Muscle Issues: Insights from Neurology for Better Health

Q: Muscle Issues: Insights from Neurology for Better Health

Hello, Sir： Your concern about ALS primarily refers to issues with motor neurons. <br>Motor neurons control muscle movement; generally, the motor neurons in the brain are referred to as upper motor neurons, while those in the brainstem and spinal cord are called lower motor neuro

Muscle issues?

Hello Doctor, I am the person who previously inquired about muscle twitching issues.
Recently, before my graduation, I visited a physician and mentioned the strange sensation in the muscles on the back of my right hand (which feels odd when I use my arm).
I also mentioned my long-term shoulder imbalance from computer use.
The doctor believes it is a problem caused by my posture over time.
Now I have noticed some issues with my left back as well (occasionally experiencing back pain), and I feel that using my left hand to lift drinks feels heavier than before (not that I can't lift them, but the weight feels lighter in the past).
Today, while eating lunch, I felt that holding my lunch with my left hand was also heavy.
During this period, I sometimes feel fatigued while speaking or have strange sensations while swallowing, but these feelings disappear after a while.
The size of my muscles seems to be the same as before; I observe them daily and take photos periodically.
However, I have noticed that the sole of my left foot often experiences intermittent twitching, mostly very subtle, and I can't see it with my eyes.
When I touch a specific muscle nearby, it feels painful; it’s a muscle on the side of the arch of my foot.
Once, I showed it to another doctor, who advised me to change my shoes.
I previously thought it was an illusion, but it turns out that the twitching does happen from time to time.
The twitching has become more noticeable in the mornings, usually when I wake up feeling half-asleep, I can feel slight twitches in various areas.
One morning, I was quite frightened by the twitching in my right side.
Additionally, the previous doctor mentioned that my right hand tendons are very tight.
I have considered returning to the hospital for a check-up several times, but since I had an electromyography (EMG) and nerve conduction study done less than two months ago, it seems that any condition might not show up.
Before leaving, the doctor provided some reassurance, but I still have those anxious thoughts.
I worry excessively about developing amyotrophic lateral sclerosis (ALS), which seems reasonable to me, and I find myself searching for information online, which only increases my fear.
Even if I don't have any symptoms, I unconsciously remember them and am very afraid of developing them.
I came here to ask you again.
Thank you for your response, Doctor.

Xin Xian Ren, 20~29 year old female. Ask Date: 2021/07/02

Dr. Jiang Junyi reply Neurology

Hello, Sir: Your concern about ALS primarily refers to issues with motor neurons.
Motor neurons control muscle movement; generally, the motor neurons in the brain are referred to as upper motor neurons, while those in the brainstem and spinal cord are called lower motor neurons.
When motor neurons become damaged, our muscles do not receive adequate nutrients and chemicals, which can lead to muscle death.
This is a chronic muscle-wasting disease that may cause muscle atrophy.
If upper motor neurons die, abnormal signal transmission may cause muscle twitching.
However, clinical diagnosis requires methods such as electromyography and muscle biopsy, among others.

You mentioned muscle twitching during sleep; several factors may contribute to this:
1.
Sleep deprivation may cause the body to enter REM sleep prematurely.
This can occur when you are overly fatigued or have irregular sleep patterns, as your brain enters the sleep cycle while your body has not yet caught up.

2.
Excessive stress can prevent the body from relaxing when falling asleep.
People often endure stress and fatigue, which may lead to involuntary muscle twitches during sleep, occurring during naps or nighttime rest.

3.
Calcium deficiency can also lead to twitching upon falling asleep.
For instance, some growing children may experience sudden twitches due to a lack of calcium.

4.
Iron deficiency may cause restless leg syndrome, leading to twitching during sleep.
If symptoms persist, it is advisable to consult a neurologist for further evaluation (peripheral neurologists are more familiar with these conditions) and to implement self-protection measures, including cleanliness and disinfection, as well as adhering to new health protocols.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and peace.
Dr.
Jiang Junyi, Taoyuan Medical Center, cares for you.

Reply Date: 2021/07/02

More Info

Understanding muscle issues, especially in the context of neurology, can be quite complex and often requires a multi-faceted approach. Your concerns about muscle twitching, perceived weakness, and discomfort in your arms and legs are valid and deserve careful consideration.
Firstly, it’s important to recognize that muscle twitching, or fasciculations, can be caused by a variety of factors. These can range from benign conditions, such as muscle fatigue or stress, to more serious neurological disorders. In your case, the twitching in your left foot and the sensation of heaviness in your left arm could be related to muscle fatigue or overuse, especially if you have been using your computer for extended periods with poor posture. Prolonged poor posture can lead to muscle imbalances, resulting in discomfort and a feeling of heaviness in the affected limbs.

The fact that you have noticed changes in how heavy objects feel when using your left hand could also indicate a change in muscle strength or endurance. This can happen due to disuse or compensatory patterns that develop over time. If one side of your body is compensating for the other, it can lead to feelings of weakness or heaviness in the muscles that are overworked.

Regarding your concerns about swallowing difficulties and fatigue while speaking, these symptoms can sometimes be associated with muscle weakness or neuromuscular conditions. However, they can also be related to anxiety or stress, especially if you are preoccupied with the fear of developing a serious condition like amyotrophic lateral sclerosis (ALS). It’s crucial to address these concerns with a healthcare professional who can provide reassurance and appropriate evaluations.

The intermittent twitching in your foot, particularly if it is localized and not accompanied by other significant symptoms, may not be a cause for alarm. However, if it persists or worsens, it would be wise to consult a neurologist for further evaluation. They may recommend an electromyography (EMG) test to assess the electrical activity of your muscles and the health of the nerves that control them.

In terms of management, here are some strategies that may help improve your muscle function and overall well-being:
1. Posture Correction: Since you mentioned that poor posture may be contributing to your symptoms, consider ergonomic adjustments to your workspace. Ensure that your computer screen is at eye level and that your chair supports your back properly. Regular breaks to stretch and change positions can also help alleviate muscle tension.

2. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can design a personalized exercise program that focuses on strengthening weak muscles, improving flexibility, and correcting posture. This can help reduce discomfort and improve overall muscle function.

3. Stress Management: Since anxiety can exacerbate muscle tension and discomfort, incorporating stress-reducing techniques such as mindfulness, meditation, or yoga may be helpful. These practices can promote relaxation and improve your overall sense of well-being.

4. Regular Exercise: Incorporating regular physical activity into your routine can help maintain muscle strength and endurance. Focus on a balanced program that includes strength training, cardiovascular exercise, and flexibility work.

5. Nutrition: Ensure that you are consuming a balanced diet rich in essential nutrients that support muscle health, including adequate protein, vitamins, and minerals.

6. Follow-Up with Healthcare Providers: Continue to communicate your symptoms with your healthcare providers. If you feel that your concerns are not being addressed, consider seeking a second opinion or asking for a referral to a specialist in neuromuscular disorders.

In conclusion, while your symptoms may be concerning, many factors can contribute to muscle discomfort and perceived weakness. A thorough evaluation by a healthcare professional, combined with appropriate lifestyle modifications, can help you manage your symptoms effectively. Remember to prioritize your mental health as well, as anxiety can significantly impact your physical well-being.

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