Nerve / muscle twitching

Posted by jeffkboyce @jeffkboyce, May 19, 2021

Hello all - over the past year or so I have had muscle twitching / nerve twitching in my lower legs and knees. I also have some mild tingling. I had an MRI and the culprit looks is at the L4/L5 area. In addition I am genetically fused at the S1 area. This has caused wear and tear issues resulting in disccompression and both foraminal and lateral stenosis. It is annoying but not painful. The Dr and P/T have told me it is mild but I have changed Drs and requested a nerve study. I do not have any loss of movement. Weakness or muscle loss. In fact I am adding muscle from resistance training. I have found heat helps in most areas so at the end of the day I sit on a heating pad. I also stretch, move and exercise. Some days are better than others. Has anyone else had this issue and if so did a decompression or fusion surgical intervention eliminate it?

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jenatsky | @jenatsky | May 24, 2021

I'm experiencing similar symptoms in my lower legs and feet and it's related to either my L5 nerve damage, my stenosis or peripheral neuropathy. The biggest item that gives me relief is movement. The more I move, walk, perform squats (against a wall using an exercise ball) 2-3 times a day. I feel this opens the nerve pathways. Sitting just closes them back up, in my opinion.

jeffkboyce | @jeffkboyce | May 24, 2021

Totally agree and thank you for the squat idea. The P/T showed me that variation it is a good movement! If you don’t mind my asking did you do any surgical procedures if so what did you do? Or are you using a conservative approach ?

jenatsky | @jenatsky | May 24, 2021

I had a L5 laminectomy and L4-S1 fusion in 1990 with stainless steel plates. My recovery took a very long time. My fall stopped me from being a nurse but I became a healthcare consultant after recovering. But I think 19 years of being a road warrior didn't help my back much. Pain is my daily pal that accompanies me everywhere I go. My sole job now is to try to remain as painless as possible. My success rate varies day to day. I love to cook but the process of using my upper body makes my mid-back and shoulders hurt more. I had a massage today for the first time since Covid locked us down. I feel very-very good today.

jeffkboyce | @jeffkboyce | Jul 30, 2023

Well an update. I had the nerve study which was normal. I did MRI, X Ray, Epidural and the nerve study. I think I had a total of 5 Drs review me.

Then … divinely I was largely symptom free for about 2 years then bam …. After hiking one day it hit me again. Most of the same areas with a new area my left insole. I get tightness, dull aches and a buzzing sensation (foot.)

The nerves in my calves are hyper active but calm down with ice and heat. I was lifting circuit training and riding stationary bike (pretty aggressively.) I think that must have reactivated everything. Strangely a heating pad works well going outside seems to make it worse (we live in Las Vegas now) then I come inside and cool down and it resolves. It feels like it is getting a little bit better as time passes. I have a consult with my Dr tomorrow.

jenatsky | @jenatsky | Aug 4, 2023

In reply to @jeffkboyce "Totally agree and thank you for the squat idea. The P/T showed me that variation it..." + (show)

I had L4-S1 fusion in 1992 after a fall in 1988. Unfortunately my fusion is with stainless steel bars, not titanium. Going forward I cannot have an MRI of torso as a consequence and replacing my bars with newer titanium is no t pain I wish to experience again. Now 30 years later I have osteoporosis, osteoarthritis, PN but walk 2 miles a day, gym 2-3 times week, stretch 2 times a day. I use buprenorphine patch every 7 days and no longer need Percocet for breakthrough pain by using THC/CBD tincture. I’m overall doing pretty well considering.

jeffkboyce | @jeffkboyce | Aug 4, 2023

Sounds like you are doing very well. I am sorry you went thru all of that. I had 3 Drs examine me 3 years ago. 2 told me to not do surgery - one said that if he did it would be a TLIF. Strangely I had 2 hernias and after the normal nerve test I backed off and my symptoms almost disappeared until June of this year. During the consult this week he suggested we try an injection first then see what that does. I think ultimately I will have to get something done. We are moving to AZ so I will take all of my lovely pics and mychart to either Mayo or somewhere in Tucson and look for resolution. My issue at the moment is shin pain and some tingling in my foot. The left side is getting a little better.

Jennifer, Volunteer Mentor | @jenniferhunter | Aug 5, 2023

In reply to @jeffkboyce "Well an update. I had the nerve study which was normal. I did MRI, X Ray,..." + (show)

@jeffkboyce One thing you may want to look at is if your pelvis is out of alignment. That can cause sciatic or low back pain. You can have pain coming from multiple sources. My pelvis does twist a bit sometimes, and for me it can cause pain down the inside of my leg that can be at the groin or lower in the calf. A good physical therapist can assess this. Perhaps this would be a question to ask your doctor. I realize you'll be doing injections. As a person who exercised a lot, you may have very tight fascia and muscle tissue.

You may be interested in looking at our discussion about Myofascial release. My PT is certified in this technique and it helps me a lot. When I release the restrictions, my body can move again and be better aligned and by doing that it resolves pain. Here are a couple links.

Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

MFR provider search :
https://www.mfrtherapists.com/

MSK Neurology - "How to identify and treat lumbar plexus compression syndrome (LPCS)"
https://mskneurology.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/

Have you heard of Myofascial Releases before?

jeffkboyce | @jeffkboyce | Aug 5, 2023

Thank you! I will look into that - my symptoms at the moment are nerve compression related and I am wondering if it is all low back. The right side is radiating pain in shin and ankle with pins / needles tingling etc. from the stenosis at L4/L5 and I think you are right I have some compression which I had before. The left side is an aggravated insole that tingles twitches and buzzes. If I irritate it gets mad then I have to relax and stretch til it goes away.