Skin Pain and Spasms: A Neurological Perspective

Skin prickling sensation?

Hello Doctor: Last week, Mr.
Zhang suddenly experienced spasms, occurring several times within a minute, with episodes recurring every few minutes.
He reported sensitivity on the right side of his skin, accompanied by a burning and stabbing pain, as well as difficulty urinating.
While walking, he also feels a rubbing and stabbing sensation in his heels.
The symptoms have persisted until today; the frequency of spasms has gradually decreased but has shifted to his right foot, where he sometimes experiences sudden weakness.
He continues to have difficulty urinating, and he feels stabbing pain upon touching his right calf, right thigh, right abdomen, and right side of the ribs (with the stabbing pain in the right leg being particularly intense).
I would like to seek your opinion, thank you!

Zhang, 20~29 year old female. Ask Date: 2023/02/28

Dr. Jiang Junyi reply Neurology

Dear Mr.
Chang,
You mentioned that "the frequency of spasms has gradually decreased, but they have shifted to the right leg, and there are times when I experience sudden weakness; difficulty urinating; and sharp pain upon touching the right calf, right thigh, right abdomen, and right side of the ribs (especially with increased sharp pain in the right leg)." It is advisable to seek medical attention promptly.
There may be a consideration of compression of the thoracic spinal nerves.
Initially, a herniated disc could lead to localized inflammatory responses resulting in lower back pain.
If it is the lumbar spine, it may extend to one or both sides of the buttocks or hips.
If a lumbar disc herniation causes nerve root compression, it can result in neuropathic pain (sciatica), with symptoms often located in the posterior thigh, lateral calf, heel, and even the dorsum of the foot and toes.
It is recommended to visit a neurology or neurosurgery outpatient clinic for examination and treatment.
Thank you for your inquiry.
If you have any related questions, feel free to discuss further!
Wishing you good health, peace, and happiness.
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2023/02/28

More Info

Hello, Zhang. Based on the symptoms you've described, it appears that you may be experiencing a combination of neurological and possibly musculoskeletal issues. The sudden onset of spasms, sensitivity to touch, and pain in specific areas of your body, particularly on the right side, can indicate a few potential underlying conditions.

Neurological Perspective
1. Nerve Irritation or Damage: The symptoms you are experiencing, such as the burning and stabbing pain upon touch, could be indicative of neuropathic pain. This type of pain arises from damage or irritation to the nerves. Conditions such as radiculopathy, where a nerve root is compressed or irritated, could lead to the symptoms you describe. This could be due to a herniated disc or spinal stenosis, which may cause pain radiating down the leg and sensitivity in the skin.

2. Multiple Sclerosis (MS): Given the nature of your symptoms, including spasms and sensitivity, it may be worth considering conditions like multiple sclerosis. MS can cause a variety of neurological symptoms, including muscle spasms, sensory disturbances, and bladder dysfunction. However, this would typically be accompanied by other neurological signs and would require further investigation through MRI and neurological examination.

3. Peripheral Neuropathy: This condition can result from various factors, including diabetes, vitamin deficiencies, or autoimmune diseases. It can cause symptoms like tingling, burning sensations, and pain in the extremities.

Musculoskeletal Issues
1. Muscle Spasms: The spasms you are experiencing could be related to muscle fatigue or strain, especially if you have been engaging in activities that require prolonged standing or walking. Dehydration or electrolyte imbalances can also contribute to muscle cramps and spasms.

2. Referred Pain: Sometimes, pain in one area can be referred from another part of the body. For instance, issues with the lumbar spine can lead to pain and spasms in the legs.

Urinary Symptoms
The difficulty you are experiencing with urination could be related to several factors, including nerve involvement or a urinary tract issue. In some cases, neurological conditions can affect bladder control and function.

Recommendations
1. Seek Neurological Evaluation: Given the complexity of your symptoms, it is crucial to consult a neurologist. They can perform a thorough examination, including neurological tests and possibly imaging studies, to determine the underlying cause of your symptoms.

2. Physical Therapy: If musculoskeletal issues are contributing to your symptoms, physical therapy may help improve muscle strength and flexibility, potentially alleviating some of the pain and spasms.

3. Hydration and Nutrition: Ensure you are adequately hydrated and consider discussing your diet with a healthcare provider. Deficiencies in certain vitamins, particularly B vitamins, can contribute to nerve health.

4. Pain Management: Depending on the diagnosis, your doctor may recommend medications to help manage pain and spasms. This could include anticonvulsants for neuropathic pain or muscle relaxants for spasms.

5. Monitor Symptoms: Keep a detailed record of your symptoms, including when they occur, their intensity, and any potential triggers. This information can be invaluable for your healthcare provider in diagnosing and managing your condition.

In conclusion, while your symptoms are concerning, a comprehensive evaluation by a healthcare professional is essential to determine the exact cause and appropriate treatment. Please prioritize seeking medical attention to address these issues effectively. Wishing you a speedy recovery and relief from your symptoms.

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