Leg Weakness and Mobility Issues

Posted by gaboslastresort @gaboslastresort, Jun 29 5:31pm

Hi! I’m new here and am sharing my situation in hopes one of you have heard of something similar to what I'm going through. For reference, I’m a 23 year old female. Since mid-January, I have been experiencing symptoms in my legs including weakness down both legs, decreased range of motion, and lack of endurance which inhibits my ability to walk distances longer than a minute or stand for a couple minutes without getting fatigued/feeling like I just ran a marathon. As a result, I no longer drive. I also struggle getting down/up from the ground due to decreased range of motion/flexibility and can only go up the stairs one by one with my left leg leading and hold a rail going down one step at a time. These symptoms have significantly impacted my daily life.

Some background is I was having bad anxiety/consistent panic attacks in Dec/start of Jan. In mid January I did a Pilates workout targeting the legs (tons of squat variations including pulsing, calf raises, etc) and I instantly knew I overdid it when my legs were shaky and stairs were tough right after. It became extreme DOMS, I had a heavy sensation as if bricks were weighing my legs down, and even lightly pressing my legs hurt. Probably irrelevant but I also got a really bad cold around that time. It’s as if my body freaked out with everything and somehow turned the DOMS into weakness that never got better.

Since then, I have seen a neurologist, rheumatologist, orthopedic dr., musculoskeletal dr., and primary and urgent care. All are stumped and don’t know what’s going on, saying it’s an unusual presentation and weird I have no other symptoms.

I have had an MRI on my lumbar spine and brain which were both clean and rule out MS. My EMG/nerve conduction came back normal. I have gotten lots of blood drawn 4 different times and everything is in normal range. From my autoimmune blood panel, only my ANA was positive (abnormal), but my neurologist said women often are positive even though they don’t have autoimmune disease. Mine was a speckled pattern and titer was only 1:80.

Since mid-February, I have been going to physical therapy 1-2 times a week and have seen slow, small improvements, but still not close to where I was before all this.

Since I struggle with walking a normal pace/cannot walk far before my legs feel completely wiped out, I only average about 1,000 steps a day if even, and my legs (especially my right which is worse), have visible muscle atrophy.

Any thoughts/suspicions on what's going on? Could my symptoms simply be caused by lack of use and get better if I gradually start moving or have someone stretch my legs each day? Or is it some rare autoimmune disease that got triggered from the leg workout/bad anxiety I was dealing with in January? Or does it sounds more like a muscular condition? Thank you in advance, I just want my life back.

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@gaboslastresort

Thank you for your response! Interesting, I have wondered if diet somehow plays a role in this since I am not the healthiest eater, but I figured it'd be weird it would happen so suddenly after a workout/anxiety/a cold. I have not thought of Celiac disease since I have never had digestive issues, stomach pain, etc, but I will mention it to my rheumatologist.
I relate to how your energy is limited/legs hurt if you overdo it. I try to keep up with PT, but it leaves me more sore/wiped out after for a couple days after, so it really is a delicate dance with not overdoing it but also trying to build strength. It's ironic since a workout arguably set this all off, yet I'm working out to try to get better. I can do more reps/exercises than when I first got there, so I guess it must be doing something.
May I ask have you tried to gradually walk more/stand more? Curious if the lack of use of the legs somehow contributes to it. I'm torn between wanting to try to do more but scared it's going to set me back to square one.

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@gaboslastresort Just the fact that you’re trying to exercise is great! We all had to start with small steps. When I got out of rehab, my biggest dream was to go outside for a walk!! But, I forgot that I was using a walker just to walk across the room. Slowly, my husband was able to get me walking.
With that in mind, you might want to join our walking group.
https://connect.mayoclinic.org/discussion/lets-go-walking-join-me-for-a-virtual-walking-support-group/
There are all kinds of walkers in the group. Some, like you, have to really work at walking and others go for miles, and some do exercises at home. So, come join us! We all walk ‘virtually’ and then compare how we’ve done.

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Iam 76 yrs old and sounds just like what iam feeling,Weakness started a few yrs ago,and steadily getting worse every day! I've been to all the same Dr s as u. All say Inflanation ,Auto amouine disease ,Shjgrems ,is what was found . All my muscle hurt and decreased mobility. It's horrible at my age . I feel for u so young. Iam a non stop person all my life . Standing ,all day working hairdresser . Now it hard to walk a few blocks. Dont know what else ,I push myself every day to try to keep moving as much as possible.

