Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Muscle Pain, Tingling Sensation In Legs And Soreness In Calfs?
Question: good morning - I have had a condition with both legs for approx 8 years - the condition I have is - aching muscles. tingling, burn sensation in both legs- they ache - muscles are sore to touch - calfs and thighs - are tired after walking a short distance - and feet soles are spongy feeling - have had many many blood test - nothing specific has been found - when I waken up is probably the worst time - told i do not have RLS or RA...my rheumatologist just put me on GABBAPENTIN and the day after I took the drug my legs the following day were 95% back to normal - after apron 10 dasds on the drug my legs are now hurting again - I take many drug as I had open bypass 2 years ago....and all is well from that surgery - take Tranadol for the pain or discomfort bur does not take all the pain away - just want o get your opinion on what may be going on - X-rays show a little arthritis in both knee but really not all that bad - it is primarily the muscle in both legs... opps I have also have my lower lumbar mRI done - nothing was found...to be honest I am so frustrated
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I understand your concern, especially considering the imaginable frustration of seeing so many different specialists.
Now considering the components of the lower limbs there are grossly 4 systems which can produce symptoms, the peripheral nerves, the muscles (nerves and muscles often related), joints, or blood vessel issues. Now I will go ahead and exclude joint issues since you say they have been excluded. Blood vessel issues usually have signs such as swelling, local temperature changes, peripheral pulse changes, so since they would also evolve more over 8 years perhaps they can be dismissed.
That leaves us with an involvement of either the nerves or the muscles. You do have a predisposing factor for peripheral nerve damage such as diabetes. Also the good response to Gabapentin indicates a possible nerve involvement. Nerve damage can be really frustrating as depending on the nerves involved may be hard to evidence on tests. Now I understand that neurologist says to have excluded nerve damage but you do not mention to have had any tests about that. I believe that a nerve conduction studies is necessary, where electrodes on the skin evaluate nerve conduction. Over the same exam also the muscles are tested through electromyography (EMG), where needles are inserted in the muscles to record their activity. So I believe nerve conduction studies and EMG are really necessary to evaluate your condition.
Also some tests about muscle damage such as creatine kinase, aldolase, LDH as well as a full metabolic panel including calcium, magnesium, potassium is necessary. Thyroid function is a necessary test as well. Perhaps you may already have had these tests as you say to have had blood tests, but as blood tests can be inumerable, for different conditions, I want to make sure you have already done these as some common causes of muscle damage.
The medication you take should also be carefully considered as some medications (such as statins for example) can cause muscle damage.
In the meanwhile since Gabapentin has had effect, even if symptoms are reappearing the dosage can be augmented gradually. You do not mention how much you take, common dosage is 900-1200 mg, but can be brought to 1800 (on paper even higher).
I remain at your disposal for further questions
Read below.
Detailed Answer:
I read your question carefully and I understand your concern, especially considering the imaginable frustration of seeing so many different specialists.
Now considering the components of the lower limbs there are grossly 4 systems which can produce symptoms, the peripheral nerves, the muscles (nerves and muscles often related), joints, or blood vessel issues. Now I will go ahead and exclude joint issues since you say they have been excluded. Blood vessel issues usually have signs such as swelling, local temperature changes, peripheral pulse changes, so since they would also evolve more over 8 years perhaps they can be dismissed.
That leaves us with an involvement of either the nerves or the muscles. You do have a predisposing factor for peripheral nerve damage such as diabetes. Also the good response to Gabapentin indicates a possible nerve involvement. Nerve damage can be really frustrating as depending on the nerves involved may be hard to evidence on tests. Now I understand that neurologist says to have excluded nerve damage but you do not mention to have had any tests about that. I believe that a nerve conduction studies is necessary, where electrodes on the skin evaluate nerve conduction. Over the same exam also the muscles are tested through electromyography (EMG), where needles are inserted in the muscles to record their activity. So I believe nerve conduction studies and EMG are really necessary to evaluate your condition.
Also some tests about muscle damage such as creatine kinase, aldolase, LDH as well as a full metabolic panel including calcium, magnesium, potassium is necessary. Thyroid function is a necessary test as well. Perhaps you may already have had these tests as you say to have had blood tests, but as blood tests can be inumerable, for different conditions, I want to make sure you have already done these as some common causes of muscle damage.
The medication you take should also be carefully considered as some medications (such as statins for example) can cause muscle damage.
In the meanwhile since Gabapentin has had effect, even if symptoms are reappearing the dosage can be augmented gradually. You do not mention how much you take, common dosage is 900-1200 mg, but can be brought to 1800 (on paper even higher).
I remain at your disposal for further questions
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
