Neurology

Ask a neurologist. Get answers to your neurology questions.

Ask a Doctor,
Get an Answer ASAP!

This answer was rated:

I just turned 70. I was diagnosed with Parkinsons Disease in…

Hi. I just turned...

Hi. I just turned 70. I was diagnosed with Parkinsons Disease in August 2005. I've also had lumbar sacral fusion and L3 laminectomy. 3 years ago. My PD is very slow moving in terms of getting worse. I have severe hip, buttocks, and leg pain. I have a spinal stimulator which hasn't done much good. I now have tingling in my legs when I stand up. I know tingling is a sign of MS. Could my luck be that bad as to have MS too?? my pain is pretty intense and is slowly getting worse.

Doctor's Assistant: What seems to make the symptoms worse or better? Any redness or swelling in the leg?

No redness or swelling. Pain and tingling in both legs. Sitting a lying down help, standing and walking make it worse.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I don't have any neurological issues in my family of origin. All my doctors, especially my PD doc continue to say my symptoms are neurological, not muscular. But no treatment for neurologic pain has brought me any relief, So I wonder if I have a dystonia? or MS??

Show More
Show Less
Ask Your Own Neurology Question
Answered in 1 hour by:
3/10/2018
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,324
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, 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 your health 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.

Let me discuss the health issues and concerns you have been having & their management point by point below here;

First of all this new onset tingling does not appear secondary to MS

This is because it is extremely uncommon for ms to start presenting around age 70

Also the tingling you have described seems starting or worsening when you stand up or walk and this pattern is not suspicious for ms

The symptoms of ms such as tingling or any other symptom are expected to be constant rather than related to any change in position etc, so it should equally bother you while lying down or sitting etc too

Also with ms certain other symptoms too are usually expected to occur such as - severe blurring of vision or loss of vision in one eye, paralysis like or stroke like symptoms on one side of the body, facial droop, double vision etc, and you have not mentioned any such symptoms so I assume you are not having any such additional symptoms so again this implies ms is unlikely the cause for the new onset tingling you have been having.

This type of tingling can be due to one of the following causes;

1) Pinched spinal nerves in the lower back/lower spine region, with or without spinal stenosis

2) Peripheral neuropathy (primary nerve damage in the legs itself)

3) Circulation problems too can rarely cause tingling sensation in the legs

4) Other health conditions that can present with tingling in the legs include the following;

a) Vitamin deficiencies

b) Thyroid disease

c) Diabetes

d) Prediabetes etc

The worsening pain appears muscle related and some of the possibilities to explain this type of pain include the following;

1) Dystonia

2) Muscle spasticity

3) Muscle rigidity

4) And the earlier mentioned causes for the tingling sensation in the legs can also cause severe and progressively worsening pain in the legs too

As you see there are several possibilities to explain this type of new onset of tingling sensation, as well as severe & progressive pain - and this will require a thorough clinical examination followed by certain relevant investigations that may include some of the following;

1) MRI scan of the brain

2) MRI scan of the spine and spinal cord (if any contraindications for mri scan is present then CAT scan can be done)

3) EMG/Nerve conduction study of the legs – this is a nerve and muscle test

4) Circulation tests such as Doppler Ultrasound of the legs

5) And certain blood tests such as the following;

a) Comprehensive metabolic panel that includes electrolytes, blood sugar, liver and kidney tests etc

b) Blood vitamin level estimation

c) Muscle enzymes such as CPK, Aldolase, LDH

d) Inflammatory markers such as ESR, CRP, ANA, RA factor

e) Thyroid tests etc

Not necessarily all the above investigations may be necessary, your clinic doctors including the neurologist will be in a position to decide which ones among the above mentioned investigations are required in your case after conducting a thorough neurological examination in the clinic. If the current neurologist is not helpful then please consider seeing another one for another opinion. And also if any of the above investigations have already been done, especially recently, then there is no need to repeat them. The precise & specific treatment plan will depend upon the results of the above mentioned investigations and in the meantime you may try some of the following therapeutic measures to help with this new onset tingling sensation and the pain;

Nerve-pain pills such as Gabapentin, or Amitriptyline

Muscle relaxants such as Baclofen, or Tizanidine

Steroid Iontophoresis

Cannabinoid CBD Hemp oil oral or sublingual preparations

Narcotic pain killer such as Lortab or Percocet

Physical therapy

Massage therapy

Hydrotherapy

Trigger point therapy (if any trigger points are present)

