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Lower Leg Tingling at Night

Q: I often have an uncomfortable tingling sensation between my knee and ankle that gets worse when I'm trying to fall asleep. Sometimes it's so overwhelming that I'm up half the night fidgeting! I haven't done anything to injure my leg, and I'm so tired of waking up exhausted. Is there anything I can do to make it through the night pain-free?

Dr. Donnica:
What you describe could be nocturnal (night-time) leg cramps. This can often be treated with a routine of stretching exercises before bed or a medication called quinine. It is possible, however, that you may have something called radiculopathy, which may have many different causes. The term radiculopathy describes pain, weakness, numbness or abnormal sensations felt through a part of the body controlled by a specific nerve or group of nerves. Severe muscle spasms or vertebral disc abnormalities (e.g. "slipped discs" or spondylolisthesis) are possible causes. "Lumbar radiculopathy" refers to irritation of the nerve or nerves leaving the lower spine involving the hips, legs, feet and toes. This requires evaluation by your physician. S/he will do a thorough physical examination focusing on your reflexes and peripheral nervous system and may want to order x-rays or a diagnostic MRI (magnetic resonance imaging). If you have radiculopathy, treatment will depend upon the diagnosis, but may involve anti-inflammatory medications, rest, physical therapy, muscle relaxants, and in some cases, surgery.

The tingling you are experiencing may also indicate something called "peripheral neuropathy." Peripheral neuropathy refers to damage of the peripheral nerves, which send information from the brain and spinal cord to every other part of the body. It may be caused by diseases of the nerves or as the result of systemic illnesses such as diabetes or nutritional deficiencies. There are many other causes as well, including everything from mechanical pressure or an injury you weren't aware of, to certain medications or toxic exposures, to autoimmune diseases such as rheumatoid arthritis and lupus. Many cases remain a mystery. Since treatment depends upon the specific diagnosis, you must see your physician for a complete exam.

Created: 4/3/2004  -  Donnica Moore, M.D.

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