If your husband has had injections for disc problems, then he may have an impinged sciatic nerve that may be causing muscle fasciculations in his calves especially if he only gets them while he is sitting down. He might have a herniated disc at the L4-5 level which is causing radiculopathy. This would account for his L5, S1, S2 nerve impingement which includes the sciatic nerve. The sciatic nerve innervates the lower extremities which includes the calves of the lower legs so that if the nerve root is impinged then it may cause irregular signals to both of his calf muscles which will result in fasciculations. Fasciculations are twitching of small muscles without purposeful movement that can be seen through the skin.

He should have an MRI of his spine and an EMG (electromylegram) with an NCV (nerve conduction velocity) test. Measuring the electrical activity in muscles and nerves can help detect the presence, location, and extent of diseases that can damage muscle tissue (such as muscular dystrophy) or nerves (such as amyotrophic lateral sclerosis). In the case of nerve injury, the actual site of nerve damage can be located. An NCV assesses how well a specific nerve conducts impulses by evaluating the speed of an impulse as it travels along a nerve. This test can help determine if there is nerve damage, the extent of the damage, and if nerves have been destroyed. EMG and nerve conduction studies are usually done together to provide more complete information.

Treatments for sciatica are: physical therapy which includes specific stretching and strengthening exercises, medications e.g. NSAID's (Motrin or Advil), epidural steroid injections to relieve inflammation (which he is already familiar with), or surgery e.g. microdiscectomy or lumbar laminectomy and discectomy to remove the portion of the disc that is irritating the nerve root.

Here is a link to the top doctors within 13 miles of Philadelphia, Pennsylvania specializing in Neurology: http://www.appointmentnet.com/list_doctors/pid/16/zip/19019/city/Phila delphia/index.html

I hope this information is helpful for you. If you have additional questions please don't hesitate to ask me.

Dr. Hanson, MD, PhD