Constant twiching under hips

[calvin1]

Hi,

I have constant twitching and spasm in my thigh muscles, especially under my hips. Also, my thigh muscles feel tight. I have Vitamin B12 deficiency. I have taken injections and also take daily oral tablets, but there is relief only after injections, and just after 2 days of taking injection twitching is back.

Also, I look very tired, people keep telling me I look tired even though I mite not be feeling very tired. I have also developed bad dark circles in last 2 years.

Plz suggest what can be the problem?

[suzsibs]

The stress of this could cause be the cause of looking tired, I must admit I have dark circles too!

Get yourself checked out to put your mind at ease.

Suz

[calvin1]

Hi,

I feel sudden contraction and expansion of muscles under my hips...this is not limited to my legs though..I also have same thing on my shoulders and sometimes forearms...

Also, a lot of people tell me I always look tired and I have also developed dark circles in last 2 years which are continously getting worse...

Thanks

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

It must be emphasized that in the majority of cases muscle twitches are benign meaning that they are of no consequence and are not resulting from a serious cause. In such cases, the twitches may be related to anxiety/stress, caffeine, and often occur after recent strenuous activity or muscle over-use. It is important in such cases to reduce stress/anxiety levels and to reduce caffeine intake. Tremors of the hands can be physiological that is exacerbated by stress/anxiety and caffeine.

Benign fasciculation syndrome (BFS) is a condition in which there are involuntary twitches of various muscle groups, most commonly the legs but also the face, arms, eyes, and tongue. If the diagnosis is confirmed and other causes are excluded, it can be safely said that the likelihood of progression or occurrence of a serious neurologic condition is low.

When BFS is present but not particularly bothersome or disabling, treatment is not necessary. If severe and it requires treatment, there are a few medication options though this condition is not very common, and the research that has been done on its treatment is limited. Minimizing caffeine and stress, and treating anxiety if it is present, will improve your symptoms.

However in general (and please understand I am not trying to imply I feel this is the case in you), when fasciculations occur in the setting of associated symptoms such as progressive loss of sensation, tingling or numbness, weakness, trouble swallowing and other symptoms, the cause may be due to a peripheral nervous system problem. In general the symptoms would not be episodic and triggered by certain things but would be more constant/frequent without consistent triggers. The location of the problem could be the anterior horn cells, the area where the nerves that supply motor innervation to our body comes from. These are the cells that give off the nerves that allow us to voluntarily contract our muscles. The diseases that might affect the anterior horn cells include ALS (also called Lou Gherig's disease), a condition called spinal muscular atrophy, polio-like viruses, west nile virus, and other infections.

Another nervous system problem, neuropathy, may also lead to fasciculations. There will again be associated weakness or sensory changes.  This may be related to your B12 deficiency. How low was your B12? Did you have additional neurological findings to the B12 value?


Lastly, often these symptoms may reflect emotional/psychiatric problems related to stress (what is called somatization disorder). The latter is a true medical condition whereby instead of a patient experiencing depression or anxiety, they experience physical symptoms, and once the stress is addressed, the symptoms resolve.

I suggest that you follow up with your primary doctor. You may benefit from evaluation by a neurologist as your primary doctor feels fit, especially given the B12 deficiency. It is important that you discuss your concerns with him/her. You may need additional basic lab work to ensure your blood chemistry, particularly your potassium, sodium, and calcium, are normal. Further workup such as EEG, EMG/NCS, or MRI would have to be decided upon by your neurologist depending on the clinical examination and historical findings.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[suzsibs]

Hi
These twitches sound like muscle fascilations, do they feel like something moving around under your skin?
It could be myoclonus but this is more of a jerk or spasm.
I do know that vitamin B12 deficiency can cause myoclonus.
Seek an opinion from your neurologist if you have one, if not make an appointment.
I hope this is useful info for you.
Feel better
Suz