[41F] Experiencing muscle weakness, stiffness, pain, and tremors

Patient Description

A 41-year-old female presents with a 1-2 week history of muscle weakness, stiffness, and pain, predominantly affecting the lower half of the body, with a severity rated at 5/10. The symptoms worsen in the evening and with movement, particularly when walking on hard surfaces. She also reports an unsteady gait and balance issues, which began 3 days ago, and slight tremors in the right hand that have been present for 4 days, worsening with increased muscle use. The patient experiences a sensation of internal shaking that started 2 days ago. Additionally, she notes slow eye movements but no numbness, tingling, or changes in bowel or bladder function. She has been diagnosed with ADD 15 years ago and is currently on Adderall XR 30mg daily for management. No other medications, allergies, or family history of neurological disorders are reported.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Parkinson's disease: This is a progressive nervous system disorder that affects movement. Symptoms start gradually, sometimes with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowing of movement.

    • Treatment usually involves medications to manage symptoms.
  • Multiple sclerosis (MS): This is a potentially disabling disease of the brain and spinal cord (central nervous system). In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Symptoms can vary widely and include tremors, unsteady gait, and muscle stiffness.

    • Treatment typically involves managing symptoms and slowing the progression of the disease with medication.
  • Peripheral neuropathy: This results from damage to your peripheral nerves, which often causes weakness, numbness and pain, usually in your hands and feet, but it may also affect other areas of your body.

    • Treatment usually involves managing symptoms and addressing the underlying cause.

Please note that these are possibilities based on the symptoms you've reported, and they may not be the actual cause of your symptoms. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your primary care doctor. They can perform a physical examination and potentially refer you to a neurologist for further evaluation.
  2. Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for your appointment.
  3. Write down key personal information, including any major stresses or recent life changes.
  4. Make a list of all medications, vitamins or supplements that you're taking.

What you should look out for

Seek immediate medical attention if you:

  • Have sudden, severe weakness or paralysis that affects one side of your body that could indicate a stroke.
  • Experience new or increasing difficulties with coordination and balance.
  • Have changes in mental function, such as confusion or memory loss.
  • Experience changes in sensation, such as persistent or progressive numbness or tingling, or loss of sensation.
  • Notice changes in your ability to control your muscles, such as difficulty swallowing, speaking or breathing.

Please remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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9 mo ago


People Also Ask


What are the common symptoms of Parkinson's disease?

Common symptoms of Parkinson's disease include tremors, muscle stiffness, slowness of movement, and balance problems. Symptoms often start gradually and may begin with a slight tremor in one hand.


How is multiple sclerosis diagnosed?

Multiple sclerosis is diagnosed through a combination of medical history, neurological exams, MRI scans, and sometimes a spinal tap. These tests help identify lesions or damage in the central nervous system.


What causes peripheral neuropathy and how is it treated?

Peripheral neuropathy can be caused by diabetes, infections, traumatic injuries, and exposure to toxins. Treatment focuses on managing symptoms and addressing the underlying cause, which may include medications, physical therapy, and lifestyle changes.


Can Adderall XR cause muscle weakness or tremors?

Adderall XR, a medication used to treat ADD, can sometimes cause side effects such as muscle weakness or tremors, although these are not common. It's important to discuss any new symptoms with a healthcare provider.

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