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Dr. David
Dr. David, Doctor
Category: Health
Satisfied Customers: 999
Experience:  Ten years practicing as a licensed family physician.
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Intermittent Morning Muscle Weakness - Please Help!

Customer Question

BACKGROUND AND FREQUENCY: I am a male, in my mid 30s. For the most part, I am healthy, with no major diseases. I do have seasonal allergies to treen pollen (Alder).  I am probably 25-30 pounds over the weight I'd like, but I'm not in any physical problems (i.e. huffing and puffing walking uphill).  For the past year and a half or so, the symptoms first started occuring every 4-5 months. Recently, it seems to be happening every 2-3 months.  On days that I go to work, I sleep about 5.5 to 6 hours (usually 5 days a week -8 hour shift, but for the past few months, 4 days a week -10 hour shift). I work sitting in front of the computer daily. On days I don't go to work, I can sleep anywhere between 8-10 hours. Having said that, it appears to resolve around sleeping. My family has no history of muscle issues or narcolepsy. I have no major diseases and do not regularly take medication, except for seasonal allergy medication (around this time).


 


SYMPTOMS: When I wake up in the morning (and it can be 1-2 hours before I normally wake up, or around the time I usually wake up), my legs, arms and stomach muscles become very weak. If while sleeping, if I attempt to raise my arm straight up, I feel as if my muscles and tendons are very weak and painful, especially if I extend and retract my arm. I can feel my shoulder muscles being very sore too.  If I lift my leg (as in sitting down and lifting my legs to put socks on), the muscle pain on my front upper side of that leg is so accute that I can't. I have to lift my leg up with one hand and cross it over my other leg in order to even put socks on. If I try to squeeze my fingers, my finger muscles feel like they are at maybe 20-30% capacity only. When I am in bed, turning/tossing around, such as turning from facing the ceiling to sideways, is extremely painful on my stomach muscles.  It feels like I did 10,000 situps the day before and today I'm paying for it. In fact, it takes half dozen tries just to do something that simple!!! For example, I might wake up maybe 1-2 hours before I would normally wake up, and notice these symptoms. I then realize I need to go release myself (urinate) but it's so hard and painful to move; I'd struggle to even get to the side of the bed. When I do get to the side of the bed, I have to pretty much mimic movements like a toddler where I face down on the bed, stick my legs out and then let my legs drop off the side of the bed. When my feet hit the ground, I rest for maybe 30 seconds and then, as if trying to carry 100 pounds, force myself up very hard to even stand up. If I attempt to get up from bed unto my feet, I feel weakness in my legs. I can walk around, but I know something's different. Weird thing is once I do stand up, I can move around. But, just the act of trying to get up is to hard. When I sit down, if I lift my legs up (like kicking the air), it's very painful on the muscles on the front of my legs.


 


Here's the kicker: if I do NOTHING and go back to bed, or simply force myself to go to work, the symptoms grandually go away. After 3-5 hours, there's absolutely no trace that I just had those symptoms. The best way I can describe it is it feels like I've been excercising hard core for like 3 days straight. My muscles feel that weak and painful!


 


CAUSES: I've noticed these symptoms occur without any triggers I am aware of. For example, one time it occured the morning after I was excercising. But most of the times though, I haven't done anything, and I mean ANYTHING strenuous the day/night before! The only thing I've been able to tie them to is when I sleep. Usually it happens like 4-5 hours into my sleep, right as I am about to wake up. One evening last week, I fell asleep early, and slept for maybe 2 hours. When I woke up, I noticed mild symptoms. That is the first time I've experienced it in the evenings. It's always been in the mornings. I do not recall any dreams that were disturbing either. I will be going to my doctor, but I wanted to get some feedback from the medical community before I go. Also, I prefer to go to the doctor when the symptoms ARE occuring so he can at least do some tests. Otherwise, 6 hours later, there will be absolutely no symptoms left. Also, when the symptoms are full blown, my neck muscles are fine. I can move my head up, down, left, right, and I feel no pain. I am able talk fine and can swallow fine.


 


My wife is 4 months pregnant.  I'm afraid that one of these mornings, I will need to get up and help her, or pick up my baby, and I won't be able to.  One morning, I had to wake up my wife, and asked her to help me sit up on the bed, so I could get up and go to work.


