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What causes leg pain?

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Posted on Mon, 6 Oct 2014
Question: Hi,

Thank you for helping me! Sorry in advance for any spelling or grammar errors.

For the last 2 weeks I’ve been having pain and other unusual sensations in my legs. I think it’s related to my veins.

I’m a graphic designer by trade so I sit in front of a computer a lot. On top of that I often sit in front of the computer or television a few hours a day for leisure activities. 2 Weeks ago I was sitting for about 19-20 hours straight working. I got up and moved a few times but for the most part I was pretty immobile. Towards the end of this marathon over nighter my legs started to ache and they got this sensation like I have to move them all the time. Akathisia but just in my legs. I’m not sure if their is a term for this…maybe restless leg syndrome? My legs also felt very tired and heavy and the veins in the tops of my feet were bulging out. Upon further inspection I discovered that my right ankle was just a little swollen.

I was pretty panicked about the whole thing because I’ve been sitting in front of the computer for long periods of time before but nothing like this had ever happened. The very slight swelling in my right ankle went down after elevating my feet for a few hours.

Since this episode 2 weeks ago my legs have been aching constantly to one degree or another. Sometimes it’s extremely noticeable sometimes it’s not so bad. On a scale of 1-10, ten being the most pain I’ve ever experienced 1 being nothing, I’d rate the leg aches at their worst a 5-6. For the most part I’d say it’s about a 2-3.

The second night after the 19-20 hour exercise in how no one should ever work, I went to the emergency room. I was very concerned about the feeling in my legs and the possibility of deep vein thrombosis, which I know can be potentially life threatening. The emergency room took a look and diagnosed it as leg cramps. Their was no more slight swelling, their was no more bulging veins…just the pain and heavy/tired feeling seemed to remain. They did a ultra sound of both of my legs (above the knees only) to check for clots and it came back fine. They also did a electrolyte test which came back fine too.

Two days later I followed up from the ER visit with a general practitioner here in town who basically said the same thing as the ER. Quit smoking (which I have) and if your gonna be sitting down make sure to get up and move at least every 2-3 hours. Neither him nor the ER seemed to think much of it…their really are no visible symptoms at all except some slight vein bulging in my feet at the end of the day or after a 1-2 mile walk.

The pain heavy/tired feeling still remained even after I made the recommend changes from the GP and ER. I’ve noticed that elevating my feet sometimes relieves the pain as well as over the counter compression socks. When I wake up in the morning it’s not so bad but by the end of the day sometimes it’s terrible. While I’m writing this is the most pain and discomfort I’ve experienced from this problem so far.

I can walk fine but sometimes my legs feel really weak and wobbly almost…they aren’t actually wobbling but they feel like they are. Sometimes I get pain in the back of the knee and my calves feel like they are extremely full…like pressure is building up in them, but they look normal. When I go for 1-2 mile walks and I get home I notice the veins in my feet are bulging out and ache. Sometimes I feel like I can feel the pain in individual veins on the tops of my feet when they bulge out, sometimes I feel like its every vein in the leg and the whole thing aches. At the end of the day some spots seem to be tender when I touch them. Last night the largest vein on the top of my left foot was bulging out more then usual and I could feel it aching individually and it hurt when I touched it. Their was no redness or swelling and the pain was gone when I woke up in the morning. After working all day I’m right back in the same boat but the entirety of both of my legs ache.

I went to the ER a 2nd time and the doctor said the exact same thing as the the first ER and the GP. The GP and the ER are all through the University of Florida (Shands) so they are all able to access the charts from the previous visit and because their are no real visible symptoms and the ultra sound came back fine from the first ER visit I’m scared they are just reading the chart and agreeing with it instead of investigating further.

I’ve been reading online about vein problems and the symptoms of it, especially the pain, weakness and restless leg sensations. What I’m experiencing seems very similar but my legs look fine. Their is no edema, no big veracious veins, no skin cracking or ulcers…they look totally fine.

I’m a extremely inactive person. I’ve been inactive pretty much the whole 30 years of my life. I’m sitting down for a majority of the day for work and leisure activities. Until recently I smoked about a pack a day for 7 years. I’m 5 foot 10 and weight about 155 pounds. I take 15mg of remeron at night to help me sleep. For the pain I’ve been taking Naproxen (I also triad aspirin) and Tramadol neither one of which seems to do much. When I take the Tramadol in the morning i get a little buzz and feel fine but at the end of the day the pain starts to set in and 50mg of tramadol doesn’t do anything.

