New symptom: Back pain

This is the place to ask questions if you have symptoms that suggest MS, but aren't yet diagnosed.

New symptom: Back pain

Postby LisaH » Tue Sep 05, 2017 6:13 pm


I have another symptom that has come on suddenly. When I went to bed last night, there was a sharp pain in my spine (a few inches above the bra line) that radiated in a line across both shoulder blades at the same time. It was really painful and lasted about 5 seconds or so, then stopped. It happened again several times today. I haven't injured myself in any way so I can't figure out what could've brought this on. Does this sound like pain that might happen with MS? Because of the changes in my walking and now this, I'm wondering if a lesion on my spine could be a possibility. Any comments appreciated very much!
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Re: New symptom: Back pain

Postby jimmylegs » Wed Sep 06, 2017 5:33 am

hard to make an informed comment when the question is dropped out of context of any earlier discussion. my 2c.
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
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Re: New symptom: Back pain

Postby LisaH » Wed Sep 06, 2017 11:42 am



jimmylegs, I recently posted about spasticity (undiagnosed-f54/topic29315.html) which is what I was referring to about changes in my walking. I could have posted about my new symptom on that thread, but the topic would be spasticity instead of back pain. As for my other health issues... occipital and trigemnal neuralgia, chiari malformation, large pituitary/sella cyst, palatal myoclonus, restless leg syndrome, benign fasciculations syndrome and I'm going to a movement disorder specialist next month. My neurologist couldn't figure out what's causing my torso spasms and referred me. I had a brain MRI last November that didn't show lesions and my follow-up MRI a couple of months ago was only of my pituitary/sella. That MRI might (or might not) have shown lesions or some other explanation of my symptoms. They could have done another MRI like last year and assessed the cyst without wasting my MRI by focusing only on that area. I'm hoping the movement disorder specialist will order an MRI of my spine at least. Can you offer feedback about my newest symptom (the back pain) now?
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Re: New symptom: Back pain

Postby Snoopy » Wed Sep 06, 2017 1:25 pm

Back pain can have many causes, some benign some more serious such as herniated/bulging discs. The pain you are having doesn't sound like what is experienced from spinal cord lesions related to MS.
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Re: New symptom: Back pain

Postby LisaH » Wed Sep 06, 2017 3:35 pm


Thanks, Snoopy. Hopefully whatever is going on with me will be figured out soon. :?
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Re: New symptom: Back pain

Postby jimmylegs » Wed Sep 06, 2017 6:43 pm

LisaH wrote:jimmylegs, I recently posted about spasticity ... I could have posted about my new symptom on that thread, but the topic would be spasticity instead of back pain.


hi again, pretty sure you can edit subject lines - that said i'd be surprised if there's a thread of any length here on the forum whose subject line aptly conveys all content therein!

of possible relevance re fasciculations: "After a routine blood chemistry examination found a corrected serum calcium of 6.8 mg/dL (reference range = 8.5–10.5 mg/dL) and muscle fasciculation, Chovstek's and Trousseau's signs were noted on physical examination, and the level of serum magnesium was found to be 0.6 mg/dL (grade 3 hypomagnesemia is <0.9–0.7 mg/dL, and grade 4 is <0.7 mg/dL). The serum potassium level was 3.0 meq/L, but other parameters, including blood urea nitrogen (BUN) and creatinine were within their reference ranges. The patient received intravenous repletion of magnesium and calcium with a rapid increase in energy and disappearance of paresthesias."
i personally aim for more like 2.3 to 2.7 mg/dL of magnesium in serum, and i've never had low calcium. but the fasciculations along with neuralgia and spasms also sound like an electrolyte link could be worth looking into. keeping in mine that 'normal' magnesium levels are problematic on their own and the range i mention here as a personal target would be considered high in many settings.


re back pain:
Muscle cramps and magnesium deficiency: case reports
https://www.ncbi.nlm.nih.gov/pmc/articl ... 7-0094.pdf

"A 17-year-old military recruit presented on sick parade with aching in his muscles and thighs, and generalized tenderness in all his skeletal muscles. ... on the morning when he reported sick, he could "hardly move" his limbs due to muscle spasm. ... The only abnormality indicated by laboratory investigations was a serum magnesium concentration of 0.54mmol/L (reference range 0.7 to 1.5mmol/L)."

aside so obviously we're into si units for this paper - divide mg/dl by .411 to get mmol/l figures. in these units, i personally aim for 1.0 to 1.1 mmol/L for serum mag.

