OpenHealth Q&A

Unexpected Leg Weakness

At 27 years old and weighing 180 pounds, I currently take a regimen of medications that includes 90 mg of Duloxetine, 600 mg of Gabapentin, and 300 mg of Wellbutrin. For the past week, I have not been taking any supplements, though I was previously on a variety including 200 mg of Magnesium Glycinate, 125 mcg of Vitamin D3, a B-Complex, 18 mg of Iron, two daily vitamin gummies, and some D-Ribose (with all but the D-Ribose endorsed by my healthcare provider). My lifestyle includes daily marijuana use and rare alcohol consumption. I've been diagnosed with several mental health conditions, including anxiety, depression, PTSD, autism, ADHD, and OCD. Additionally, I was identified as having familial tremor and myoclonus at the age of 19, and I experience restless leg syndrome. Since childhood, I have been dealing with chronic pain and fatigue, which have progressively worsened. Any physical exertion tends to exacerbate these symptoms the following day, leading to increased pain and exhaustion. Although I used to maintain a high fitness level, exercise has only compounded my issues. On good days, I may find it challenging to remain upright and often have to retreat to bed throughout the day. After several consecutive days of activity, I can become nearly incapacitated. Early in life, I believed my symptoms were rooted in psychological issues; it was only when I acknowledged their physical nature that I began experiencing relief. A physician suggested fibromyalgia as a possible diagnosis, but I’ve also noticed similarities with ME/CFS. Recently, after a brief 15-minute walk with my dog followed by relaxation in a hot tub and a shower, I encountered an alarming bout of persistent cramping in my calves. Despite my expectation of increased fatigue and pain the next day, I instead found myself struggling to walk even ten feet without becoming winded. This experience was markedly different; my knees felt precarious, as if my kneecaps were shifting irregularly. Interestingly, while the cramps in my legs persisted, I noticed a significant reduction in all other chronic pain, reaching its lowest level in recent memory. Over the subsequent week and a half, my condition gradually improved. My pain remained negligible for about two weeks, and I was pleasantly surprised that exertion did not trigger any pain surge the following day. The calf cramping subsided within two or three days and has not returned even after a month. During the period of leg weakness, I found my calves immensely weakened, while my thighs remained unaffected. However, my baseline fatigue has heightened, and I’ve become less resilient to chronic pain after engaging in physical activity, probably due to the contrast with the unusually low pain levels I experienced. I consulted a doctor during this episode, and several tests were performed. An EKG showed no abnormalities, while an x-ray of my lumbar spine revealed a 10-degree scoliosis on the right side and a sacralized L5 vertebra. A subsequent MRI confirmed there were no slipped discs or compressed nerves, and an EMG did not identify any muscle issues, although nerve review results are still pending. All lab results were normal. During a physical examination, my doctor noted hyperreflexia, which is not unusual for me, but this time it was particularly pronounced. Striking my knee prompted an involuntary, shock-like reaction throughout my body, triggering a sequence of muscle responses similar to my myoclonus experiences. Subsequently, my reflexes returned to their usual hyperactive state. While dealing with leg weakness, I also observed a shift in my myoclonus, experiencing clustered spasms that left me momentarily “locked up,” resembling the onset of a myoclonic seizure. Additionally, I suffered from nightly headaches during this period, which alleviated after resting in a dark room for a while.

Answers (1)

4/2/2025, 5:50:52 PM

OpenHealth AI

It sounds like you’ve been navigating a complex array of health challenges, and your recent experience of leg weakness and cramps understandably raises concerns. It's essential to address these symptoms carefully given your medical history and the variety of conditions you’re managing.

Main Points:

1. Leg Weakness & Cramps: Your leg weakness and cramping could be related to various factors, including physical exertion, medication effects, or underlying neurological concerns.
2. Complex Medical Background: Your history with chronic pain, fatigue, myoclonus, and other mental health conditions complicates the picture, making personalized assessment crucial.
3. Immediate Focus on Monitoring & Support: Currently, it’s vital to monitor your symptoms carefully and seek supportive measures to help manage your experience.

Explanation:

Your episodes of leg weakness, especially following physical activity, align with symptoms often seen in conditions like fibromyalgia and potentially ME/CFS, which involve similar exertion intolerance. The episodes of calf cramping and sudden weakness may suggest transient muscle fatigue, possibly exacerbated by the underlying nervous system irregularities you experience with hyperreflexia and myoclonus. Moreover, the disparity between your pain levels and fatigue after exertion might indicate a sensitivity to changes in activity, characteristic of these chronic conditions.

It's reassuring that diagnostic tests have ruled out acute issues (such as compressed nerves or disc problems), but ongoing evaluation may still be necessary considering your symptoms' complexity.

Next Steps:

1. Track Symptoms: Start a symptom diary for a few weeks, noting activities, energy levels, pain, and any episodes of leg weakness or cramping. This will help identify patterns and triggers linked to your symptoms.

2. Activity Modification: Gradually adjust your activity levels. Consider engaging in shorter, gentle stretches or low-intensity routines rather than prolonged exertion. Pay attention to how your body reacts.

3. Hydration & Nutrition: Maintain proper hydration. Ensure you’re getting electrolytes (potassium, magnesium) which can help with cramping. Reintroduce your supplements cautiously, especially those previously endorsed by your healthcare provider, after assessing any interactions with your medications.

4. Relaxation Techniques: Implement consistent relaxation methods such as gentle yoga, stretching, or mindfulness to help manage stress and possibly reduce muscle tension.

5. Follow-Up: Stay in contact with your healthcare provider regarding your ongoing symptoms, especially any significant changes like increased weakness, frequent cramping, or new neurological signs. Discuss the results of your nerve studies when available for further guidance.

6. Support Network: Engage with support groups or forums to connect with others experiencing similar challenges. Sharing experiences and strategies can be encouraging.

If any new symptoms arise, especially significant changes in your neurological functions or unexplained persistent pain, prioritize reaching out for professional advice. Taking these steps can help you navigate your symptoms while prioritizing your overall well-being. Please remember, you're not alone in this and it's perfectly okay to seek support when needed.