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@catartist

I too am challenged in past 6 months with leg weakness and pain ( long had some). I have a muscle atrophy condition (RA and prednisone for 35 years). Lost 4 glute muscle and some shoulder ones. Anyone else have this. I PT and try moving as much as possible - fear of further damage I try to put aside - Dr.s can’t tell me what to expect. Anyone?

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Prednisone long term can cause steroid myopathy but I would urge you to consider other possibilities. A muscle biopsy may be the only way to be sure. I have been on prednisone for over 30 years and my Drs never considered any other cause for my muscle weakness and atrophy until I became wheelchair dependent and insisted we look further. I was on placquenil over 25 years as well. A muscle biopsy at Mayo Clinic showed neuromuscular toxicity from the Placquenil!
After stopping the drug and not improving, I was then diagnosed with CIDP, a form of Guillain Barre Syndrome mentioned previously. All the while all my Drs urged me to reduce my prednisone, which was the opposite I needed for my RA, SLE and CIDP. They made me feel guilty for taking it, but it was the only thing keeping me going. So it’s never simple and one must have facts, not assumptions of what is going on. Good luck.

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@slkanowitz

Prednisone long term can cause steroid myopathy but I would urge you to consider other possibilities. A muscle biopsy may be the only way to be sure. I have been on prednisone for over 30 years and my Drs never considered any other cause for my muscle weakness and atrophy until I became wheelchair dependent and insisted we look further. I was on placquenil over 25 years as well. A muscle biopsy at Mayo Clinic showed neuromuscular toxicity from the Placquenil!
After stopping the drug and not improving, I was then diagnosed with CIDP, a form of Guillain Barre Syndrome mentioned previously. All the while all my Drs urged me to reduce my prednisone, which was the opposite I needed for my RA, SLE and CIDP. They made me feel guilty for taking it, but it was the only thing keeping me going. So it’s never simple and one must have facts, not assumptions of what is going on. Good luck.

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So good to hear from someone experiencing like symptoms! Tho’ I am so sorry! RA itself does this myopathy/ atrophy - much worse with daily steroid ! No one really spelled it out till I actually started loosing muscles (2 glutes on each side are empty fatty tissues now - useless) only max left, also in arm and shoulders some loss. No one suggested a biopsy - not sure they think it’ll help any at this point. I haven’t given up but feel Drs may have. How has new info helped you? ( I took plaquenal for a while years ago but not now. Orencia probiotic, methotrexate, and Cymbalta for pain and handling it, tramadol more recently. I lost so much weight that I am eating very intentionally- protein, minerals, calories, bit B12 and such. The exercising is helping balance a bit but exhausting- hope you can get improvement! THAT is the question - what to do and expect?? Thank you for sharing

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@reets70

Have you been tested for Gullian Barre? It also is an auto immune illness and it sounds like your symptoms. Or what about Polymyalgia Rheumatica?

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One of the many tests I have undergone in hopes of a diagnosis is EMG and nerve conduction (which would diagnose Guillan Barre among other things) but results were normal. I have also undergone imaging tests like MRI of lumbar and brain, and those were clean. Inflammation markers like sedimentation rate and C reactive protein are not elevated, so polymyalgia rheumatica doesn't seem likely either. Strange how all tests are showing normal, but based on my symptoms I'd think something would show up as off in them.

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@ukjanet

Hi again. Thanks for coming back to me. I’m sorry to learn how much this
is affecting your social life. You’re far too young to have to deal with
this. I only drive short distances and this is because I sometimes have
such strange sensations in my legs I feel as if they could cramp at any
time and I’ll go in the back of somebody. As soon as I get into the
drivers seat I start to get anxious. I’m sure that this makes things a
whole lot worse. Do you find that you have more energy in the mornings. I
do. I start each day full of optimism but by early evening my legs start a
dull ache. It usually passes before I go to bed and I sleep well. Two
years ago it was found I had protein in my blood and I was diagnosed with
MGUS. (It’s a pre cancer of the bone marrow) I now have to have my bloods
done every few months. There is a chance that my symptoms could be due to
that (CIDP) although the neurologist says he’s absolutely sure it’s not.
Like you I miss my old self and spend ages looking at photos of when I was
‘normal’. It’s impossible to explain to people what the pain feels like
but it’s just as if I’m ploughing through mud. I get so exhausted that I’m
scared I won’t pick my feet up and I’ll end up falling over. That hasn’t
happened yet. Where are you in the States? I’m in Los Angeles right now
staying with family. I have another appointment with my neurologist in
August but I don’t expect any answers. Do you think it could be MS or
Myositis? They seem to tick all the boxes. Lots of people have had muscle
aches after the Covid vaccine so that’s another possibility. I’m going to
keep on walking and also exercising on the static bike to keep up muscle
tone. Keep up with your PT. I see a Chiropractor every week. I do
exercises for spinal stenosis. It can’t do any harm! Please write back.
We can help each other through this and we have to keep positive. A few of
the people who have replied did make a complete recovery. Take care xx

