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Suggest Treatment For Hemifacial Spasm And Muscle Stiffness
Question: Hello, I am 71, and suffer and have suffered from R hemifacial spasm over the past 6 years. I am under the care of a neurosurgeon for botox injections, which are not totally successful. I have now developed pain and stiffness in both L and R neck muscles, and wonder if this could be a mild form of cervical dystonia, or be due to what I suspect too as a result of a side effect of having to take rosuvastatin to control cholesterol. Statin drugs have caused muscle pain in other areas before and I had discontinued them. However after discontinuing this one for 3 months, the pain had virtually gone. I had to restart the rosuvastatin 3 weeks ago, as the cholesterol result was not good, and the pain is returning I would be grateful to have your comments. Cheers, XXXX
Brief Answer:
could be dystonia
Detailed Answer:
Your neck pain and stiffness could be due to a dystonia.
Muscle pain from statins is usually a more generalized pain, not confined to a specific area. It also does not always cause stiffness. In addition there are two types of muscle pains from the statins, one is just a side effect of the medication, the other is a serious form of muscle breakdown called rhabdomyolysis. This is very serious and can cause kidney failure. To determine the difference doctors do a blood test called CPK which is elevated in rhabdomyolysis but not in the general side effect of muscle pain.
If you have muscle pain starting after a statin you need the CPK checked.
If you think you may have dystonia you need to talk to your neurologist about what might be causing that.
I hope you are feeling better soon
Dr. Robinson
could be dystonia
Detailed Answer:
Your neck pain and stiffness could be due to a dystonia.
Muscle pain from statins is usually a more generalized pain, not confined to a specific area. It also does not always cause stiffness. In addition there are two types of muscle pains from the statins, one is just a side effect of the medication, the other is a serious form of muscle breakdown called rhabdomyolysis. This is very serious and can cause kidney failure. To determine the difference doctors do a blood test called CPK which is elevated in rhabdomyolysis but not in the general side effect of muscle pain.
If you have muscle pain starting after a statin you need the CPK checked.
If you think you may have dystonia you need to talk to your neurologist about what might be causing that.
I hope you are feeling better soon
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thankyou XXXXXXX for your prompt reply. I had a ck test done 22-4-13 while under the care of heart specialist which read 116U/L. A follow up done after starting the Crestor showed 150 U/L. I stopped taking Crestor 22.12.14 following severe neck muscle pain for 3 months, and pain slowly improved, and was almost gone, when the cholesterol test doubled from 2.1 LDL to 5.6 when tested 24-5-15, so I started the Crestor 3 weeks ago, and now the neck muscle pains are coming back. I needed to know that I wasn,t a candidate for the muscle breakdown, which might have been caused by the statin. Hopefully, this isn't the case? I see the neurologist again for a botox injection for Hemifacial spasm 30th April, so will discuss this also with him. Presume I will have to continue with pain killers? Just one of the 'draw backs of growing old??!!! Appreciate your help, Cheers, XXXX
Hi XXXXXXX I sent a reply to you 7 hours ago, and as I haven't heard back from you with your comments, I'm wondering if it has perhaps not reached You? would be pleased to hear back if you can, especially to know what a ck reading amount would indicate muscle damage caused by statins.Do you know of any other medication, that would be able to successfully lower cholesterol levels?
Many thanks,
XXXX
Hi XXXXXXX I sent a reply to you 7 hours ago, and as I haven't heard back from you with your comments, I'm wondering if it has perhaps not reached You? would be pleased to hear back if you can, especially to know what a ck reading amount would indicate muscle damage caused by statins.Do you know of any other medication, that would be able to successfully lower cholesterol levels?
Many thanks,
XXXX
Brief Answer:
Hi XXXXXXX
Detailed Answer:
Sorry for the delay, I am in US and do not keep computer on while sleeping.
Normal CPK is 10-120, any elevation above this can mean that the statin is irritating the muscle tissue. Serious elevations in the 4-500 range or even higher is what you would see with rhabdomyolysis. However if you have any elevation at all while on a statin this is a concern and it would need to be followed carefully.
There are many other medications besides statins that an be used to lower cholesterol. You would need to talk to your local physician to see which one might work for you or even if a combination of medications could be used instead of the statin.
Working on a low carbohydrate diet, getting your weight in optimal levels and one hour of exercise daily can also be very helpful.
I wish you the best
Dr. Robinson
Hi XXXXXXX
Detailed Answer:
Sorry for the delay, I am in US and do not keep computer on while sleeping.
