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Anyone know what diagnosis for continuous muscle contractions? Met a patient without diagnosis.

Discussion in 'Skeleton, Skin, Muscles, Hair, Teeth, and Nails' started by waiting, Apr 8, 2015.

  1. waiting

    waiting Senior Member

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    I met a patient who has been ill for a few years now, and is on disability unable to work, but still has no diagnosis. I was wondering if anyone here perhaps has an idea what this could be?

    Primary problem is continuous muscle contractions, knots in muscles, muscle cramps (particularly after exercise).

    There is also fatigue.

    They have suffered from anxiety for 12 years, which preceded this more recent muscle problem.

    They have tested positive for Rheumatoid Factor once, but on a subsequent test, this was negative. Their doctor is holding off referring to a rheumatologist for now.

    They have elevated leukocytes.

    "Chronic fatigue syndrome" and fibromyalgia have been mentioned, but not diagnosed.

    Acupuncture, massage therapy, supplements have not helped to date.
     
    oceiv likes this.
  2. PennyIA

    PennyIA Senior Member

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    Have they tried muscle relaxants? I had these subcutaneous lumps forming that they wondered was due to knots in the muscles, the relaxants didn't prevent/solve the lumps issue - but once I started the relaxants I found out how tight my muscles had been and I can feel them tighten up immediately before my next dose is due.
     
    oceiv likes this.
  3. waiting

    waiting Senior Member

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    Thanks for the suggestion, @PennyIA. I think they said they were offered Anaprox, but were reluctant to start on it and then end up on it long term, while still not knowing the cause.
     
  4. Kati

    Kati Patient in training

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    Could it be a form of dystonia perhaps?
     
    oceiv likes this.
  5. waiting

    waiting Senior Member

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    Thanks @Kati, I'll pass that on.
     
    oceiv likes this.
  6. WillowJ

    WillowJ คภภเє ɠรค๓թєl

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    There are other diseases in the world--and even in rheumatology--in addition to RA?! I do not know why the doc would wait on a referral, if the GP/PCP does not know what it is.
     
    PennyIA likes this.
  7. adreno

    adreno PR activist

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    Stiff person syndrome?
     
    Sidereal likes this.
  8. waiting

    waiting Senior Member

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    Yes, I was surprised as well. I told them that from what I have read, in autoimmune disease (maybe a lot of diseases), it can take several years for the DX to become apparent ... show up on various tests, fulfill criteria, etc.

    Still, I agree the relevant specialist should be the one following the person.
     
    WillowJ likes this.
  9. waiting

    waiting Senior Member

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    Thanks, @adreno -- I'll pass that along, too. The Johns Hopkins site lists dystonia as a differential for SPS (stiff person syndrome).

    Both Dx's have cautions about exercise so even that alone would be a key reason to get a DX as early as possible.

    What a group of astute diagnosticians we have here on PR! I knew this would be the place to ask this.
     
    adreno likes this.
  10. ukxmrv

    ukxmrv Senior Member

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  11. waiting

    waiting Senior Member

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    Valentijn and ukxmrv like this.
  12. troi

    troi

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    Try a good, very good, physical therapist or body worker. I get knots that are chronic but trigger point releases help a lot, especially in the short term. They restrict normal movement most of the time and interfere with stretching since they don't "give" so something else does.
     

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