*note in quoted study above how anything in the 0.7-0.9 range is considered 'normal' but meanwhile in the study prior, same levels are considered grade 3 hypomagnesemia* on to case 2

"An 81-year-old woman was admitted to the central health care facility from an outlying area of Newfoundland because of severe abdominal cramps, poorly controlled by analgesics. ... The pain was so intense that morphine (5 to 15 mg intramuscularly) and muscle relaxants were given (diazepam and a combination of acetylsalicylic acid and methocarbamol), but with only temporary effectiveness.
Laboratory investigations were unremarkable except for serum magnesium levels of 0.49 and 0.51 mmol/L. Oral supplements of magnesium were initiated but caused fluid diarrhea [JL edit: how much you wanna bet they gave her high dose mag oxide, poor thing]. Slow intravenous infusion of 5 g of magnesium sulfate was started in a total of 2000 mL N saline over 24 hours, which resulted in her being completely pain free by the third day. She was discharged "never feeling better for years" after another week."

i could go on, but it's my bedtime :)
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
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Re: New symptom: Back pain

Postby LisaH » Wed Sep 06, 2017 7:11 pm


Yes, jimmylegs, I can edit subject lines... but doing so wouldn't make much sense to me because a lot of symptoms, etc. have been discussed. It seems to me that regardless of the symptom mentioned, you think it's related to a nutritional deficiency of some kind. I'm sure you realize that symptoms might not be related to nutrition in any way and could be MS or another illness. :confused:
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Re: New symptom: Back pain

Postby jimmylegs » Thu Sep 07, 2017 1:25 am

yes i'm generally interested in whether people can demonstrate optimal status and rule out the possibility that extremely common nutritional issues are not a factor in their own case. if you won't/can't, so be it. good luck!
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
User avatar
jimmylegs
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Posts: 10780
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Re: New symptom: Back pain

Postby LisaH » Thu Sep 07, 2017 7:28 am


I understand that it's a possibility, jimmylegs, but your replies only focus on that and seem to disregard other possibilities. My blood work was normal with the exception of vitamin D. My neurologist told me that low vitamin D couldn't cause my extreme muscle spasms/jerking and referred me to a movement disorder specialist. I wish someone would reply who has experienced symptoms similar to mine and offer some insight. I do know that it's something and I'm so frustrated because it will soon be a year since these symptoms began. It's actually been longer than that because I had an optical migraines (aura with no migraine) in July of 2016 and then another one several months later. Since my serious head pain hadn't come on yet, my eye doctor explained what an optical migraine is and left it at that. Things have progressed to the point now that I don't feel like myself anymore.
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Re: New symptom: Back pain

Postby jimmylegs » Thu Sep 07, 2017 10:22 am

i comment through the lens of the body of research i've chosen to follow in particular over the past decade. i follow it in particular because it is underrepresented in health care and health care education, as has been documented extensively here on the forum. i wouldn't pretend to have any particularly useful info in other spheres.

re 'normal' bloodwork results - we've established existing issues with 'normal' ranges at length all over this forum including, in my case, in the auto signature that follows my every post.

i'd be interested to know whether your neuro has more or less than the average 23 hours of contract nutrition education that is typically provided in us med schools (as documented here at TiMS). assuming that you're dealing with a pro who's enjoyed at least that full day's worth of nutrition study (or perhaps a few hours more if your health care pro is on the upper end of the bell curve), did he or she mention specifically that your muscular issues *could* be associated with low mag - which in turn is *associated* (possibly causally) with low d3 levels? related: natural-approach-f27/topic29354.html#p249333

my muscular issues have certainly resolved since taking a mere pharmacist's magnesium advice seriously almost a decade ago.

i'm so glad to be this end of the learning curve - when i experience the hint of an optical migraine (also documented elsewhere on this site), magnesium shuts it down in no time.

but what do i know - i'm just some schmuck with a decade of symptom management and science/nutrition study under my belt!

it has been frustrating during this time to watch the misadventures of others here at TiMS who have, for one example, experienced lab-documented chronically low magnesium (and i should say specifically LOW NORMAL) in the context of ongoing d3 megadosing, with associated spasticity and pain to the point of eventual suicide.

it's much more rewarding when individuals (eg TiMS user zyklon) are receptive, do the work, figure out their actionable options and feel better as a result. introductions-f20/topic28969-150.html#p249343

for my part i am so glad that i ran into the pharmacist i did when my low magnesium levels were causing life-threatening problems. if he'd been able to share what i've learned over the past decade about the optimal daily doses and forms, i'd have been spared an annoying multi-year learning curve but considering that he turned my life around, i will take it. anyhoo, that's more time than i should have given to this so, peace out!
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
User avatar
jimmylegs
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Re: New symptom: Back pain

Postby LisaH » Thu Sep 07, 2017 4:27 pm


I'm not sure how much education my neurologist has had in nutrition. He seemed quite adamant that my torso spasms/myoclonus are much too intense to be related to a nutritional deficiency. As for the fasciculations I have (mostly in my left calf lately), I can see how that has the possibility of being related to nutrition. My neurologist thinks those are benign fasciculation syndrome but I'm wondering if they could be related to the more violent spasms/myoclonus I'm having. I guess that's why he referred me to someone with more experience in movement disorders. Maybe my fasciculations and myoclonus are both related in some way to my neuralgias or the cyst/tumor in my head. I have no idea. At this point, I'm just desperate to find out what's wrong with me and hoping that the movement disorder specialist might figure it out. Thank you for the information you provided.
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Re: New symptom: Back pain

