I have a twitching in my right leg and a weak bladder. Please assist.

Q. Can conservative care and physical therapy help with leg twitching and and weak bladder?

Answered by
Dr. Aida Abaz Quka
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 28, 2023

Hello doctor,

Since eight months, I have been having twitching in my right leg and foot and extremely mild weakness combined with intermittent bladder hesitancy. I finally had an MRI of my lumbar spine. I am currently a college student doing a studyabroad and so I am attaching my MRI results.The results are:


Rectification of lumbar lordosis in the sagittal plane. Alterations in the morphology of the L4 vertebral body at the level of the anterior region of the upper vertebral endplate. Signs of degenerative disc disease in L2/L3 in L3/L4. Disc overflow in L2/L3 in L3/ L4. A slight decrease in the amplitude of the lateral recesses in L4/L5 and L5/S1. The spinal canal is normal. There are alterations at the level of the roots of the cauda equina.


Signs of degenerative disc disease in L2/L3 in L3/L4. Disk spillage in L2/L3 in L3/L4. Alterations in the morphology of the L4 vertebral body at the level of the anterior region of the upper vertebral plate. We recommend evaluating the history and correlating it with a radiographic study. I would like to know what my next step should be. With my age, do you think conservative treatment and physical therapy would be beneficial?

Thank you.



Welcome to icliniq.com.

Considering your symptoms (attachment removed to protect the patient's identity), I recommend performing nerve conduction studies to exclude possible neuropathy and a brain MRI (magnetic resonance imaging) to exclude MS (multiple sclerosis).

The lumbar spine MRI is not conclusive about any disk herniation, which could lead to nervecompression and it could explain your symptoms. So it does not define your symptoms. That is why I recommend going for the tests mentioned above. Another test to consider is vitamin B12 plasma levels for possible deficiency. Physiotherapy is the best tool to help improve your situation, concomitantly with Vitamin B complex, omega-3 fatty acids, and alpha lipoic acid supplements.

I hope you will find this information helpful.

Kind regards.

Hello doctor,

I had a brain MRI three months back due to my symptoms. However, the only result was “few, small, nonspecific hyperintensities in the subcortical white matter predominantly in the frontal lobe.” My neurologist stated that it was normal and did not explain my symptoms. Additionally, there were no signal abnormalities in that MRI and the MRI of my cervical spine.

Thank you.



Welcome back to icliniq.com.

Thank you for the additional information provided.

Coming to this point, I recommend following up with a brain MRI (magnetic resonance imaging) after a year to examine the possible progression of the white matter hyperintensities. Now, the only thing to do is to take the above supplements and do physiotherapy. Nerve conduction studies can help exclude possible peripheral neuropathy or nerve compression.

I hope you will find this information helpful.

Please reach out to me for further queries on icliniq.com.

Kind regards.

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