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Swelling in calf and legs after waking up. Muscle spasms in calf. History of bike fall. Looking for suggestion?

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Internal Medicine Specialist
Practicing since : 2001
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Onset: sudden, 5 weeks ago. Healthy,active(sports).
Waking up: completely normal, always. Then, swelling of calf, both legs, starting as soon as one hour after getting up in the morning. But NOT the feet, NOT the ankles, NOT the upper legs. Sensation of permanent spasm of the muscles(calf) a few days a week, left calf. Diameter of calf increasing 2cm(7/8inch) in pm; huge!
Doppler of legs, normal.
Urine normal.
Blood normal, thyroïd normal.
Electrocardiogram normal.
Oxygen saturation normal.
X-ray lungs normal.

History. Bike fall 12 weeks ago, on the side, feet clipped, no speed. Left knee: contusion. Fells ok now. Right knee: femoral-patela syndrom, almost ok. Both knee: still a noise of sqwish-sqwish at flexion.
Stopped all sports for 1 1/2 months, but walking 5km 3x/week. Back to light jogging and small-easy bicycle outings(15km), without pain, the past two weeks.
Not much change on calf-swelling-situation.
Meds. Topical Lamisil three months BID. Off treatment 3 weeks. No improvement on calf swelling.

What/where else should i investigate??
Very very very uncomfortable all day.

Thank you.
Posted Sun, 19 Aug 2012 in Bones, Muscles and Joints
Answered by Dr. Ram Choudhary 2 hours later

Welcome to healthcare magic!
Your problem is most likely an apparent one!
The mostly possibility is incompetent valves in calf veins but color Doppler is the gold standard investigation and that has been documented as normal.
I would still advise to repeat one two weeks later with a more experienced doctor.
Another possibility is lymph-oedema that is also a system of thin ducts in limb and which carry lymph from periphery to the heart.
It's problem can be detected by Lymphography.

But first do one thing.
1.Measure the girth of calf at fixed point when you get up.
2.Then just do house hold work or just roam around effortlessly for 2 hours then measure the girth.
3.And lastly go for yours routine vigorous schedule of exercise and immediately following it measures the girth.
If case one & two girth is same and the third is more, you are absolutely normal and the increase is due to exercise induced increase circulation.
YOU need to consult an orthopedician for your noisy knees that problem is not linked to this one.
For this you need only some pain killer and muscle relaxants.

I hope this advise would be helpful for you.

Still if you have any queries or doubts, please write me back,
I would be happy to solve them.

Wish you a great health!

Above answer was peer-reviewed by
Follow-up: Swelling in calf and legs after waking up. Muscle spasms in calf. History of bike fall. Looking for suggestion? 8 days later

Vein system normal. It doesn't seem to be a vascular problem: feet, ankles and upper legs stay normal. Ankles don't swell ever. Very weird.

New information: after triple checking, the problem (calves getting huge and muscle pain) occurs ONLY WHEN I'M AT WORK, even if i do the same walking, sitting, motion, on days off.

Could this be a muscular problem, triggered by something in the environment, like air conditioning, computer, wi-fi, electric box, molds, posture????

Answered by Dr. Ram Choudhary 2 hours later


Welcome back to healthcare magic Physicians!
It is not something external, the environmental things you have mentioned do not have that much energy to cause changes like that but the exercise and posture is probably precipitating the problem.
The system affected may be the muscles, veins, lymphatics or some neurological problem also a remote possibility.
Please get a physical examination done by a physician, it is really a very perturbing issue that you are suffering from.
I think the advise would be helpful for you.
If you still have queries if any, please feel free to communicate back.

And if satisfied with my solution then please accept the answer and take a moment to post your view in the Review Section about my Clinical skills!

Wish you a great XXXXXXX
Above answer was peer-reviewed by
Follow-up: Swelling in calf and legs after waking up. Muscle spasms in calf. History of bike fall. Looking for suggestion? 3 days later
Not a follow-up question but just a note.

I did see a physisian who ran the tests mentionned aboved.
Everything is negative, and this physician doesn't see what else could be tested neither to whom i should be refered to.
So that's that.
I have a very annoying condition. With very obvious signs and symptoms, no diagnosis, no plan to investigate more, no treatment or ways to make me feel better.
Now, i just have to wait and see if it goes away with time.

It gives you a good idea how efficient the health care system is in our 'so poor' province of Québec, Canada.

Thank you very much.
I did appreciate your detailed answers, which gave me leads.
Will get back to you if i have any other questions.

Answered by Dr. Ram Choudhary 8 hours later
Welcome back.
I am so sorry that your problem remains unsorted out.
Let the every thing be negative and dump them, If you can keep a positive attitude then every thing is OK.
At times a functional disorder of legs called Restless leg syndrome may be there causing such symptoms but difficult to diagnose.
A vitamin supplement like Supradyn/Becosule-Z and Alprazolam+Sertraline at bed time for long duration is quite effective.
You can try this in care of your physician there.
I hope you would get better sans diagnosis.
Above answer was peer-reviewed by
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