Worried and confused by EMG: Hyperreflexia + Polyneuropathy

Hello - I’m an 45M after a lengthy 8(mo) and exhaustive (IMO) of chasing down what I thought was lumbar spinal related nerve pain things took some interesting twists.

Let me preface this by admitting as someone who doesn’t usually suffer from much stress or anxiety - it’s through the roof while I wait for an appointment with Neuro on 1/23. That has mostly brought on by a big shift in the past month of

- bilateral symptoms (thinking this was initially sciatica)
- unexplained intermittent leg weakness - - I’m still able to go for daily walks - but legs feel stiff / spastic - tons of fasciculations in both legs (left are new) thighs down to ankles
- No foot drop (read lot on that)
- Not a diabetic / nor alcoholic - last A1C was 5.2 in January of 2025

- EMG results (which I’ve attached)

Nonetheless - I’m very nervous about autoimmune issues - MS/ALS in particular .. and the doctor who that was probably brought on by the Physiatrist who ordered or performed most of the above ordering that EMG and the neuro referral .. in my mind that only equals bad things .. and the waiting game is torture and I realize things like MS/ALS are lengthy to diagnose.. but I’m not even sure I fully understand what my tests have revealed at this point.

Thanks for reading.

In the past year I’ve had the following things done this year:

2/25 C Spine MRI (chronic neck pain)

3/25 Right foot XR (tingling in right foot where foot felt really hot (not too touch)

4/25 Lumbar + SI Joint XR (nagging low back pain that had become worse - later informed worsening pain was in Sacrum)

6/25 SI Joint ESI - no relief

7/25 Lumbar MR - broad based bulge at L4L5, mild bulging at L3L4+L5S1, mild annular tear at L2/L3 right foraminal tearing

8/25 Right Arm EMG (suspected Cubital tunnel - neg but positive for carpal tunnel)

9/25 ESI L2/L3 - no relief of sacrum pain or new lower right outer leg pain radiating to foot

9/25 XR Hip XR - Combined bilateral FAI (mild according to clinical exam)

11/25 - ESI - L4L5+S1S2 - extremely painful down rt leg to big toe - may have resolved sacrum pain - low leg pain still remains

12/25 - LUMBAR MR - due to new bilateral lower leg weakness radiating down to feet - still more prevalent in right leg. - No significant changes from July MR despite new symptoms.

12/25 - EMG Lower Extremities - see attachment.

Thanks for reading and I welcome all input - good, bad, otherwise - shared experience etc.

PS - during the summer I got a RX for Gabapentin but I didn’t like the idea of taking it because we still didn’t know what was wrong and I guess we still don’t know now. It’s 300mg