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Dr. Andrew Rynne

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Exp 50 years

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Suggest treatment for severe leg pain, nausea, cough and fever

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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 16512 Questions

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Posted on Sat, 11 Mar 2017 in Veins and Arteries
Question: Extreme pain both legs - ache is continuous , back also - biput not as severe - now a fever of 100.8 -
Slight nausea - cough !
XXXXXXX
doctor
Answered by Dr. T Chandrakant 32 minutes later
Brief Answer:
As detailed below.

Detailed Answer:
Hi.
Thanks for your query, albeit short.
To recapitulate: Male/75 - extreme pain both legs - continuous - back pain also, not as severe - fever 100.8 - nausea - cough - on medications Lyrica, Gabapentin - got Aspirin for fever ...

I was wondering as you are already on Lyrica and Gabapentin, whether for leg pain may be due to sciatica or neurological pain. If this is so and of a long duration, the probable diagnosis of pain in both legs can be correlated by MRI of the lower spine with any slipped disc or so.
Cough, fever increase in leg and back pain, nausea may be due to flu as it increases the muscle and joint pains too.
Another possibility can be muscle cramps or rarely of deep vein thrombosis of the calf area if there is also swelling and redness to be considered although looks less possible with the history you have provided.
For fever it is better to take Paracetamol than aspirin as you have got nausea indicating possibility of gastritis so common with the medications that you are already taking and with the symptoms one gets. You can take Paracetamol three to four times a day.
Hence better to add on a PPI like Omeprazole too.
Cough suppressants should be taken as coughing increases the back problems.
Also watch for constipation, take a mild laxative as constipation increases the back problems and leg pains.

Please give additional information:
Any previous investigations or already diagnosed problems?
If the leg pain a new and recent problem or present since long ago?
Is there any swelling in the legs?
Any redness?
Waking increases the pain or reduces it?
Any other information, reports that you would like to share.

Awaiting for your feedback.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. T Chandrakant 13 hours later
Pain is greatest at waking - no redness nor swelling - fever may or may not be new - failed to indicate that there is some issue with balance - quick movement could cause a fall - but quick hands to grab something to stay up ! No falls yet !
doctor
Answered by Dr. T Chandrakant 2 hours later
Brief Answer:
As detailed below.

Detailed Answer:
Thanks for your feedback.
Since the pain is severe at walking without any swelling or redness can be due to local muscle spams or due to sciatica, nerve roots compressed at the lower lumbar spine.
But this needs to be confirmed. :
High resolution ultrasound to rule out any DVT that is deep vein thrombosis or muscles problems and
MRI of the lower spine to see for any disc prolapse.
Please get both these important tests to get a proper diagnosis and a proper management will be possible then.
Continue the medicines you are already taking.

I hope this answer helps you to get an early diagnosis and proper management.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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