Hot fomentation

Short wave diathermy

Infra-red light therapy

Ultrasound therapy

TENS (Transcutaneous Electric Nerve Stimulation)

Interferential therapy

Laser therapy (Cold laser therapy or Low Level Laser Therapy)

Acupressure Mat and Pillow Set for the relief of pain

CES (Cranial Electrotherapy Stimulation) treatment

ESI (Epidural steroid injection)

Botox spinal injections etc

In addition to the above treatments the following natural or herbal treatments too can help;

Limbrel (Flavocoxid)

Nettle Root extract

S adenosyl methionine (SAMe)

Glucosamine + Chondroitin + MSM combination

Methyl Guard Plus (which is a combination of active forms of vitamin b12, vitamin b9/folate, vitamin b6, vitamin b2) etc

The above are the various treatment options to consider, but please see not all these above mentioned treatments may be required in your case; I am trying to provide a list of the various treatment options like this so that you are familiar with several treatment options that are available for helping with your severe, refractory & progressively worsening muscle pain, as well as the new onset tingling sensation, 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) As mentioned earlier above there are many different underlying causes for the symptoms you have mentioned.

2) A thorough evaluation and clinical examination in the clinic by a neurologist followed by certain relevant neurological investigations as mentioned earlier above (certain specific/relevant blood tests, Scans, Nerve & muscle tests etc) can help us in ascertaining the precise cause for your symptoms

3) The specific treatment will depend upon the particular diagnosis that is made after the above investigations and in the meantime please consider trying some of the above mentioned treatments to help with obtaining relief from these bothersome symptoms you are suffering from.

4) And very importantly please see this type of health situation can be diagnosed & successfully treated, so please not to lose hopes; please ask your current neurologist/pd specialist for the above mentioned further evaluation, neurological/medical investigations as well as the therapeutic modalities mentioned earlier above, if the current neurologist/pd specialist etc not helpful then please try to see another one to receive another opinion. And I also can strongly reassure you, the new onset tingling certainly does not appear secondary to MS, it is due to one of the other causes as I had mentioned earlier above but certainly not due to MS, so please not to be scared.

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

Ask Your Own Neurology Question
Customer reply replied 4 months ago
Thanks Dr Subbanna!! You must have spent some time pulling info together. You’ve given me relief from my panic feelings about MS. I will be back in touch. What’s your take on cauterizing the sacral brain bound sacral nerves. I’m nervous about doing it but I’ve got to find something to deal with my pain. Thanks again. I got more than I expected,Kent

You are very welcome Kent! My pleasure! I am very glad you found the above information helpful! And I am sorry I could not reply earlier since I was away from the computer and just returned.

If you are inquiring about RFA or Radiofrequency ablation, then it is another treatment options that is available for getting relief from the leg pains. This procedure is also called by various other names such as the following;

Radiofrequency neurotomy or

Radiofrequency neurolysis or

Radiofrequency neuroablation or

Radiofrequency rhizotomy etc

During this procedure radio frequency waves are used to produce heat, and the heat is generally applied to an area called as DREZ (Dorsal root entry zone), and this is the region of the spinal cord where the pain signal carrying sensory nerve roots enter the spinal cord. By generating heat in this region this region of the spinal cord gets ablated thus destroying the ability of this region to transmit pain signals to the brain.

This is a minimally invasive procedure without the risk of any major complications and is also found to be effective in treating severe pain in the legs etc

So if you remain refractory to other treatment modalities then this type of rhizotomy or ablation procedure in the region of sacral spinal cord/sacral spinal nerves too can be tried.

And once again, there is certainly no suspicion for MS in you, and I earnestly hope you find the above information & list of treatments helpful to you.

Please let me know if you have any additional questions or if you want to discuss this further. And please take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. Rating me now does not close your question and if you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services!

Wishing you all the very best!

Best Regards!

Dr Subbanna MD

Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,324
Experience: American Board Certified Neurologist, Internal Medicine
Verified
Dr Subbanna MD and 87 other Neurology Specialists are ready to help you
Ask your own question now
Was this answer helpful?

