Could this be ALS - fasciculations and muscle soreness

[Tekfreak5]

Hello,

I have gone through and read the stickies and while most everything makes sense, theres still a few things I am confused about so i figured I would post here. 42 year old male. As a short backstory, a year ago I lost my only parent, my mom, and had caregiven for her for two years prior. Worst stress and grief of my life. Over the past year much has changed such as chronic fatigue, but one thing was that I kept getting injured doing normal weights at the gym or normal tasks (injured hand muscle opening jar, pulled rib/lat/bicep muscles doing weights) that all happened on my right side. Most of these never truly healed. On top of that, I developed joint pains in my fingers and toes all on the right side. I chalked it all up to my body going through complete exhaustion of the caregiving stress and grief. That was until 3 weeks ago

3 weeks ago I started with a twitch isolated to one muscle in my right upper arm that would last 15-20 seconds with multiple twitches. After 3 days it started affecting multiple muscle groups in my upper right arm, except they were split second twitches. 6 days in started predominantly affecting my right thigh and knees. I would say 80% of the fasciculations are in the right knee/quad, 15% in the left, and 5% randomly in both shoulders, forearms, calves, arms, etc. They feel like little worms digging into my muscles. 4 days ago I started feeling unexplained muscle soreness in my right quad which is now also in the shin.

So far I have had CBCs taken, and basic nuero tests at the chiro (push, pull, etc). I did have an EMG of my right arm in early February (well before the twitching started) for a completely different reason (numbness/pain when sleeping on right arm) that came out clean except a pinched ulnar nerve. I would have taken solace in this knowing that nerve damage would have already accumulated by then, but since the twitching and muscle soreness is mostly in my right leg, is it possible that the ALS is affecting the leg first and that the arm EMG could have been ok but still have ALS?

The fact my muscles became so injury prone on the right side over the past year and now have fasciculations and soreness happen so rapidly in the past 3 weeks leads me to believe this is essentially unilateral. Ive read stories where the fasciculations happened first before weakness, but what I cant figure out is how long or short it takes for ALS to progress if the first symptom truly is twitching, and if so, would muscle soreness come next like mine up until a sudden inability to use the muscle? Could the constant injuries to the right side over the past year been the warning for me that the muscles are deteriorating?

I have a neuro appt scheduled for april 12th. Until then I just feel in constant fear. I was starting to hope this was just BFS but now that muscle soreness has started in the right leg my panic alarm is in absolute overdrive.

Thanks for reading, im sure I will be one of thousands here who have posted something similar thats not close to what ALS looks like, but I still feel my feelings and fears are valid, at least to me.

 

[lgelb]

Soreness and overuse injuries are not characteristic of ALS onset. Nor are migrating twitches that feel like worms. Recurrent lifting injuries sound like an issue that PT could evaluate -- you could have pre-existing weak/injured muscles that are compromising the safety of your lifts. I would get that done via your PCP before you do more lifts.

 

[Tekfreak5]

Thank you. I did want to clarify that the muscle soreness I have exhibited in the leg that has the majority of the twitching has been absent any lifting. I havent touched weights in almost two weeks when I started getting the twitching and wanted to rule out overuse of the muscles. So this soreness has been about 1.5 weeks out of any weights. It can be a dull muscle ache/pain lasting for hours similar to when one has the flu with my entire quad, or it could come and go quickly almost like a zapping pain when it comes to my shins.

regardless, judging from your response one with ALS onset does not exhibit muscle twitching at rest all over the body, even if it is only a small majority of the twitches?

 

[lgelb]

Correct. The motor neurons would have to all die at once.

Just because you haven't lifted for 2 weeks, doesn't rule out an ongoing condition or injury that makes you injury-prone. Even if time is the only remedy, 2 weeks is hardly a healing period for many things.

The purpose of a PT eval would be to see what kind of a regimen or therapy could "harden" the areas of risk. It is a domino effect.

 

[Tekfreak5]

I went to PT last week and they said that my IT band and quad felt tight but that was about it - and thats nothing new as ive always had tight muscles since ive been inflexible all my life despite stretching - although its def tighter than my baseline currently. It cant be coincidence that the twitching started predominantly in the right leg weeks ago and now I have a dull soreness there now the past week there with limited exertion of it. What I havent been able to fully grasp regarding ALS progressions is how the weakness progresses - I read that one would have muscle weakness where they cannot lift their arms or walk stairs, but does that mean its overnight that it happens out of the blue or is there a progression where theres red flags? My concern is that the soreness/additional tightness in my right quad is the pain of the beginning stages of atrophy and/or nerves dying in conjunction with the fasciculations