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Depending on findings, you may be referred to a neurologist (for suspected MS, neuropathy, or ALS), a rheumatologist (for fibromyalgia or chronic pain muscle spasms), or a physiatrist / sports medicine specialist (for musculoskeletal causes)

Vitamin B12 injections are generally safe and well tolerated, with fewer side effects than corticosteroids

Appropriate personal protective equipment should be used, and laboratory waste must be disposed of according to approved procedures

Moving forward, the best approach depends on the individual patient, the doctor says

Sa1100 randomized open label trial comparing efficacy of oral versus intramuscular vitamin B12 supplementation for treatment of vitamin B12 deficiency