Objects fall from the hand and blood pressure spikes: symptoms that require quick investigation | Prof. Rafi Carasso
What causes leg edema, how to relax tense neck muscles, and are the various symptoms related to each other? Prof. Rafi Carasso answers listeners' questions.
I am 79 years old and suffer from leg edema. Blood tests showed a moderate decrease in kidney function. I am being treated with blood pressure medication, and the doctor is considering adding to the drug treatment. Also, I suffer from frequent urination. Are these things related? "Leg edema may stem from several combined factors. On one hand, there is the effect of medications: certain drugs for lowering blood pressure, particularly those belonging to the calcium channel blocker family, tend to cause fluid retention in the ankle area as a side effect. A change in dosage may alleviate the phenomenon. On the other hand, it is possible that this is renal fluid retention, since when the kidneys do not excrete fluids and salts optimally, more extensive fluid accumulation may occur in the body.
Regarding frequent urination, the phenomenon is usually explained by a combination of excessive drinking and age-dependent changes in the prostate. New generation drugs have an interesting mechanism: they were originally developed for diabetic patients because they help excrete sugar in the urine, but studies have shown significant evidence that they may protect kidney function and slow down renal deterioration even in patients without diabetes. At the same time, it is recommended to complete the structural investigation, such as a kidney ultrasound, and to be careful about reducing sodium in the diet, since excess salt worsens fluid retention."
I am 70 years old, with a history of ankle surgery and chronic leg pain. Recently, severe neck pain appeared, accompanied by weakness in the hand, to the point of dropping objects, calf pain at night, severe fatigue, and blood pressure that jumped to 160/110. Is a connection to a past thyroid problem or magnesium intake possible? "In situations that combine several symptoms, it is worth trying to separate the possible factors, and only a thorough medical investigation will be able to determine an accurate diagnosis. Neck pain accompanied by weakness that radiates to the arm or hand may correspond to structural changes in the cervical vertebrae that exert pressure on the nerve roots. Similarly, pain in the calves or a feeling of instability in the legs, especially when they increase while lying down at night, may stem from changes in the lumbar spine.
On the other hand, extreme fatigue and general pain can sometimes be linked to a passing viral infection. Regarding magnesium or the thyroid gland - it is less likely that this is the source of all the phenomena. Two indicators require quick medical attention: weakness in the hand and difficulties with gripping, since a condition where objects fall from the hand requires neurological evaluation; and high blood pressure values of 160/110, regarding which it is recommended to see a doctor and consider continuous monitoring with a blood pressure Holter. If the symptoms do not improve, it is recommended to perform general blood tests, including vitamin B12 and electrolytes, to rule out nutritional deficiencies."
I am 65 years old and dealing with Parkinson's. My main suffering is from cervical dystonia that pulls the head to the side and causes severe pain. Past Botox treatments did not help. Are there alternatives, and could an ultrasound-guided injection improve the response?
"Cervical dystonia is a condition where uncontrolled and unbalanced activity of the neck muscles occurs. The phenomenon can appear as a separate problem or as part of the symptoms of Parkinson's disease. The accepted treatment is based on injecting botulinum toxin to relax the tense muscles, but for the success of the treatment, great precision is required in choosing the muscle and the dosage. An ultrasound-guided injection allows the doctor to observe the deep neck muscles in real time and direct the substance precisely to the tense muscle, which increases the chances of success.
Alongside the injections, it is sometimes recommended to combine systemic drugs for muscle relaxation and focused physiotherapy, which aims to sharpen motor control and strengthen opposing muscles. In particularly resistant cases, one can consult in dedicated clinics for movement disorders regarding other advanced options. The therapeutic aspiration is always to find the delicate balance between reducing pain and contraction and maintaining the stability of the neck and head."
I was diagnosed with axonal polyneuropathy, and I suffer from a severe burning sensation and difficulties in walking. Drug treatment does not provide sufficient relief. What is the meaning of the diagnosis, and is it recommended to continue physical activity despite the pain?
"Polyneuropathy means damage to the peripheral nervous system involving several nerves simultaneously, usually symmetrically in both legs. When the damage is sensory, the brain distorts the signals and interprets them as discomfort, sensations of 'gravel', or burning. And when there is motor involvement, there may be difficulty in activating muscles, expressed, for example, in difficulty getting up from a chair. The causes of polyneuropathy are very diverse, ranging from genetic or age-dependent changes to metabolic problems.
As a first step, it is recommended to ensure a comprehensive blood test for vitamin B12 is performed, since sometimes there is a problem with its absorption in the digestive system. Physical activity and physiotherapy are very important for maintaining muscle strength and balance, but one should not ignore severe discomfort. If prolonged walking increases the burning sensation, it is correct to shorten the distance, stop for scheduled rests, and not cross the pain threshold."
These conversations do not constitute personal medical advice. One should always consult and be examined by a family doctor or a specialist doctor.