Normal CPK is 10-120, any elevation above this can mean that the statin is irritating the muscle tissue. Serious elevations in the 4-500 range or even higher is what you would see with rhabdomyolysis. However if you have any elevation at all while on a statin this is a concern and it would need to be followed carefully.
There are many other medications besides statins that an be used to lower cholesterol. You would need to talk to your local physician to see which one might work for you or even if a combination of medications could be used instead of the statin.
Working on a low carbohydrate diet, getting your weight in optimal levels and one hour of exercise daily can also be very helpful.
I wish you the best
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thankyou XXXXXXX I am sorry to bother you, not realising the time difference or where you are resident. However, should I be concerned about continuing the statin, when prior to my starting it in April 2013, my CPK was 116, and now it is sitting at 150,and should I look for other alternatives. I had used a bezafibrate before, which tended to raise my creatinine levels to 105,122,and latest level 111umol/L which is high by NZ standards,showing some problem with kidney function,which I believe is common for my age group. I try to eat sensibly, and my weight is 73 to 74 Kg which is ok with my height, and BP 122/72 last time it was taken, as I am also on BP medication. Sorry to be a nuisance, but would appreciate your advice.
Many thanks,
XXXX
Many thanks,
XXXX
Brief Answer:
Hi XXXXXXX
Detailed Answer:
No bother at all, just sorry about the delay. I think if you have your CPK level checked again and it is not getting higher then it is probably okay to continue the statin. However if you continue with the pain that you think may be related to the statin then it may be time to try alternatives. I would not suggest trying the fibrates again if they raised your creatinine levels.
Zetia (ezetimibe) is one that is not as powerful as a statin, but has less side effects. It can be combined with a low dose of statin or red yeast rice in some people and get good results. Red yeast rice is a supplement that has been shown to lower cholesterol.
One thing that some cardiologists in the states are trying is every other day statin and in some cases it can work and not cause so many side effects.
It sounds like you are very healthy generally so that is a good thing.
Remember also that high cholesterol is only one of the risk factors for vascular disease so if you are healthy in other ways (good blood pressure, good weight, no diabetes, regular exercise like walking, no smoking) then having high cholesterol may not harm you.
Except for a few hours at church I'll be around most of the day so feel free to send me more questions if you have them.
Kathy Robinson
Hi XXXXXXX
Detailed Answer:
No bother at all, just sorry about the delay. I think if you have your CPK level checked again and it is not getting higher then it is probably okay to continue the statin. However if you continue with the pain that you think may be related to the statin then it may be time to try alternatives. I would not suggest trying the fibrates again if they raised your creatinine levels.
Zetia (ezetimibe) is one that is not as powerful as a statin, but has less side effects. It can be combined with a low dose of statin or red yeast rice in some people and get good results. Red yeast rice is a supplement that has been shown to lower cholesterol.
One thing that some cardiologists in the states are trying is every other day statin and in some cases it can work and not cause so many side effects.
It sounds like you are very healthy generally so that is a good thing.
Remember also that high cholesterol is only one of the risk factors for vascular disease so if you are healthy in other ways (good blood pressure, good weight, no diabetes, regular exercise like walking, no smoking) then having high cholesterol may not harm you.
Except for a few hours at church I'll be around most of the day so feel free to send me more questions if you have them.
Kathy Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
good morning XXXXXXX Thankyou so much for your caring, and advice. I feel so much more comfortable after receiving your thoughts, and will carry on at this stage, and see how the pain progresses. I continued, yesterday taking 2 panadol 3 times a day, and a 500g Naproxen morning and night, which my Dr had suggested, if needed, and I had a good day, and a good sleep, without being woken with the pain in the early hours, which stopped me sleeping properly. I don't like having to resort to all these pills, but seems I have to, to enjoy my sporting activities etc, and trying to keep up with energies of my 8 grandchildren??!I will look for the red rice yeast, and see if it is available in NZ.It has been so good to chat with you,as the Dr here is so busy,and I don't feel comfortable perhaps 'holding' up the next patient's appt.with my worries! May God Bless you and give you a happy life.Take care,Cheers, XXXXx
Brief Answer:
good to talk to you
Detailed Answer:
I wish you the best and I hope you are out of pain soon
Kathy Robinson
good to talk to you
Detailed Answer:
I wish you the best and I hope you are out of pain soon
Kathy Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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