How JustAnswer works

step-image
Describe your issueThe assistant will guide you
step-image
Chat 1:1 with a neurologistLicensed Experts are available 24/7
step-image
100% satisfaction guaranteeGet all the answers you need
Ask Dr Subbanna MD Your Own Question
Dr Subbanna MD
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,324
6,324 Satisfied Customers
Experience: American Board Certified Neurologist, Internal Medicine

Dr Subbanna MD is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me.

Susan O.USA

Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help.

Mary C.Freshfield, Liverpool, UK

This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!!

AlexLos Angeles, CA

Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult.

GPHesperia, CA

I couldn't be more satisfied! This is the site I will always come to when I need a second opinion.

JustinKernersville, NC

Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around.

EstherWoodstock, NY

Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know.

RobinElkton, Maryland

< Previous | Next >

Meet the Experts:

Dr. Mark

Dr. Mark

Neurologist (MD)

2,191 satisfied customers

Neurosurgeon - Brain, spine, and peripheral nerve surgery

Jack Scariano Jr

Jack Scariano Jr

Neurologist (MD)

1,056 satisfied customers

Board Certified Neurology 1982 30 years experince. Also expert in Pain Medicine

Dr. Bob

Dr. Bob

Neurologist (MD)

3,773 satisfied customers

Neurology & Int Medicine (US Trained): 20 yrs experience

healthydoc

healthydoc

Board Certified Physician

1,851 satisfied customers

Board Certified U.S. Neurologist

Dr. F

Dr. F

Board Certified MD

266 satisfied customers

Neurosurgeon with more than 20 years experience in practice and teaching.

Phytube.com

Phytube.com

Neurologist (MD)

86 satisfied customers

Pediatric Neurology and Developmental Medicine with Special Research In Pain Medicine/Medications

Stroke Doc

Stroke Doc

Board Certified Physician

51 satisfied customers

I am board-certified in Neurology and the subspecialty Vascular Neurology.

