
What Causes Pain And Weakness In The Limbs And Shoulder Pain?

Iam 37 years old, I am suffering from below symptoms
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1. Hands and legs pain and weakness.
2. Burning pain in fingers and toes
3. Numbness in hands and legs
4. Inbalance while walking. Feel of falling while walking and when rapid eye movement
5. Neck pain which comes and goes.
6. Shoulder pain which comes and goes.
7. Feeling sleepy, dizzy and weakness
8. Sleepy eyes
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I have consulted Neurologist and undergone below tests.
1. Vitamin B-12
2. TSH
3. Vitamin D
4. Nerve condunction study for both upper limbs and lower limbs which came normal
5. Brain and Spine MRI scan
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I have attached the reports. Please look and reports and suggest the possible cause of the symptoms. Are these due to vitamin deficiecy ?
Report for Cervical spine says mild loss of hydration at all levels and there are subtle disc bulges at all levels. Is this something to be concerned.
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Vitamin D deficiency can explain pain.
Detailed Answer:
Hi XXXXXXX chowdary,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist, here to answer your query.
I have gone through your reports. Vitamin D levels are very low, almost closing to severe deficiency. Vitamin D supplementation can help improve your pains.
Burning pain and numbness in extremities, may be indicative of neuropathy. Nerve conduction studies may come out to be normal in small fibre neuropathy.
Further, Blood sugar and inflammatory markers should be done like ESR(Erythrocyte sedimentation rate) and CRP(C reactive protein).
Hope that helps.If you have some further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)


You mentioned the burning pain and numbness may be indicative of neuropathy. What are the tests to be performed to confirm the neuropathy. What is the treatment for neuropathy. Do we have permanent cure for this ?
Tested the blood sugar fasting and post fasting which came out to normal.
Did you get chance to go over the spine MRI report. My main concern is about the Cervical Spine MRI report which says -
"Mild loss of hydration at all levels and there are subtle disc bulges at all levels." Is this causing the issue ? Will this dehydration and disc bulge progress and cause further complications ?
Please advice.
Thanks,
XXXX
No.MRI changes should not cause these issues.
Detailed Answer:
Hi XXXXXXX chowdary,
Thanks for being in follow-up with details.
I have gone through your MRI Spine report. Spine changes are subtle with mild disc bulges.These are unlikely to cause these symptoms.
Neuropathy can be established with clinical examination and Nerve conduction studies (NCS).Sometimes, in early stage, NCS may come out to be normal.
Treatment of neuropathy include antineuralgic medicines(pregabalin, amitriptyline, duloxetine) along with methylcobalamin. Along with the treatment also depends on the cause of neuropathy. The cause should be detected and corrected.
Hope that helps.If you have any further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)


Are the dizziness and sleepy eyes also caused by neuropathy ?
Also as there are mild disc bulges, Will these cause any issues in the feature ? Is there any treatment to reverse these bulges ? Are these bulges progressive? I mean will it bulge more and cause further problems. What are the precautions to be taken to control the bulges.
Thanks in advance.
Thanks,
XXXX
Spinal exercises should keep you fit.
Detailed Answer:
Hi XXXXXXX chowdary,
Thanks for being in follow-up.
Neuropathy usually don't cause dizziness and sleepy eyes.
Further, Mild disc bulges are common and may be seen in many middle aged persons.They are not a cause of major concern.However, they are indicative of getting cautious for future.Spinal exercises should be done on a regular basis forever, to keep spine healthy so that these disc bulges don't progress.These are usually not reversible. They can be progress, if one does not take adequate physical measures like spinal exercises.
Precautions- Regular spinal exercises, Sleeping on flat surface, Sitting straight as far as possible and reduce forward bending posture.
You can consult a good physiotherapist.He can tell you spinal exercises and posture training as well,along with other precautions.
Hope that helps.If you have some further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)


I have visited neurologist today for clinical examination. He has gone through the reports and did some clinical examinations like romberg which is positive. He told that the symptoms could be due to vitamin deficiency and prescribed below medicines
1. Felicita OD 1 each day
2. D-Rise sachets 1 every week
3. Prothiaden 25 mg 1 every night for 1 week and 2 after 1 week if no relief in the symptoms.
Asked to get back after 1 month. Hope I am on the right track. Thank you
Regards,
XXXX
Yes. Its the right approach.
Detailed Answer:
Hi XXXXXXX chowdary,
Thanks for being in follow-up.
Romberg's positive suggests that it may be neuropathy. The treatment plan as suggested by your neurologist is optimal. You can continue according to the same.
I hope to see you improve.If you have no further questions for now,please close the thread and write a review.
I shall be glad to have you in follow-up if you have any query in future.
Hope that helps.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

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