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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5352
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I am a 36 yr old male and have had an on and off burning

Customer Question

I am a 36 yr old male and have had an on and off burning sensation in my right biceps for a few days and random twitching of legs arm, butt , shoulder etc for a few weeks which taking magnesium and vitamin D has seemed to help reduce. I don't have any weakness but just am concerned mainly about the burning feeling in the right bicep that I am not excerting anything on and still getting that feeling
Submitted: 2 years ago.
Category: Neurology
Customer: replied 2 years ago.
My GP says that it is anxiety as I have been thru a stressful time that is causing the twitching which seems to go away by night time. Ofcourse I got on the Internet and it says twitching is an ALS symptom but after weakness and much else so my concern is would a burning or over exerted muscle feeling that hurts in a bicep be something I should be concerned about ?
Expert:  Dr. Bob replied 2 years ago.

Hi there. Are you in good health otherwise? Are you taking any medications other than the supplements?

Customer: replied 2 years ago.
sir, I am in good health 6'2 164lbs and never smoke or drink. I had been under a weirdos intense stress this past month and began twitching in my legs and all over really and my GP pulled my vitamin D level 3 weeks ago and it was an 18 which was way low and after a few days of 7,000 iu per day of Vitamin D and about 600mg per day of magnesium I began to feel better with the twitching subsiding by maybe 80% and thetightness in my calf muscles big sides being relieved although there is some twitching in he morning still but by night none. My main concern though is the right bicep that has had the on and off burning pain and some twitching like the legs and other arm and eye , butt etc on and off , that bicep has a feeling of fatigue like it has been in use when it has not been in use and just feels sore. Obviously I shouldn't have googled because twitching comes up as als and that is terrifying. When I read things like twitching only comes after severe weakness and muscle atrophy and only after a muscle has started dying and is mainly one area and not all over twitches that makes me feel better but then I hear contradictory to that as well. This has all been going on for 3 weeks. I just wanted to ask a Neurology expert because my GP may not know what muscle burning or muscle fatigue pain could mean
Expert:  Dr. Bob replied 2 years ago.

This does not sound at all like ALS. Low vitamin D is often a marker for inadequate sun exposure as the skin normally makes vitamin D when exposed to UV rays. Fasciculations and focal paresthesias (e.g. burning) are most commonly related to stress, fatigue, poor sleep, too much caffeine, etc. It is very common in otherwise healthy young persons like yourself. :-)

Expert:  Dr. Bob replied 2 years ago.

Hi. I received your request but cannot speak by phone at this time. I would be happy to continue our conversation however by chat. Do you have further questions?

Customer: replied 2 years ago.
I understand you are busy and not able to speak on the phone at this time but possibly do you have another time that we could talk on the phone about it, I do not mind the cost of this as it would help me to gain an understanding of the symptoms I am having of muscle twitching in legs, arm, eyelid, butt etc. the feeling of my bicep muscle being fatigued and burning has subsided but comes and goes and I was wondering if that is a aymptom of either too much vitamin d that I am taking or too much or too little of another nutrient and if you thought it was a problem that it seemed to be just the burning overused muscle feeling in that arm versus the other.
Expert:  Dr. Bob replied 2 years ago.

This does not sound like hypervitaminosis D. This is a rare condition, anyway, and would not be expected to result from the usual supplemental doses. You could have your doctor check your levels to be sure, but this is much more likely to be the result of something else. Do you work out?

Customer: replied 2 years ago.
I don't work out , I am typi g this with my left hand because typing with my right this afternoon seems to really flare those forearm muscles up on my right and I dont think its carpel tunnel because I don't type much anyway. I can't remember straining them to be getting this feeling. Maybe I just rest then over the weekend is good advice I don't know but I just know it's a strange feeling of having exerted muscles in that arm with not much exertion being put out. It's not a weakness feeling but a fatigued muscle feeling
Expert:  Dr. Bob replied 2 years ago.

These types of symptoms are often the result of an unsuspected injury (often with pain starting only the next day or two) or repetitive micro-trauma from some task that one is doing multiple times per day. The nerves and muscle bundles may already be hyper-excitable due to stress, fatigue, health anxiety, etc so it is a "double hit phenomenon."

Customer: replied 2 years ago.
It is for sure painful from time to time so If it was muscle atrophy could that be the cause of the pain ? Does musle weakening begin with a burning pain in that muscle keeping on exciting the muscle until it's exhausted ? I keep getting worried about the als scare because I had read it often had started in an arm but then again my twitches are all over the body not constant but leg , thigh, arm, butt, eye etc. I really appreciate you taking all of this time with me it helps me a lot and I will pay whatever I need to for it. Also tomorrow or even next week if you had time for a call I am happy to pay for that also. I just want to explain the burning / over exerted muscle pain and listen to your view of if you have ever seen an als patient and Wha symptoms they felt from your prospective as a Dr.
Expert:  Dr. Bob replied 2 years ago.

Atrophy is usually visible or measurable. Your doctor should have checked you for this. Weakness, such as that associated with ALS does not start with burning pain. It is usually associated with fine motor activities such as buttoning one's shirt or writing. Your symptoms do not suggest this at all. And you are too young for this to be a serious consideration as it typically hits in one's 50's, possibly 40's.

Customer: replied 2 years ago.
It almost feels like someone keeps stroking my funny one up under that bicep and I can feel it down to my middle finger lightl
Expert:  Dr. Bob replied 2 years ago.

You might have a median mononeuropathy. That nerve runs down the biceps region into the wrist and first 3 fingers primarily. It is typically associated with repetitive strain and is benign. Rest is the initial treament, along with anti-inflammatories if tolerated.

Customer: replied 2 years ago.
When you say my first three finger do you mean pinky, ring and middle finger ? That is where I have felt some numbness in those finger tips that comes and goes and also tingling that iSight and comes and goes and I feel it like it's hitting my funny one up under my bicep.
My GP did look at my muscles etc and prescribed .25mg of Ativan to help me relax and not think about it once a day for 2 weeks. It just concerns me due to the twitching in different places and the intermittent burning and thinking something serious could be wrong . I am glad you pointed out the median mono nerve, should I ice it or try not to type, write or text on it for a few dad to help it relax ?
Expert:  Dr. Bob replied 2 years ago.
That sounds more like the ulnar nerve which passes close to the surface at the inner elbow and innervates the 4th and 5th digits (i.e. ring finger and pinky). You might be experiencing strain or inflammation in both the median and ulnar nerves. Either way the etiology is usually from repetitive microtrauma and the treatment is rest, ice and NSAIDs. Keyboarding and texting are risk factors. Try to cut down on these and any other repetitive tasks you are performing with the arms and hands. Wear an elbow pad and a wrist splint to reduce motion and protect the respective nerves.