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Hi! That's great you're still trying to drive a bit, I understand the anxiety that comes with it. I haven't attempted driving since January when this weakness for me began because I'm anxious I'll get in an accident due to how quickly my legs give out strength/endurance wise. I miss it and want to try, but if I can't do it I'll be really discouraged since it used to be so easy for me.
I am very stiff first thing in the morning, but I suppose my leg energy is at its peak then the more I use them throughout the day they get more tired and I need to not overuse them.
I am also in California! In Orange County, so not too far from LA. My rheum said myositis isn't likely since my bloodwork for inflammation, creatine kinease protein, etc is totally normal. And EMG/nerve conduction was normal. I have no lesions on lumbar/brain, so MS was ruled out too. I just scheduled a cervical/thoracic MRI next month just to check no lesions there either. My rheum recommended I find a neuromuscular doctor, but those she knows are booked until fall which is so far away.
Yes, I am going to keep up with PT because I have slowly been able to do more reps/more exercises since I started back in February, so it must be doing something. I may try to slowly increase my steps each day too to see if that does anything for my endurance, which is the thing I want to get back to normal the most. I hope you find some help through your Chiro and static bike! I have considered Chiro but am nervous it'll tweak something weird. I tried acupuncture/cupping three times the other month but it sort of made things worse so I stopped.

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@ginger3344

Check out the sypmtoms of CIDP, mine sounds like what your going through. They feel that mine is an autoimmune reaction to the covid vaccine, they are reporting many cases now. UCLA nueromuscular docs are great, mine started 3 years ago after the first vaccine.

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Did they diagnose you with CIDP? If so, curious what tests did you undergo to get that diagnosis. I have already done so many tests like imaging MRIs, tons of bloodwork, emg/nerve conduction, and all is normal as if I have nothing wrong.
I need to schedule an appointment for neuromuscular, likely through UCI, but they are booked until fall which is so far away.

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@gaboslastresort

Did they diagnose you with CIDP? If so, curious what tests did you undergo to get that diagnosis. I have already done so many tests like imaging MRIs, tons of bloodwork, emg/nerve conduction, and all is normal as if I have nothing wrong.
I need to schedule an appointment for neuromuscular, likely through UCI, but they are booked until fall which is so far away.

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Yes CIDP and most likely from the Covid Vaccine! UCLA nueromuscular is fast and great! They are honest about the fact that they see a lot more of it. Mine started a few days after the Vaccine , i started falling down and lost strength in my left knee, which would just give out and Down I went... It started in my left leg and they thought it was a spine problem . After fusing S-1
L-5 and L-4 and L-3 it just got worse over the next few months. At first local (Ventura CA.) docs thought it was GBS and started me on IVIG which helped some < 44 infusions for 4 hours each) Dr. Trikamji. put me on the rituxan (rituximub) and I am able to walk now with a cane.

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I had symptoms of CIDP for years and had normal EMGS x 3. It wasn’t until the 4th EMG that nerve damage showed up. A spinal tap sometimes shows high protein but not always. There are special autoantibodies against myelin and other nerve cell proteins that may be done on serum but only the neuromuscular specialists order those. You need a NM specialist who will take a stand based on your signs and symptoms even if all tests are normal. That is what is meant by a “clinical “ diagnosis and someone who has seen it enough times won’t require proof. I wish everyone going through this luck and strength.

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@gaboslastresort

Did they diagnose you with CIDP? If so, curious what tests did you undergo to get that diagnosis. I have already done so many tests like imaging MRIs, tons of bloodwork, emg/nerve conduction, and all is normal as if I have nothing wrong.
I need to schedule an appointment for neuromuscular, likely through UCI, but they are booked until fall which is so far away.

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I was diagnosed by EMG/nerve conduction test plus a spinal tap is required. Spinal tap gave me a severe migraine.

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