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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Oncology
Satisfied Customers: 11176
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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Over the past month I have been having some issues with my

Customer Question

Hello! Over the past month I have been having some issues with my shoulder and left arm. It started with my thumb which when bent would involuntarily shake periodically. Then my arm would become tense and the muscles especially my hand had a sore feeling (but not sore to touch). Since then, my shoulder blade which aches and would hurt for over a month has not been so bad. However, it started again when my thumb started shaking the night before last. Yesterday, I decided to start doing kettlebell exercised again a nd today my shoulders are sore but my left shoulder blade area/muscles are extremely sore and hurt a bit to move. Additionally, tonight I had some buzzing/odd feeling for a couple minutes in my ring and pinky fingers. I have had x rays of my cervical and thoracic spine, cat scan of neck with contrast, cat scan of brain, x Ray of shoulder blade, breast ultrasound and chest x Ray,...all were normal. This went away for about a week but came back when my thumb started doing that again. I'm also worried because once this went away, my leg on the left side started feeing odd to walk on, as if it took more effort and sometimes uncomfortable to walk on my ankle (this went on for 4-5 days. Yesterday I used the exercise bike for the first time in awhile and when I got off my thigh muscle in my left leg was extremely stiff/sore, more so than my other muscles and took longer to settle down. Anyway, I want to note that I do worry A LOT about health related stuff so while I want to say this could be all stress/anxiety I know the pain in my shoulder blade on the left side of my back isn't as well as some of my other issues. I can walk fine. However, the other day in Macy's it was harder for me to walk around because my ankle/thigh felt uncomfortable (left side). Anyway, I am hoping I don't have some kind of horrible spine cancer or ALS or something. Thanks!
Submitted: 1 year ago.
Category: Oncology
Expert:  khagihara replied 1 year ago.

You could have multiple sclerosis. You should see a neurologist.

Customer: replied 1 year ago.
Thanks! Now I'm really worried. I am worried that I have ALS. I don't know why my shoulder would continue to hurt/muscles near the shoulder blade despite all these tests and my thumb shaking at times.
Customer: replied 1 year ago.
My leg has also been weird but that comes and goes. I was to a neurologist a couple years ago and all was fine.
Customer: replied 1 year ago.
I have no atrophy in my muscles
Customer: replied 1 year ago.
I have been prescribed baclofen for the past month and recently neurontin but I haven't taken the neurontin yet.
Customer: replied 1 year ago.
I have seen a rheumatologist and they think my shoulder is purely muscular. I should also say that I worry a lot about health stuff and have anxiety about health.
Expert:  Dr. Rick, MD replied 1 year ago.

Hi. My name is***** and I am online and available to help you today. Thank you for your patience.

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Customer: replied 1 year ago.
I have spoken to you before. Just concerned about periodic shaking I have in my thumb which leads to muscle tension in my arm (left side) and ultimately shoulder pain. I had shoulder pain for about a month and then recently my leg started feeling harder to walk with (not heavier) just uncomfortable. When I worked out the other day I had way more soreness/tension in my left thigh and left shoulder blade than I did on the other side. My left thumb shakes from time to time when bent. I spoke to you and had said I was worried about possible tumors in my spinal cord or ALS. I have had a neck cat scan with contrast, breast ultrasound, chest x Ray, x Ray of shoulder blade as well.
Expert:  Dr. Rick, MD replied 1 year ago.

Good Morning and happy almost-new year.

Given what you have posted here today and our previous conversation I very, very, very much doubt you are suffering from ALS or any other horrible condition like a tumor etc.

You most likely have myokymia:

The most likely cause of your symptoms is called myokymia. Myokymia is an involuntary, local twitching of a few muscle fibers in the body of a muscle. This twitching, if it occurs in a limb, is not strong enough to actually move a joint but can be felt and sometimes seen as an area of quivering.

Myokymia commonly involves the eyelids and muscles around the orbit although it can affect any muscles in the body. It often appears and resolves for no apparent reason and has not been linked to any underlying significant pathology. What causes myokymia? Studies have shown that it is associated with anxiety, stress, lack of good sleep, high caffeine intake and the use of some drugs.

