[21M] Experiencing intermittent symmetrical leg pain with tingling sensation

Patient Description

A 21-year-old male reports intermittent leg pain that is symmetrical and migratory, with episodes of pain occurring randomly and sometimes abating for up to two weeks. The pain is described as nerve-like, with a tingling quality, and rated up to 6 out of 10 in severity, though there are periods with no pain at all. The pain does not worsen with exercise and is alleviated by massage. Additionally, the patient experiences occasional shakiness but no numbness, weakness, or changes in skin color or temperature. No impact on bladder or bowel control has been noted. The patient has a past medical history of cholinergic urticaria at age 15, which resolved after 10 months. Currently, the only medication being taken is Finasteride, and there are no known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Restless Legs Syndrome (RLS): This is a condition that causes an uncontrollable urge to move your legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you're sitting or lying down. The sensation can be relieved by movement, such as walking or stretching. The pain is often described as crawling, creeping, pulling, throbbing, aching, itching, or electric shocks.

    • Treatment usually involves lifestyle changes and medication if necessary.
  • Peripheral Neuropathy: This is a result of damage to your peripheral nerves, often causing weakness, numbness, and pain, usually in your hands and feet. It can also affect other areas of your body. Your symptoms are symmetrical and have a tingling quality, which can be associated with this condition.

    • Treatment involves managing the condition causing your neuropathy and relieving symptoms with medication.
  • Anxiety Disorder: Anxiety can cause physical symptoms, including leg pain. You mentioned that your leg pain started after a period of worry and that you've been feeling anxious and shaky. These symptoms could be related to an anxiety disorder.

    • Treatment typically involves psychotherapy (cognitive-behavioral therapy), medication, and lifestyle changes.

Please note that these are possible explanations, and it's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Try to maintain a regular sleep schedule. Sleep deprivation can exacerbate symptoms of RLS and anxiety.
  2. Regular physical activity may help to reduce symptoms. However, don't overdo it as excessive exercise can worsen RLS.
  3. Limit caffeine, alcohol, and tobacco, which can worsen RLS and anxiety symptoms.
  4. Practice stress management techniques such as meditation, deep breathing, and yoga to help manage anxiety.

What you should look out for

Please seek immediate medical attention if:

  • Your symptoms worsen significantly or suddenly
  • You experience severe pain
  • You have difficulty walking or moving your legs
  • You experience any other new or concerning symptoms

Remember, I'm an AI and this advice is based on the information you've given me. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of Restless Legs Syndrome (RLS)?

Common symptoms of Restless Legs Syndrome (RLS) include an uncontrollable urge to move the legs, often accompanied by uncomfortable sensations such as crawling, creeping, pulling, throbbing, aching, itching, or electric shocks. These symptoms typically occur in the evening or nighttime hours when sitting or lying down and can be relieved by movement.


How is peripheral neuropathy diagnosed and treated?

Peripheral neuropathy is diagnosed through a combination of medical history, physical examination, and tests such as nerve conduction studies, electromyography, and blood tests. Treatment focuses on managing the underlying cause, relieving symptoms with medications like pain relievers or anticonvulsants, and lifestyle changes.


Can anxiety cause physical symptoms like leg pain?

Yes, anxiety can cause physical symptoms, including leg pain. Anxiety can lead to muscle tension, increased nerve sensitivity, and other physical manifestations that may result in pain or discomfort in various parts of the body.


What lifestyle changes can help manage symptoms of RLS and anxiety?

Lifestyle changes that can help manage symptoms of RLS and anxiety include maintaining a regular sleep schedule, engaging in regular physical activity without overexertion, and limiting caffeine, alcohol, and tobacco. Stress management techniques such as meditation, deep breathing, and yoga can also be beneficial.


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