My overall suspicion is that my inactive lifestyle has possibly permanently damaged the veins in my legs and sitting down for so long 2 weeks ago caused the symptoms to rise above a subclinical level on the pain scale. Because I have to sit down for work I’m worried my legs aren’t able to heal. I’m also worried that they will always feel like this or I’ll get DVT and a pulmonary embolism. I feel like sitting down or even standing is causing the blood pressure in my veins to rise in my legs and the muscle contractions that pump the blood back up the legs aren’t happening. Maybe the valves in my leg veins are damaged. Some days my legs feel like they are getting better, but the next day they will be worse.

What would you recommend doing about this whole situation? This wasn’t a problem at all until 2 weeks ago. Are their any other tests that can be performed to check for leg vein problems? Is their a way to test the blood pressure in my legs or see if my veins are expanding too much? What is the likelihood of me getting deep vein thrombosis and then after that getting a pulmonary embolism and dieing?

Is it possible this isn’t related to my veins at all and it’s some sort of muscle or nerve problem? I’ve looked online a lot and I have no idea what’s going on. The doctors I’ve talked to so far think it’s muscle related but I’ve had muscle aches, cramps…pulled muscles before and they are nothing like this at all. If you were having these symptoms what would you do?

I’m gonna go see a phlebologist here in town as soon as possible are their any specific things I should tell him/her?

I’m really sorry for not being brief here but I’m really worried and wanted to tell the whole story. I can’t express enough how much I appreciate you doing this service cause I’ve kind of been freaking out about this for 2 weeks now and need some help.

Thanks for your time.
doctor
Answered by Dr. Hardik Sanghvi (42 minutes later)
Brief Answer:
Most probably its due to muscle cramps.

Detailed Answer:
Hi, dear.
I have gone through your entire question.
I can understand your concern. I know you are in deep trouble. I will help you to come out of this situation.
Your problem is very tricky. There are many conditions producing this kind of pain.
Varicose vein is one of that. But you don't have persistent symptoms. It is prone in the patient which are habitual of prolonged standing. Moreover your pain is not like the pain of varicose vein. So its not like varicose vein.
Deep vein thrombosis can cause that. But you don't have any symptoms of deep vein thrombosis and your ultrasound is also normal. So its not like deep vein thrombosis.
Peripheral vascular disease can produce pain. But pain aggravates by walking some distance and relieved by rest which you don't have so its not like that also.
So all major disorder are less likely. Muscular cramps is the possibility or you may have some neuronal disorder. But cramps are most likely.
You should go for some investigation like serum calcium level, serum b12 level and blood sugar.
You can take drug like muscle relaxant which help you in the pain instead of taking naproxan and tramadol you should take analgesic with muscle relaxant which will help you. Consult your doctor and take treatment accordingly.
If you still have doubt then you can go for color Doppler test. It will help you.
Please send me all reports so I can help you further.
Hope I have answered your question, if you have doubt then I will be happy to answer.
Thanks for using health care magic.
Wish you a very good health.





Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Answered by
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Dr. Hardik Sanghvi

Hematologist

Practicing since :2008

Answered : 7039 Questions

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What causes leg pain?

Brief Answer: Most probably its due to muscle cramps. Detailed Answer: Hi, dear. I have gone through your entire question. I can understand your concern. I know you are in deep trouble. I will help you to come out of this situation. Your problem is very tricky. There are many conditions producing this kind of pain. Varicose vein is one of that. But you don't have persistent symptoms. It is prone in the patient which are habitual of prolonged standing. Moreover your pain is not like the pain of varicose vein. So its not like varicose vein. Deep vein thrombosis can cause that. But you don't have any symptoms of deep vein thrombosis and your ultrasound is also normal. So its not like deep vein thrombosis. Peripheral vascular disease can produce pain. But pain aggravates by walking some distance and relieved by rest which you don't have so its not like that also. So all major disorder are less likely. Muscular cramps is the possibility or you may have some neuronal disorder. But cramps are most likely. You should go for some investigation like serum calcium level, serum b12 level and blood sugar. You can take drug like muscle relaxant which help you in the pain instead of taking naproxan and tramadol you should take analgesic with muscle relaxant which will help you. Consult your doctor and take treatment accordingly. If you still have doubt then you can go for color Doppler test. It will help you. Please send me all reports so I can help you further. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.