The best way to treat myokymia is to get more sleep, decrease caffeine intake and decrease stress. The good news is that myokymia is not a sign of serious underlying pathology and often resolves on its own.

Here is an excellent article on this topic:

http://emedicine.medscape.com/article/1213160-overview

Does this make sense to you?

Don't forget to mash the positive (excellent is the most fun to push) feedback button.....without this important step on your part the funds you left on deposit are not released and my kids will spend another cold winter barefoot ;)

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Dr. Rick MD FACS

Customer: replied 1 year ago.
I do tend to worry a lot about stuff but the shaking in my thumb (occassionally) and my shoulder blade pain is pretty real. I've also had issues with lymphnodes. Back in July I had a sore lymphnode in my neck that was enlarged. They did an ultrasound and although it was enlarged nothing was odd about it. They happened to find a thyroid nodule and did a biopsy of that and it was benign. However, I have recently had 2 more lymphnodes pop up (pretty small) one in my arm pit the size of a pinky nail (they did an ultrasound and said it looked normal) and one that is smaller than the size of a pea above the original lymphnode close to my chin bone (left side). That one also started out sore and Now is not but is still there...no bigger, just the same. That was about a week ago. I had a cat scan with iv contrast before the other small node showed up in my neck recently and they said that my node showed a little enlarged but nothing worrisome and that nothing was abonormal. I'm also worried about lymphoma or something but I know it's unlikely. Thanks.
Customer: replied 1 year ago.
I agree with myokymia but when my thumb shakes you can clearly see it (only when bent) and it is the tip of my thumb after the joint. Thanks!
Expert:  Dr. Rick, MD replied 1 year ago.

Thanks for that additional information.

Given all that we has discussed I believe your primary issue is your anxiety over your health.

Such strong anxiety can cause all sorts of things like your thumb shaking.

So. What should you do?

Try to find a psychologist and psychiatrist well versed in treating health related anxiety so you can get the help you need.

Does this make sense to you?

I realize that this was not the answer you were hoping to hear but it would be unfair to you and unprofessional of me were I provide you with anything less than truthful and honest information.

Surely, you prefer that I tell the truth rather than what you wish to hear. Because it reflects very poorly on me unless you press one of the top three feedback choices, keep this in mind when rating my answer and please do not punish me for being honest. I understand that this may not be easy to hear, and I empathize.

Even though my answer was not quite what you were hoping for, please understand that my priority was to provide you with the most honest information. With that in consideration, I hope that you found my answer useful. Please click the excellent feedback button so that I can receive credit for my efforts.

Dr. Rick MD FACS

And the good news?

You can be helped and you do not have any sort of horrible medical condition.

Have a Wonderful and Safe New Year!

Customer: replied 1 year ago.
That is the answer I wanted to hear. I would never punish you even if it was a scary answer. What do you think of the whole lymphnode situation? I started going back to my psychologist this week but it's hard when I have tension in my muscles/shakiness in my thumb, etx not to think it's serious. Thanks.
Expert:  Dr. Rick, MD replied 1 year ago.

My pleasure.

Lymphnode come and go.....nothing to worry about in the vast majority of cases

Don't forget to rate me :)

Customer: replied 1 year ago.
Thanks I will rate you. I understand what you are saying in terms of the lymphnodes. However, I have one that is easily felt in my neck and hasn't gone down since July...isn't that alarming? It hasn't gotten bigger but hasn't gone down. I had ct scan of my neck with contrast and it showed it was a little enlarged but no signs of cancer or abnormalities. Of course, I realize that's not a biopsy. Since then they found one under my arm (about the size of a pinky nail) and did an ultrasound and I guess it was normal/not mixed tissue and I had pain near my left jaw bone a weekish ago and found another one above the original one which is smaller than a pea. It no longer hurts but is still there. I am worried that I have some type of lymphoma.
Customer: replied 1 year ago.
I'm also worried because as of a couple days ago I've been getting nauseous at random times, mostly at night but sometimes during the day. Just brief periods of feeling kind of queasy, not throwing up. I know I'm not pregnant. I had bloodwork done about 1-2 months ago and all was fine. Your input on the lymphnodes would be great as I am pretty worried I'm really sick.
Customer: replied 1 year ago.
Just wondering if anyone was available? Thanks!