QUESTION

One of my feet has been feeling weird—it buzzes, almost like I’m standing on a cell phone! What’s going on?

ANSWER

Occasional twitches or feelings of vibrating or buzzing in an arm, a leg, hand or foot are common and normal. These small, involuntary muscle twitches are called “fasciculations” and most of the time are just annoying. Fasciculations are most noticeable when you’re resting. Moving the affected body part generally stops the buzzing feeling, but it may return when you rest the muscle again. Numbness and muscle cramps might accompany the buzzing. Fasciculations are neuromuscular—your nerves (neurons) for some reason make your muscles move involuntarily—but why this happens can vary and isn’t fully understood. Possible triggers include a low level of calcium, magnesium or potassium…muscle strain…fatigue…alcohol…excess caffeine…and smoking. Certain medications, such as the antihistamine diphenhydramine (Benadryl) may also cause fasciculations, as can anxiety and depression. There is a condition called benign fasciculation syndrome (BFS), a neurological disorder characterized by recurrent twitching of various muscles, usually in the calves and thighs. The diagnosis of BFS usually is made when the muscle twitching lasts for extended periods and comes back regularly. While it is “benign,” that term fails to describe how annoying and disruptive the symptoms—burning, feelings of “pins and needles,” tingling, buzzing, muscle fatigue and/or muscle pain—can be. BFS may go away on its own…go away and come back…or last for months or longer. There isn’t a cure for BFS, however the condition does not pose a threat to a patient’s general health. It’s a good idea, though, to tell your doctor about your symptoms so that he/she can recommend whether to have a neurologist run some tests to rule out other serious neurological disorders. Note: In case you’re concerned, if it turns out that you do have BFS, there is no danger that it could “turn into” a more serious neuromuscular disease such as ALS. According to several large studies, there is no link between the two conditions. Nor does BFS cause the muscle wasting and weakness that is characteristic of ALS.   Long-lasting or recurring BFS can be managed with lifestyle changes, supplements and/or, if needed, medications. Including bananas, oranges, avocados, leafy greens and mineral water (which contains up to four times as much calcium and magnesium as regular tap water) in your diet can boost levels of potassium, magnesium and calcium…or you can take supplements of these minerals. If your BFS is related to a muscle injury, you may just need time to heal. If your exercise routine is very rigorous, try easing up on it—it might be too rigorous. Reduce stress, for instance, by practicing meditation, tai chi or yoga. Have a relaxing massage—weekly to start, and if it helps ease discomfort, see how frequently you need to keep it up for it to be beneficial. Cutting back on or eliminating caffeine (not just coffee and tea, also chocolate and cola), getting enough sleep and keeping your workday to reasonable hours also can help calm down the unwanted vibes. If these measures aren’t enough to stop the buzzing, your doctor may prescribe a medication such as a beta-blocker, an antiseizure drug, a muscle relaxant or an anti-inflammatory to reduce inflammation that may occur and to potentially reduce peripheral nerve hyperexcitability.

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