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I have had continuing, random spasms over the past 5-6

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months that seem to begin...
I have had continuing, random spasms over the past 5-6 months that seem to begin in the upper right breastbone area and migrate to the right shoulder blade area. The spasms last about 15 minutes, cause a feeling of slight weakness, and pain in the right shoulder blade area. I have measured the spasms to usually be accompanied by blood pressure increases from a normal 130/70 , 68 pulse to 170/85 or so and 80 pulse.I have had Stress/Echo, MRI , CAT scan and Endoscopy tests in September-November 2017 and the examining physicians have not been able to find a cause.Can you help me or offer an opinion on the cause of these "spasms?"Thank you
Submitted: 6 months ago.Category: Neurology
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Answered in 57 minutes by:
1/2/2018
Neurologist: Dr Subbanna MD, Neurologist (MD) replied 6 months ago
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,333
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi BOB, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I am sorry to hear about the muscle spasms as you have described above. As a Neurologist I frequently diagnose & treat this type of health situation and I can certainly help you in this regard.

I see you have had investigations done so far but all in vain and have not identified any underlying pathology or explanation for these spasms

There are many possibilities and one possibility is it may be secondary to irritation of a nerve in the breast bone, or shoulder or shoulder blade area that is causing these intermittent muscle spasms

I see you have had mri scan cat scan etc but I am not sure whether you have had a nerve and muscle test called as EMG/Nerve conduction test or not

If you have not had the above mentioned nerve and muscle test then please ask your neurologist to arrange for this test and this test can show pathologies related to muscle and nerves

For example if there is any intermittent compression or irritation of a nerve in the above mentioned areas is causing this type of intermittent muscle spasms then the above mentioned nerve and muscle test (EMG/Nerve conduction test) can help in identifying this

I see you have had mri and cat scans and I assume these are of the spine region. If spine mri or cat scan has not already been done then you need a scan of the spine too since pinched spinal nerve can cause this. An mri scan is superior to a cat scan, so if scans have not already been done please ask your neurologist to arrange for an mri scan of the spine to look for pinched spinal nerve in the back/spine area.

The above mentioned nerve and muscle test (EMG/Nerve conduction test) can also help in exploring the possibility of pinched spinal nerve, and this test can detect pinched spinal nerves that are missed by mri or cat scan too – so this is a very helpful test for the type of symptoms you have been having.

And also an mri or cat scan of the breast bone, shoulder and shoulder blade area too can help to look for any local pathologies causing this symptom.

And if you have not had any brain mri scan done then it is also recommended now.

Please see no need to repeat any of the above neurological investigations if any of these have already been done, if you see any of the above neurological investigations have not already been done then please ask your neurologist to arrange for these tests and these can help in establishing the diagnosis.

And I am sure what are the treatments you have tried so far to help with these muscle spasms, if you have not tried the following then please consider to give these a try and these can help in treating & preventing these muscle spasms occurring in the future;

A) During an acute attack of muscle spasms the following treatments can help;

Heat or Cold therapy in the form of hot or cold compresses

Epson salt compress

Massaging the muscles

Gentle stretching exercises of the muscles

Over the counter muscle spasm & muscle pain relieving topical creams or sprays (muscle rubs) such as Biofreeze or Myoflex etc

B) For the prevention of future attacks the following treatments can help;

Muscle relaxants such as Tizanidine or Baclofen, or Dantrolene

Over the counter Electrolyte preparations (containing magnesium, potassium & calcium)

Over the counter Tonic water preparation (contains quinine)

If over the counter tonic water does not help then prescription Quinine preparations

One of the nerve-pain pills like Gabapentin or Amitriptyline

Electrotherapies such as TENS or Interferential therapy

Cold laser therapy

Hot fomentation

Short wave diathermy

Infra-red light therapy

Ultrasound therapy

A course of physical therapy

Botox injections to the affected muscles etc

I am not telling all these above mentioned treatments are required in your case; I am trying to provide a list of the various treatment options like this so that you are familiar with various treatment options that are available for your condition and you may try to use them as necessary. If you see any of the above treatments you have already tried please disregard them and you may explore the treatment options which you may have not yet tried.

To summarize once again;

1) Please see we need to rule out the possibility of nerve irritation or nerve injuries, or pinched spinal nerves, or localized muscle injuries etc as mentioned earlier above that can cause this type of localized muscle spasms.

2) Please ask your neurologist to arrange for neurological investigations such as an EMG/Nerve conduction nerve and muscle test, MRI or CAT scan of the breast bone, shoulder and shoulder blade area, an MRI scan of the spine, and an MRI scan of the brain etc – if any of these investigations have already been done then there is no need to repeat them, but if you see any of the above investigations have not already been done then please ask your neurologist to arrange for these investigations, and these investigations can help us in finding out the precise cause for these new symptoms and then treated appropriately.

3) In the meantime if you see any of the above treatments you have not already tried then please consider trying them, and these can help in providing relief from these muscle spasms you have been experiencing.

4) The blood pressure rise appears a reaction to the muscle spasms and as soon as the cause for these muscle spasms is identified, treated and this problem gets resolved then the blood pressure issue is not expected to occur in the future again.

5) And also very importantly, please see this type of health issue can be diagnosed & successfully treated, so please not to be scared or not to lose hopes, an early diagnosis and treatment gives the best chance for quick & complete cure so please try to follow up with you Neurologist asap (or see one if you have not already seen one so far) and try to undergo the various neurological investigations as discussed earlier above which can help in establishing the diagnosis and guide us further in choosing the most appropriate course of treatments to help you with your health situation, and in the meantime please consider trying some of the treatments mentioned earlier above to help you with getting relief from these annoying, bothersome recurrent muscle spasms you have been suffering with.

Wishing you a quick & complete recovery! And also Wishing you the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further.

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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