[40M] Experiencing sudden leg weakness and muscle symptoms

Patient Description

A 40-year-old male reports sudden onset of leg weakness that has occurred four times within the last month. The weakness is severe, rated 10/10, and does not improve with rest. Additionally, the patient experiences severe leg soreness in the front thigh, resembling lactic acid build-up after excessive exercise, which worsens when getting out of a chair or climbing stairs. The soreness is alleviated by Advil or steroids. The patient also describes muscle tightness, soreness, twitching, and spasms throughout the body, occurring mostly at rest, and has been persistent for four months. The tongue feels tingly and sore, like a pulled muscle, and this sensation is constant. The patient has a history of rheumatoid arthritis, diagnosed four years ago, and is currently on bi-weekly 40mg Humira injections. No other medications are reported, and there is no known drug allergy. No recent injuries, changes in swallowing or breathing, bowel or bladder function changes, muscle wasting, or significant weight loss have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Rheumatoid Arthritis (RA) Flare-Up: Given your history of RA and the fact that you're experiencing widespread muscle soreness and spasms, it's possible that you're experiencing a flare-up of your RA. RA is a chronic inflammatory disorder that can cause pain, swelling, and stiffness in the joints. It can also cause symptoms in other parts of the body, including the muscles.

    • Treatment for RA flare-ups typically involves medications to reduce inflammation and control the immune response, such as non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs).
  • Fibromyalgia: This is a chronic condition characterized by widespread pain and tenderness, often accompanied by fatigue, sleep disturbances, and cognitive difficulties. The muscle spasms and twitching you're experiencing could be related to fibromyalgia.

    • Treatment for fibromyalgia typically involves a combination of medication, exercise, stress management techniques, and healthy lifestyle habits.
  • Myopathy: This is a general term referring to diseases of the muscles that are not caused by nerve disorders. Myopathies can cause weakness, pain, and spasms in the muscles. They can be caused by a variety of factors, including inflammation, endocrine disorders, metabolic disorders, and certain medications.

    • Treatment for myopathies depends on the underlying cause and may involve medications, physical therapy, and lifestyle changes.

Please note that these are potential explanations for your symptoms, and it's important to consult with a healthcare professional for a definitive diagnosis.

What you can do

  1. Consult with your doctor: Given the severity and duration of your symptoms, it's important to consult with a healthcare professional. They can provide a thorough evaluation and determine the most appropriate treatment plan for you.

  2. Monitor your symptoms: Keep track of your symptoms, including when they occur, how long they last, and any factors that seem to make them better or worse. This information can be helpful for your doctor in diagnosing your condition.

  3. Rest and hydrate: Make sure to get plenty of rest and stay hydrated. These measures can help your body recover and can also help manage some of your symptoms.

  4. Over-the-counter pain relievers: Non-prescription pain relievers, such as ibuprofen (Advil) or acetaminophen (Tylenol), can help manage pain and inflammation. However, these should be used as directed and not for prolonged periods without consulting a doctor.

What you should look out for

Seek immediate medical attention if you experience:

  • Difficulty breathing or swallowing
  • Sudden, severe pain
  • Loss of consciousness
  • Symptoms that are rapidly worsening or are severe

Remember, while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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10 mo ago

People Also Ask


What are the common symptoms of a rheumatoid arthritis flare-up?

Common symptoms of a rheumatoid arthritis flare-up include joint pain, swelling, stiffness, and fatigue. Some people may also experience muscle pain and weakness, as well as general malaise.


How is fibromyalgia diagnosed and treated?

Fibromyalgia is diagnosed based on a history of widespread pain lasting more than three months, along with other symptoms such as fatigue, sleep disturbances, and cognitive difficulties. Treatment typically involves a combination of medication, exercise, stress management, and lifestyle changes.


What are the potential causes of muscle spasms and twitching?

Muscle spasms and twitching can be caused by a variety of factors, including dehydration, electrolyte imbalances, stress, fatigue, and certain medical conditions such as fibromyalgia or myopathy. It's important to consult a healthcare professional for an accurate diagnosis.


When should I seek immediate medical attention for muscle weakness?

You should seek immediate medical attention if you experience difficulty breathing or swallowing, sudden severe pain, loss of consciousness, or if your symptoms are rapidly worsening or severe.


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