07-21-2006, 06:03 PM
I have lupus and it's not under the best control yet. I've been on 6 - 10 mg prednisone and 400 mg placquenil for 13 mo. now with some relief. I have burning and very painful feet on both sides the doc thinks is neuritis. I had an EMG yesterday and the nerve part came out pretty good. The right side was tested and the muscle part showed 3 abnormal muscles out of about 10 tested 1 in my lower back and 2 on my lower leg. I think this was a pretty high percent. The doc was trying to make me feel OK with it and I have the neurologist appt on Wed. I need your input on this....is this part of lupus? Does any one else have abnormal muscles...what does it mean. thanks, you guys are so great. debann
07-22-2006, 08:22 AM
Hi debann. I am new to the site. I have lupus and sjogrens. A few weeks ago I had an EMG. My nerve part came out fine too, but I apparently have problems with my c-spine (neck). I had an MRI last week and will go over it with her on Thursday. My neuro says that it is part of lupus. As I say, just another thing to add to the pile. I hope to have more answers then.
I have some neck pain, not a lot. But I also have painful/burning feet, usually after work (my rheumie says it because I'm getting older. I'm 41 and he's full of crap). And, I wake up alot of times with either a partial numb arm or totally numb arm. The nerve in the neck is most likely the culprit. It sucks. But, my neuro is great. Sorry I don't have more info yet.
Keep us posted on your results. I'd love to compare notes with you. Take care.
07-24-2006, 03:28 AM
Although lupus most often occurs alone, many people with lupus also have symptoms characteristic of one or more of the other connective tissue diseases. This is generally known as "overlap". There are several well-recognized overlaps that may affect people with lupus, such as Rheumatoid Arthritis, Myositis, Scleroderma, Mixed Connective Tissue Disease, Sjogren's syndrome and others.
Of the overlaps listed above, myositis is the one that will generally have the following:
- increased blood levels of creatine kinase (CK), a substance that leaks from injured muscle
- abnormal electrical activity of muscles detected by electromyogram (EMG)
- muscle biopsy showing muscle cell degeneration and inflammation that is found in a muscle biopsy.
Myositis is a rare but well-recognized complication of systemic lupus erythematosus (SLE). The muscles can be seriously damaged by SLE, the muscles of the trunk of the body can be affected (i.e., neck, pelvic girdle and thighs, shoulder girdle and upper arms). Nerves as well as muscle fibers can be caught up in the inflammatory process and, occasionally, weakness of the wrists and hands or the ankles and feet may occur as a result of nerve damage.
The diagnosis of SLE myositis is relatively straightforward. There are chemical enzymes (e.g., CPK, SGOT, SGPT, aldolase) which are normally concentrated within muscle fibers and which escape into the blood circulation when muscle fibers are being damaged by inflammation. Thus, tests for these chemicals in the blood are abnormal in SLE myositis. These tests can also be used to determine the severity of muscle involvement: more severe myositis results in a higher level of these enzymes in the blood. Such tests are therefore useful in the diagnosis of SLE myositis, and in following the course of the disease and its response to therapy.
Just as the electrocardiogram (EKG) reflects damage to heart muscle, the electromyogram (EMG) can be used to determine the character of muscle damage in lupus myositis. When inflammation is present, the EMG shows a characteristic pattern of electrical response. A microscopic examination of a sample of muscle tissue (biopsy) may also be taken from a painful muscle to confirm the presence of inflammation and to help identify the severity of the inflammation.
Treatment. Corticosteroids (prednisone) are necessarily prescribed for the treatment of SLE myositis. High doses (50 mg. per day or more of prednisone or equivalent) are initially given for prompt suppression and control of the inflammation. The steroid dose is gradually reduced as the inflammation subsides, as determined by the patient's symptoms and enzyme levels in the blood. The vast majority of people with lupus respond promptly and well to corticosteroids. It is seldom necessary to augment treatment with cytotoxic or immunosuppressive medications.
Once the acute, inflammatory phase is past, a well directed exercise program should be started to help the patient regain normal muscle strength and function.
Discuss this possibility with your doctor to see if this might be the cause of your symptoms.
I wish you the best :P
Peace and Blessings