still be deprived of it!
Magnesium is very difficult to absorb and the more supplemental D you take the more magnesium you need. It is common that people who take large doses of D3 and recommended doses of magnesium, suffer from BOTH, vitamin D and magnesium deficiencies.
One of the best oral forms is Magnesium Theonate.
I personally use Magnesium Chloride Transdermally (Transdermal Magnesium Oil)

If all the aforementioned observations are considered, the prescribed drugs and supplements may fall short in delivering notable and sustained improvement.

Just my educated opinion.

Best wishes,
Niko.
Avatar universal
UPDATE:

I have saw many threads where people post a question with symptoms many others are facing and they never provide any Update. Here I am back with an update after 40-ish of posting this.

The random pain in different body parts has been subsided. It pains like 2-3 times a week now or sometimes no pain, mostly concentrated in one left thigh and left palm along with fingers that too when I am super stressed out or typed a lot of stuff. It doesn't now stop me from doing my daily work and I feel living my life again finally!

For Vitamin-D , I go outside and walk daily about 30 minutes in full sunlight, also get sweat out. It's good that in the state I live, sunshine would be there up to November. So, I am fully focusing on taking natural vitamin-D dosage. I will do a blood test for Vitamin-D again after 4 months because it is very costly.

Regarding Twitching, unfortunately they are still there. Some days it gets wild, like twitches whole day, thumps, happens ALL over the body. Some days it is soft or no twitches. But yeah, it hasn't stopped yet. I am not feeling any weakness for now.
1530171 tn?1448133193
The twitching is likely largely due to  low  vitamin D and  low magnesium levels.
As the levels of these increase, the twitching should  subside.
If you drink sodas, coffee, if you consume a lot of carbs, if you have anxiety, you definitely need extra magnesium. Please refer to one of my previous posts for best types, as oral supplemental Mg  absorption  is  rather poor.
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