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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31274
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Customer Question

I have a back tingling that awakens me. It moves (I think depending of muscles I have used including sitting in front of a computer. I have tried everything, checked medicine, nuero-muscular therapy, chiropractic therapy, physical therapy, massage, acupuncture. I sleep 3-5 hours maximum. Five hours is very unusual usually three and a half. Last night after five hours my back was tingly from shoulders to about sacrum. My chest and abdomen was tingly. It woke me up and I had to get up and move to get rid of sensation. Happens only when in bed for a while. Sometimes a little tingly even when I take a ten minute nap to make up for loss of sleep. After six years of actively trying to figure out with internist I am very discouraged. They say I don't have MS or fibromyalgia. I am active and force myself to do yoga, walking, hiking, zumba just to move body. It is worse at night when I sit or am in car for long time. I have checked medicines, I am afraid of sleeping pills and addiction however this last month I have been taking Xanax. Some times better sleep but always some form of tingly sensation. Last night I took Sleep Aid instead with benedryl ingredient that makes me sleepy. Slept five hours but worse tingly sensation ever. Does not hurt but distracting. Feels like muscle stimulator that they used at Chiropractic office before adjusting my back. If i had a full time job I would not be able to get through the day. Any ideas?
Submitted: 4 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 4 years ago.
Greetings Kathy.

What did your nerve conduction velocity study and MRI of the back show?

Dr. Arun
Customer: replied 4 years ago.
Sorry for the delay in my response. My 91 yr old mom needed my assistance.
I have not had a nerve conduction velocity study nor MRI. They ruled out MS and fibromyalgia because the symptoms did not match. The sensations were not bad enough that the MD did not request any other tests. I have been working with the nurse practicioner to rule out meds, hormones, stress. I talke crestor and estrogen/ progesterone and vitamins. Also therapy. Now because I have tried so many therapies and it still continues to occur (it is less with the therapy) and last night was stronger and the area was my entire back I am thinking something else should be investigated. I have not talked to my MD and wanted to investigate on-line to bring info to him. I do not have any sharp pains. The feeling now during the day is as if I have worked out and my muscles are saying I over did the workout. (This is a new sensation) Usually I do not have the ache and stiffness once I wake up and move around. It's the feeling one would get if they hiked 10 miles up a mountain without regular hiking and the feeling the thighs would have afterward because they were not used to the exercise and full of lactic acid etc.. Tightness. This is a new sensation. Could it be my muscles were stimulated so that they are fatigued. The tingling only happens when I have been lying down for a while. There seems like a four hour window and then it is strong enough and wakes me up. I will try to answer as soon as I am able. If I do not get back to you today is that okay? In 13/4 hours I have an appointment, sort of acupunture. Also tomorrow I have a nueromuscular appointment where she give sme deep and sometimes very painful massage. That has been the most successful for relief. I live in a remote town with an incredible MD and assoc. but for specialized testing, which I will do, I must travel 2-5 hours.

Thank you for your patience.
Expert:  Dr. Arun Phophalia replied 4 years ago.
Hello Kathy,

Your symptoms are suggestive of neuropathy. Following are the causes of neuropathy (many times cause is not known);

1) Diabetes
2) An underactive thyroid gland
3) Excessive use of alcohol
4) Thiamine deficiency
5) Vitamin B 12 deficiency (pernicious anemia)
6) Vitamin B 6 (pyridoxine) taken in excessive amounts
7) Drugs, medications, herbs
8) Autoimmune diseases
9) Heavy metals such as lead and mercury.

Following investigations are done;

1) Electromyography/nerve conduction studies (EMG/NCS)

2) MRI of the spine and brain

3) blood glucose and glycosylated hemoglobin

4) serum B12 level with methylmalonic acid (with or without homocysteine),

5) serum protein electrophoresis

6) Anti-nuclear antibody

7) Lyme testing

8) Rheumatoid factor

9) Sjogren's syndrome testing (Anti-Ro, Anti-La Antibodies)

This should give the diagnosis and guidelines for the management.

Supplements and alternative integrative therapy protocols are;

1) Evening primrose oil
2) Acetyl-l-carnitine
3) Alpha-lipoic acid
4) Benfotiamine (Milgamma), 100 mg, is a lipid-soluble vitamin B1 analogue
5) Vitamin E

Your physician may consider to start Gabapentin or Pregabalin, if symptoms are significant and persistent. You may continue with acupuncture, acupressure and deep massage.

Please take your time to reply.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.


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