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What causes sudden onset of extreme pain in the leg at night?

Answered by
Dr. Robert Galamaga


Practicing since :2002

Answered : 2631 Questions

Posted on Tue, 14 Mar 2017 in Bones, Muscles and Joints
Question: What could cause sudden onset of extreme pain in right leg and inability to stand or walk on that limb.
I had knee and hip X-rays that were normal and an MRI of my lumbar spine all normal. Joints have good movement without pain. The pain comes from the bottom of my foot through my lower leg then continues above my knee and into my hip. The pain worsens at night and the more I'm up on the walker.
Answered by Dr. Robert Galamaga 11 minutes later
Brief Answer:

Detailed Answer:
hello and thank you for sending the question.

I am sorry to hear that you are experiencing extreme discomfort.

I have a couple of ideas that might help us get to the bottom of this. Since your pain seems to originate in your foot and extend above your knee it might be reasonable to evaluate the nerve conduction system in that region. This can be done with the test called electromyelogram. This is a test that is typically done by a neurologist or a physical medicine specialist.
another consideration would be some type of vascular compromise. This would mean a disturbance in blood flow in your arteries or things may be contributing to some of your symptoms. Disruption in blood flow of veins might lead to some swelling of the legs and associated pain.

blood flow can be evaluated by ultrasound study that can be ordered by your doctor.

lastly some of your symptoms may be related to inflammation or arthritis in the joint which may affect your muscle strength and flexibility. For this reason it might be reasonable to try a short course of anti-inflammatory medication such as ibuprofen which you can take as directed on the bottle.

lastly a course of physical therapy may be reasonable to help assess your flexibility and strength which might gradually help you feel better and decrease the severity and frequency of your symptoms.

thank you again for sending the question.


Dr. Galamaga
Above answer was peer-reviewed by : Dr. Nagamani Ng
Follow up: Dr. Robert Galamaga 35 minutes later
I'm currently in PT I was in it due to knee surgery for shredded meniscus and arthritis. I was totally healed but still seeing her to strengthen the muscles around the joint. I had an allergic reaction to ibuprofen plus my platelets stay in the sixties due to autoimmune hepatitis. The dr has me on Vicodin 10/325 1 q6 hrs. But it doesn't touch the pain

I will see if I can get the electromylagram. I have had trigeminal neuralgia for 15 years and have a high pain tolerance but this is just as extreme as trigeminal neuralgia.

I have an appointment with a rheumatologist but can't get in till the end of April I saw a neurologist this past summer but he only focused on the trigeminal neuralgia and dismissed all the other symptoms I am having and now I can't even walk, work or take care of my children. It feels like if you don't fit into a certain box of symptoms no one wants to help find answers
Answered by Dr. Robert Galamaga 15 hours later
Brief Answer:

Detailed Answer:
Thanks for the additional info.

I'd be interested to see what the EMG shows.


Dr Galamaga
Above answer was peer-reviewed by : Dr. Raju A.T

The User accepted the expert's answer

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