Postby jimmylegs » Thu Sep 07, 2017 5:04 pm

sounds good. if you're in the states, you can try this: http://www.lifeextension.com/vitamins-s ... blood-test
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
User avatar
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Posts: 10780
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Re: New symptom: Back pain

Postby LisaH » Thu Sep 07, 2017 9:56 pm

Thanks for the link. I am in the states... North Carolina.
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Re: New symptom: Back pain

Postby jimmylegs » Fri Sep 08, 2017 10:49 am

it's a sweet deal.

these days i can actually access private testing via an online vendor where i am too, but they don't offer an affordable $22 serum mag option like life extension. just a pricy rbc mag test. and if i did happen to want an rbc mag test, life extension offers it for $88 whereas here i'd have to pay over $120. so the options and the pricing are both sucky via this local vendor.

$22 is pretty reasonable to find out where you sit in the range for serum mag - low normal like ms patients and others with various chronic illnesses, or high normal like healthy controls. i like how the test description specifies that magnesium "helps maintain normal muscle and nerve function"

re normal range: i like this study https://www.ajol.info/index.php/thrb/ar ... iew/120470 in which the reference range for healthy controls was 0.81-1.29 mmol/L vs a typical reference range 0.65-1.05 (i've seen 0.7-1.1 used locally, range can vary depending which lab you use, which study you're reading, etc). i really like its mention of 2.0 mmol/L as the low end of hypermagnesemia.

another recent fave:
Perspective: The Case for an Evidence-Based Reference Interval for Serum Magnesium: The Time Has Come
http://advances.nutrition.org/content/7/6/977.short
The 2015 Dietary Guidelines Advisory Committee indicated that magnesium was a shortfall nutrient that was underconsumed relative to the Estimated Average Requirement (EAR) for many Americans. Approximately 50% of Americans consume less than the EAR for magnesium, and some age groups consume substantially less. A growing body of literature from animal, epidemiologic, and clinical studies has demonstrated a varied pathologic role for magnesium deficiency that includes electrolyte, neurologic, musculoskeletal, and inflammatory disorders; osteoporosis; hypertension; cardiovascular diseases; metabolic syndrome; and diabetes. Studies have also demonstrated that magnesium deficiency is associated with several chronic diseases and that a reduced risk of these diseases is observed with higher magnesium intake or supplementation. Subclinical magnesium deficiency can exist despite the presentation of a normal status as defined within the current serum magnesium reference interval of 0.75–0.95 mmol/L. This reference interval was derived from data from NHANES I (1974), which was based on the distribution of serum magnesium in a normal population rather than clinical outcomes. What is needed is an evidenced-based serum magnesium reference interval that reflects optimal health and the current food environment and population. We present herein data from an array of scientific studies to support the perspective that subclinical deficiencies in magnesium exist, that they contribute to several chronic diseases, and that adopting a revised serum magnesium reference interval would improve clinical care and public health.

revisiting the neuro's comment re spasticity being too severe for a nutritional deficiency, perhaps he's not read the literature on magnesium deficiency induced tetanus and the use of magnesium to treat both dietary and infectious tetanus.

The Magnesium-Deficiency Tetany Syndrome in Man (1960)
https://www.ncbi.nlm.nih.gov/pubmed/13840893
excerpt: "When first seen, all the patients had tetany manifested by either spontaneous carpopedal spasm or positive Chvostek and Trousseau signs. In addition, 3 had generalized convulsions, and in 2 these were the initial manifestations of the disease. Athetoid motions of the extremities also occurred in 4 patients. ... The serum magnesium concentration of all 5 patients was markedly depressed when tetany was maximal, ranging from 0.60 to 1.33 milliequiv. per liter.

***(JL edit: converted, that's 0.3-.0.665 mmol/l - note that the upper end of this range would be characterized by some as 'normal' ie magnesium deficiency induced tetany AND 'normal' serum mag at the same time)***.

All patients were treated with intramuscular injections of magnesium sulfate (MgSO4·7H2O), 2 to 4 ml. of a 50 per cent solution (1 to 2 gm.) every four hours. Concomitant with a rise of the concentration of magnesium in the serum to normal or slightly elevated values, there was a prompt and dramatic relief of tetany. In 4 patients continuation of this therapy resulted in complete recovery, without recurrence of tetany."

Magnesium as first line therapy in the management of tetanus: a prospective study of 40 patients (2002)
http://onlinelibrary.wiley.com/doi/10.1 ... 8_6.x/full
odd sx? no dx? check w/ dietitian
DRI=MINIMUM eg bit.ly/1vgQclQ
99% don't meet these. meds/lifestyle can affect levels
status can be low in ms & other cond'ns
'but my results are normal'. typical panels don't test all
deficits occur in 'normal' range
User avatar
jimmylegs
Volunteer Moderator
 
Posts: 10780
Joined: Sat Mar 11, 2006 3:00 pm


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