 


Does anyone know what this is? Could I just be so tense at night sometimes that it triggers my body to do this? Is there some waste byproduct that my kidney isn't filtering out (somehow at night only) that's causing my muslces to be weak? Please provide me links with evidence on these type of issues if someone comes across. I understand someone will always be first at something and it is possible that I am the first person to experience these symptoms.

Submitted: 2 years ago.
Category: Health
Expert:  Dr. David replied 2 years ago.

Dr. David :

Hello, I would like to help you with your question about the symptoms of muscle weakness that you have been experiencing. It is important for you to visit your doctor for an examination, and I'm glad that you are planning a visit. You are not the first person to get these kinds of symptoms. From your description, it sounds like you may be showing early signs of a neurological condition called multiple sclerosis. Here are some links that describe the condition and the symptoms: http://www.webmd.com/multiple-sclerosis/guide/recognizing-multiple-sclerosis http://www.mayoclinic.com/health/multiple-sclerosis/DS00188/DSECTION=symptoms http://www.multiplesclerosisinformation.co.uk/#/early-signs/4534171305 http://www.patient.co.uk/health/Multiple-Sclerosis.htm Of course, there are other possibilities besides multiple sclerosis, but this is certainly a possibility that needs to be ruled out. Please let me know if you have some questions about this. Dr. David

Dr. David :

I hope that this information is helpful for you. Please let me know if you have any additional questions and I will send the answers as soon as possible. If not, please hit the Accept button so that I can receive credit for my work.

Customer :

Hello Dr. David. Thank you for responding, but I've already looked up multiple sclerosis, and I did so again, extensively after reading your response. I highly doubt I have MS since nothing else about the disease matches my symptoms except that I am in the 20-40 year old range. It seems more similar to fibromyalgia, although, I do not meet the requirements as listed by the U.S. National Library of Medicine, where it states:

Customer :

To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 areas, including

  • Arms (elbows)

  • Buttocks

  • Chest

  • Knees

  • Lower back

  • Neck

  • Rib cage

  • Shoulders

  • Thighs

Blood and urine tests are usually normal. However, tests may be done to rule out other conditions that may have similar symptoms.

Customer :

What I will do going forward is keep a diary of what I eat, and see if there's a link between when this happens and what I ate the day before. My wife and I cook heathy homemade, lowfat food, and we rarely eat fast food, so I doubt it's anything horrible we are eating. Thank you for your response and let me know what else you might think of. I seriously wonder if it's something related to the way I position myself when I sleep, low oxygen levels in my bloodstream, lactid acid buildup at night (possibly due to the liver not working properly), etc. I will go in for a test with my doctor to find out.

Dr. David :

Hi. Thank you for the additional information. There are two other similarities between the symptoms that you are experiencing and the symptoms of MS that you may have overlooked. You report that you experience both muscle weakness and muscle pain. Muscle pain is another symptom of MS. The most prominent feature of your symptoms that make them seem like symptoms of MS is that they are intermittent. The symptoms are severe one minute and then a few hours later they are completely gone. This is an important symptom feature in MS. People in the early stage of MS have severe symptoms which go away completely and then return later. Your symptoms do not sound like symptoms of fibromyalgia to me. Fibromyalgia symptoms are not intermittent the way that MS symptoms are intermittent. Also they do not sound like a reaction to food, improper sleeping position, or low oxygen levels. They sound like the symptoms of a neurological condition and specifically MS, but that is only my opinion. Of course, you will need to get a physical examination and some testing in order to find out for sure what is going on. I truly hope that I am mistaken and that you do not have MS. Please keep in touch and let me know what you find out from your doctor. I would be happy to offer you a second opinion an any treatment strategy that your doctor may present to you.

Customer :

Hi Dr. David.

Customer :

Thanks for the response again. I have been busy. The muscle pain I'm describing is very similar to if you've been excercising a long time and your muscles are sore. I guess that's what I meant. The muscles are sore, and stiff. There are no involuntary contractions. Just weakness and soreness. It almost feels like my tendons are sore, more so than my muscles. I will let you know what I find out. Thank you again.

Dr. David :

OK, take care.

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