[43F] Experiencing severe vertigo and leg heaviness

Patient Description

A 43-year-old female presents with a 6-month history of constant heavy legs, muscle tension in the legs and buttocks, and severe vertigo. The heaviness in the legs is described as constant, affecting the buttocks, thighs, and calves, and it significantly limits her ability to walk. The patient rates the leg pain as an 8 out of 10, with intermittent pain in the calves and shins, and constant pain on the outer thigh. Vertigo occurs with slight movements and even while breathing, rated closer to severe, and sometimes relieved by adjusting the back or propping the head. Additionally, the patient reports a hyper flexed motion in the buttocks when shifting weight side to side for the past 5 months, and a tight sensation with difficulty flexing the foot, suggesting slight atrophy for the past 4 months. The patient also experiences whole body tension, particularly tight and stiff shoulders and back, rated an 8 out of 10 in severity. Lower lumbar pain and tingling are present, with no sudden loss of bowel or bladder control. The patient has a blurry vision at times but no severe headaches or acute vision loss. Past medical history includes a chronic cough diagnosed 3 years ago and high blood pressure diagnosed 8 years ago. The patient has been on Suboxone for 7 years at a dosage of 16 mg per day and reports no allergies or adverse reactions to medications. No other medications, vitamins, or supplements are being taken. There is no family history of neurological diseases, and the patient denies any use of alcohol, tobacco, or recreational drugs.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Peripheral Neuropathy: This condition results from damage to the 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 of heaviness in the legs, pain and pins and needles sensation in the foot, and muscle tension could be related to this condition.

    • Diagnostic tests for peripheral neuropathy often involve neurological examinations, nerve function tests, blood tests, and in some cases, nerve biopsy.
    • Treatment typically involves managing the condition causing your neuropathy, relieving symptoms, and improving physical function.
  • Vertigo: Vertigo is a sensation of feeling off balance and is typically caused by problems in the inner ear or brain. It can be associated with a feeling of motion when you're not moving, which you have described.

    • Diagnosis usually involves a series of tests, including balance tests and imaging studies such as a CT or MRI.
    • Treatment of vertigo depends on the cause and severity of the symptoms. It can include medications, physical therapy maneuvers, and in some cases, surgery.
  • Musculoskeletal issues: Your symptoms of muscle tension, hyper flexed motion in your buttocks, and lower lumbar pain could be related to issues with your muscles, ligaments, tendons, and bones. Conditions such as sciatica, lumbar disc disease, or muscle strain could be possible.

    • Diagnosis often involves physical examination, imaging studies like X-rays or MRI, and sometimes electromyography to evaluate the health of muscles and the nerve cells that control them.
    • Treatment can include physical therapy, pain relievers, and in some cases, surgery.

Please note that these are just possibilities and not a definitive diagnosis.

What you can do

It's important to seek medical attention for your symptoms. A healthcare provider can perform a thorough evaluation and order appropriate tests to determine the cause of your symptoms.

In the meantime, here are some general suggestions:

  1. Try to maintain a healthy lifestyle. Regular exercise, a balanced diet, and adequate sleep can help improve your overall health and may help alleviate some of your symptoms.
  2. Over-the-counter pain relievers may help with your muscle tension and leg pain. However, it's important to use these medications as directed and not exceed the recommended dose.
  3. For your vertigo, try to avoid sudden changes in position or rapid movements which might worsen your symptoms.

What you should look out for

You should seek immediate medical attention if you experience:

  • Sudden, severe pain in your legs
  • Sudden worsening of your vertigo
  • Difficulty walking or moving your legs
  • Loss of sensation in your legs or feet
  • Loss of bladder or bowel control

Please remember, this advice is intended to be general in nature, and specific causes may need different management. Always consult with a healthcare provider for appropriate examination, diagnosis, and treatment.

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10 mo ago

People Also Ask


What are the common causes of peripheral neuropathy?

Peripheral neuropathy can be caused by diabetes, infections, traumatic injuries, metabolic problems, inherited causes, and exposure to toxins. It can also be a side effect of certain medications.


How is vertigo typically diagnosed and treated?

Vertigo is usually diagnosed through a combination of medical history, physical examination, and tests such as balance tests, hearing tests, and imaging studies like CT or MRI. Treatment depends on the underlying cause and may include medications, physical therapy, or surgery.


What are the symptoms and treatment options for musculoskeletal issues like sciatica or lumbar disc disease?

Symptoms of musculoskeletal issues like sciatica or lumbar disc disease include pain, numbness, and tingling in the lower back and legs. Treatment options may include physical therapy, pain relievers, lifestyle modifications, and in some cases, surgery.


What lifestyle changes can help manage symptoms of muscle tension and leg pain?

Maintaining a healthy lifestyle with regular exercise, a balanced diet, and adequate sleep can help manage symptoms. Over-the-counter pain relievers may also be used, but it's important to follow the recommended dosage and consult with a healthcare provider.


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