[38M] With muscle spasms, numbness, and charley horses

Patient Description

A 38-year-old male presents with muscle spasms in the lower left back, numbness in the arms when sitting in certain positions, and almost immediate charley horses in the legs, particularly in the right thigh when kneeling. The charley horses are described as sharp, cramping pain rated 7 out of 10 in severity. These symptoms have been present for months. The patient also reports dull lower left back pain, which can make walking painful for a minute or two after standing up, but then the pain lessens, and he can walk normally. There is no calf pain, no weakness in the arms or legs, no changes in sensation in other parts of the body, and no changes in bowel or bladder function. The patient has no history of spinal issues or injuries and does not use tobacco, alcohol, or recreational drugs. He is currently taking Adderall 30mg twice a day and Effexor 75mg twice a day, as prescribed. There are no allergies to medications. Family history includes degenerative disc disease but no other significant conditions like heart disease, stroke, autoimmune diseases, diabetes, cancer, or psychiatric illnesses.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Muscle Spasms and Charley Horses:

    • Electrolyte Imbalance: Sharp, cramping pain in your legs, especially at night, could be due to an imbalance in electrolytes like magnesium, potassium, or calcium. This is common in people who engage in strenuous activities.
    • Dehydration: Not drinking enough water can also lead to muscle cramps and spasms.
  2. Numbness in Arms:

    • Nerve Compression: Numbness in your arms when sitting in certain positions could be due to nerve compression, such as from poor posture or repetitive strain. Conditions like carpal tunnel syndrome or thoracic outlet syndrome could be contributing factors.
    • Cervical Radiculopathy: This condition occurs when a nerve in the neck is compressed or irritated, causing pain and numbness that can radiate down the arms.
  3. Lower Back Pain:

    • Muscle Strain: Dull lower back pain that improves after walking could be due to muscle strain or overuse, especially given your daily strenuous activities.
    • Degenerative Disc Disease: Given your family history, this could be a contributing factor to your lower back pain.

What you can do

Muscle Spasms and Charley Horses:

  • Hydration: Ensure you are drinking enough water throughout the day, especially if you are engaging in strenuous activities.
  • Electrolyte Balance: Consider incorporating foods rich in magnesium, potassium, and calcium into your diet. Bananas, spinach, and dairy products are good options.
  • Stretching: Regularly stretch your leg muscles, especially before and after physical activity. Gentle stretching before bed may also help.
  • Warm Compress: Applying a warm compress to the affected area can help relax the muscles.

Numbness in Arms:

  • Posture: Pay attention to your posture, especially when sitting. Ensure your workstation is ergonomically set up to reduce strain on your arms and neck.
  • Stretching and Strengthening: Gentle stretching and strengthening exercises for your neck and arms can help alleviate nerve compression.
  • Breaks: Take regular breaks to move around and change positions if you are sitting for long periods.

Lower Back Pain:

  • Heat and Cold Therapy: Applying a cold pack initially and then a warm pack can help reduce inflammation and relax the muscles.
  • Exercise: Engage in low-impact exercises like walking or swimming to strengthen your back muscles without putting too much strain on them.
  • Proper Lifting Techniques: Be mindful of your lifting techniques to avoid straining your back. Bend at your knees and keep your back straight when lifting heavy objects.

What you should look out for

While your symptoms are not immediately life-threatening, you should seek medical care if you experience any of the following:

  • Severe or worsening pain: If your pain becomes severe or does not improve with home remedies.
  • Weakness or numbness: If you develop weakness or numbness that does not go away or spreads to other parts of your body.
  • Changes in bowel or bladder function: Any changes in your ability to control your bowel or bladder should be evaluated immediately.

Remember, while I can provide some guidance, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. You can use MDandMe to journal your symptoms, track your progress, get insights, and share your medical notes with your provider.

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6 mo ago

People Also Ask


What causes muscle spasms and charley horses in the legs?

Muscle spasms and charley horses can be caused by electrolyte imbalances, dehydration, or overuse of muscles. Ensuring proper hydration and a balanced intake of minerals like magnesium, potassium, and calcium can help prevent them.


Why do I experience numbness in my arms when sitting in certain positions?

Numbness in the arms when sitting in certain positions is often due to nerve compression, which can occur from poor posture or repetitive strain. Conditions like carpal tunnel syndrome or cervical radiculopathy may also contribute.


What are some common causes of lower back pain?

Common causes of lower back pain include muscle strain, poor posture, degenerative disc disease, and overuse. Family history and lifestyle factors can also play a role.


How can I prevent muscle cramps and spasms?

To prevent muscle cramps and spasms, stay hydrated, maintain a balanced diet rich in essential minerals, stretch regularly, and ensure proper posture during activities. Warm compresses and gentle exercises can also help relax muscles.


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