Compression Neuropathies, Fasiculations & PsA

General
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So I am having issues with peripheral neuropathy, probable nerve entrapmemts, and fasiculations.

I underwent a nerve conduction test in my hands and wrists. I received a DX of severe carpal tunnel syndrome. But I have numbness associated with the ulnar nerves as well. I had injections in both wrists with only limited relief. The hand symptoms have been an ingoing issue since at least 2009 maybe earlier.

I started having fasiculations (twitches) in my legs, primarily my calves. I have episodes of sciatic pain & discomfort. The fasiculations have been gradually increasing and are no longer limited to my calves. It seems near constant now at least at a low level and can increase with activity. I had started PT but the issue predates that and persists.

There is a 'hotspot' on the top of my left foot that is constantly twitching and spasming. At peak it make me want to crawl out of my own skin it is so irritating. I put a compression sock on and wrap an ice pack around it but sometimes it seems unrelenting.

I take multivitams and eat food rich in magnesium so I do not suspect a deficiency. I was on naproxen for quite a while but ceased it do to GI issues. I even ceased NSAIDs altogether for a number of weeks. I obtain from and have limited caffiene with no relief.

I have an appointment with a neurologist next week.

Since starting PT, I have been getting what I suspect are cercicogenic headaches and what I expect is nerve pain radiating out across my shoulder. I had a flare of sacroiliitis that was accompanies by fasciculation near my tailbone and in my thighs. I also now have fasciculation occurring in my upper body. My hands have gone numb as I type this and a twitch is in my upper left arm.

I had hoped PT would bring relief over all but right now it seems to be escalating things.

My rheumy has me now ceasing Humira and starting cimzia. But the 'specialty' pharmacy has yet to get their act together so it will be two weeks since my new script was submitted before I see new meds.

Anyhow, I am just wondering what experience anyone may have with escalating fasiculations or entrapment neuropathies and any strategies for relief.

Of course, I will follow through with the nuero. And of course treating the PsA as the underlying condition is the primary approach.

My experience with my hand issues has me less than optimistic about another set of nerve conduction tests. From my standpoint, my hand symptoms are complex. I have classic symptoms of carpal tunnel syndrome but the other half oh my hands go numb as well. And on my left hand, at time just my thumb goes numb. I have had episodes of nerve pain that radiated in a straight line between shoulder and elbow. I suspect that inflammation is proabaly causing multiple compression points which vary over time. The doctor that performed the nerve test in my hand/arms insisted I only had CTS & it was in no way related to PsA. I simply do not believe that. I fear a similar experience with these lower body issues. Just a little frustrated right now if the lengthy ramble had not already made that apparent.

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Well my PCP referred me to the neurologist for an assessment of the fasiculations and a lower body nerve study. My thought originally was that if the testing can pinpoint trouble spots some locally applied approaches my better mitigate it. But now that things seem to have escalated I am floundering a bit as to how best to approach this upcoming appointment. I do not want to walk into the appointment and ramble.

But I do want to effectively communicate the larger context.

I have reasonable expectations in so far as I understand their is no magic wand to wave and make it all go away. I am only now just beginning to really assess where my mobility is limited through PT and it is a very gradual process. The pain I can manage. My mobility I am working on. The numbness I manage by switching activities, cold therapy.

It would have to be the twitching ... not the ocassional here and there things or mild fluttering. But the incessant day long, can't sleep flares. And this one spot in my left foot has been a severe problem in that regard. If there is a way to turn it down a few notches... I could function.

I tried lyrica at one point as it was suppose to help with nerve pain but at that time that was far from a major issue. Well, actually talking this out has already helped me to prioritize. That is a good first step to presenting this in a concise yet effective way to the neuro. Thanks for your guiding questions!