Persistant fasciculations and muscle cramps

[Mako]

Hi everyone,

I am a 39-year-old male experiencing symptoms for the past three weeks that have me concerned about ALS. I understand that only a neurologist can provide a reliable diagnosis after conducting the necessary tests (e.g. EMG). I have an appointment scheduled in about a month and a half. I am feeling very anxious, and perhaps discussing my case here might help me better manage this waiting period.

Three weeks ago, I started experiencing a lot of fasciculations in my dominant right arm. Typically, I don’t worry about fasciculations, as I have had them for many years all over my body without issue. However, what seems different this time and has caused concern is: (1) the sudden onset and persistence of the symptoms; (2) the fasciculations (which are very visible) occur only in my right arm (mainly in the biceps, triceps, shoulder, and forearm) and happen quite frequently. They are impossible to ignore.

After a few days of muscle twitching, I began experiencing muscle pain in my feet (both), arms (both), calves (both). I would describe the pain as if it is the beginning of a cramp, like the muscles are always on the verge of cramping, without cramping. This pain is almost constant, and becomes stronger when I go to bed. This second symptom ahs really concerned me as I have never experienced it before.

I have a friend living with ALS. We discussed these symptoms a bit (he’s having regular fasciculations and muscle cramps), but I don’t want to be disrespectful and talk too much about my “little concerns” with him. I promised him I would see a neurologist.

I am wondering if my symptoms might be exacerbated by anxiety. It seems to me that even if muscle cramping is common at the onset of ALS, it shouldn’t appear all over the body immediately?

Any insights or similar experiences would be greatly appreciated.

Thank you.

 

[lgelb]

You are correct -- cramps, fascics, twitches, what have you do not typically appear in a widespread fashion, nor with pain, as you describe, with ALS onset.

Pain and unhappy muscles frequently feed on each other and spread to more places as a result. I expect your neurology visit to be reassuring, but I would see your PCP first if you haven't to explore any possible systemic explanations. If lying down makes things worse, I would look closely at your bed frame/mattress/pillow, and all your sitting surfaces, as these become less effective over time.

 

[Mako]

Thank you Igelb for your feedback. While the muscle twitches have slowed down, I am now most concerned about the sudden onset of cramping pain in both of my legs. I will wait patiently for my upcoming medical appointment to see what's going on.

 

[KimT]

There's a benign condition called Cramp Fasciculation Syndrome. My neurologist talked about it and said (Mayo Clinic) Valium is often successful at treating this when nothing else works.

Just keep hydrated, eat a healthy diet, avoid caffeine, stretch the areas that are causing you issues, and look forward to a clean EMG.

 

[lgelb]

Just to be clear, most would consider Valium as a last resort for benign cramp syndromes, not the first. It is sedating and tolerance can occur.

If the cramps are stronger when you lie down, I'd consider a low voltage heated mattress pad, which can be placed either over or under your mattress or overlay, and, of course, a warm-to-hot shower or bath before bed.

And it seems paradoxical, but if you don't already use a fan at bedtime, that and/or adjusting your climate control can help cool you off to the point where the mild heat to relax your muscles doesn't overheat you. There is research to suggest that the "cooling off" part after a hot shower or whatever helps you sleep more deeply.