< Previous | Next >

Related Neurology Questions
Show me procedure for spinal fusion. I have spinal stenosis
I have spinal stenosis and spondylitis in the lumbar area--- much pain in lower back , hips and down both legs. Got epidural and doing chiropractor and acupuncture without relief… read more
Dr. Mark
Dr. Mark
Neurologist (MD)
Doctoral Degree
2,191 satisfied customers
I have been diagnosed with dystonia...grandmother had
I have been diagnosed with dystonia...grandmother had Parkinson's. How do I know if I have dystonia or Parkinson's … read more
Dr. Bob
Dr. Bob
Neurologist (MD)
Doctoral Degree
3,773 satisfied customers
I have burning pain in sciatic area of left buttock which
I have burning pain in sciatic area of left buttock which then runs through other part of left buttock and ends in upper part of left thigh. Am fused from L3-S1 and had last surgery 5/19/16 to remove … read more
Dr. Bob
Dr. Bob
Neurologist (MD)
Doctoral Degree
3,773 satisfied customers
Had PLIF back surgery approx 8 years ago at L4-L5-S1 which
Had PLIF back surgery approx 8 years ago at L4-L5-S1 which was successful. Re-Injured my back 2 yrs ago while awkward lifting. Pain confined to spine itself in vicinity of fusion. Mri showed moderate … read more
neuromd2012
neuromd2012
Neurologist/Staff Clinician
Doctoral Degree
2,815 satisfied customers
History: 40-year-old male status post lumbar fusion. Back
History: 40-year-old male status post lumbar fusion. Back pain and left leg pain. Technique: A standard CT scan of the lumbar spine was performed without contrast. Multiplanar reconstructions were uti… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,827 satisfied customers
Back,hip,buttocks,hamstring,calf cramping. Feels like
Back,hip,buttocks,hamstring,calf cramping. Feels like electricity down the leg into the foot. Switches body sides. At times can not walk without help. The worst is bed and standing. Had L3 L4 surgery … read more
healthydoc
healthydoc
Board Certified Physician
1,851 satisfied customers
I am 37. I unexpectedly lost my mother 6 weeks ago. About
Hi I am 37. I unexpectedly lost my mother 6 weeks ago. About ten days later I woke with pins and needles in my hand, which quickly went. Over the last few weeks though I have been having tingling in m… read more
healthydoc
healthydoc
Board Certified Physician
1,851 satisfied customers
I have tingling in the r8ght leg and discomfort in the right
i have tingling in the r8ght leg and discomfort in the right leg when I LIE ON the right side that started with a stroke. what can i do to manage this condition. THE discomfort is less than a m9nth qg… read more
Dr. Mark
Dr. Mark
Neurologist (MD)
Doctoral Degree
2,191 satisfied customers
I have severe hip pain ~8 and knee pain ~6. Doctors have
I have severe hip pain ~8 and knee pain ~6. Doctors have ruled out hip joint or knee problems, disease, back causes. I have had an mri of the back, knee xrayed, hip xrayed, total body scan, and blood … read more
Dr. Mark
Dr. Mark
Neurologist (MD)
Doctoral Degree
2,191 satisfied customers
I had THR in oct 2011 am having chronic sacral ,buttock
I had THR in oct 2011 am having chronic sacral ,buttock pain, plus terrible pressure and flatulance cannot weight bear on leg as get awful pain in and around lateral hip and groin. Have had MRI scan w… read more
Dr. Mark
Dr. Mark
Neurologist (MD)
Doctoral Degree
2,191 satisfied customers
I have been diagnoed with pd in jan 2010 - i was put
i have been diagnoed with pd in jan 2010 - i was put straight onto meds modopar x 125 x 4 times aday - i am now on neupro paTCHES AS MY NEURO THOUGHT THAT MY MEDS WERE NOT GETTING TO MY BRAIN VIA MY G… read more
Dr. Bob
Dr. Bob
Neurologist (MD)
Doctoral Degree
3,773 satisfied customers
Husband is 56- diagnosed with Parkinson's 5 yrs ago. Just
Husband is 56- diagnosed with Parkinson's 5 yrs ago. Just realized that most of his symptoms are nonmotor .... major sleep and now pretty serious pain issues- quality of life deteriorating .... these … read more
CaliforniaMD
CaliforniaMD
Post-Doctoral Degree
1,419 satisfied customers
I am 65 years old. I have myback fused from the S1-L4. It
I am 65 years old. I have myback fused from the S1-L4. It has been 12 years since the operation. During the period since the operation I have had an additional operation (decompression lamenectomy) to… read more
Dr. Mark
Dr. Mark
Neurologist (MD)
Doctoral Degree
2,191 satisfied customers
I am scheduled for surgery on my neck to "cut out" a tendon
I am scheduled for surgery on my neck to "cut out" a tendon that has buckled and is pressing on my spinal cord. My concern is that only one problem is being addressed with this surgery. The MRI report… read more
RH
RH
Doctor of Medicine
1,944 satisfied customers
47 yold male Lynch syndrome MSH2 GENE MUTATION=bLADDER
47 yold male Lynch syndrome MSH2 GENE MUTATION=bLADDER CANCER 7/08-hAD cERVICAL PLATE FROM C4-7 and lumbar Laminectomy l3-l5 all 5/10/9/10 had blood clot from going septic on 10/10 -was told I have ha… read more
HouseDoc
HouseDoc
Attending Neurologist
Doctoral Degree
1,313 satisfied customers
MY MRI SHOWS AN 8MM ANTEROLISTHES OF L4 OVER L5. 2MM
MY MRI SHOWS AN 8MM ANTEROLISTHES OF L4 OVER L5. 2MM RETROLISTHESIS OF L3 OVER L4 AND S/P INTERVAL L4 LAMINECTOMY WITH ASSOCIATED POST OPERATIVE CHANGES IN PARASPINAL SOFT TISSUE. IT ALSO SHOWS L3/L4 … read more
Dr. Mark
Dr. Mark
Neurologist (MD)
Doctoral Degree
2,191 satisfied customers
I just had 2 surgeries for removal of spinal stenosis at
I just had 2 surgeries for removal of spinal stenosis at L2-3. The first surgery-- a lumbar decompression --- didn't detect a disk problem at L3 and the second surgery removed a large amount of disk m… read more
RH
RH
Doctor of Medicine
1,944 satisfied customers
In July 2009 I started having tremors when going downstairs.
In July 2009 I started having tremors when going downstairs. At first it was mainly my right side. It progressively got worse. It started effecting both legs and the tremors became more noticeable and… read more
Phytube.com
Phytube.com
Neurologist (MD)
MD
86 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x