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Family Medicine (Expert Forum)
pains in leg/arm
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
pains in leg/arm
by Jackie13, Jun 03, 2002 12:00AM
Hello,
Thank you for providing this service. I apologize for the length of my post but I wanted to give you as much information as possible.
About 2 weeks ago I began developing pain in the back of my left calf and behind my knee. In particular it hurt to straighten my leg fully while standing up. In addition it felt sort of prickly/itchy behind my knee and in my upper calf. I went to the doctor, who ordered an ultrasound for suspicion of DVT, although I did not have any of the associated redness/warmth or significant swelling. (I had just flown round trip from Boston to Hawaii and the doctor indicated that long trips can sometimes lead to clotting.) The ultrasound was normal, and the doctor suggested it could be a ruptured baker's cyst.
The pain started to subside a bit, and yesterday I did some walking around, more than I had done since the leg pain started. My left leg became very achey and I could see a brownish/bluish streak (like a vein, but browner, about 4 inches long) on the inside of my calf, with a small, soft tender little bump right at the top. Even after sitting with my feet elevated for several hours afterward the ache continued and the little bump reappeared whenever I stood up or sat with my feet down instead of elevated. I had a similar little bump on my ankle.
I am wondering if this could be a varicose vein? I am a 31 year old woman and have never had one before. Would this have caused the pain from 2 weeks ago as well? I have never noticed symptoms before, what would cause it to appear suddenly? Or could this be related to a baker's cyst? Another thing I turned up on the internet while looking up my symptoms is superficial phlebitis, which scared me to death after the previous blood clot suspicion, even though the ultrasound was negative. Would superficial clots show up on an ultrasound? Is there any risk of them becoming DVTs?
Additionally, while I was at the doctor for the leg pain, she took some blood from my arm for routine testing. My arm just above the inner elbow has become very very sore since then. The test was 10 days ago. It feels like a strained muscle and it is very painful to straighten my arm fully and to the touch. It is painful enough to wake me up when I roll over in bed. There are some superficial veins that have become fairly prominent in that area, but no redness, swelling, etc. Perhaps I am just hyper-sensitive now to the idea of blood clots, but it is rather worrisome to me considering that it has been 10 days since I had blood drawn and the symptoms are actually getting worse.
One more symptom - this may not be relevant but I thought I would mention it. For the past 4 weeks my toes and the bottoms of my heels have been very tingly when I first get out of bed. I do not notice it at all until I put my feet on the floor, and then it goes away in a few seconds. This is in both feet.
Any insight at all would be very much appreciated.
Regards,
Jackie
Thank you for providing this service. I apologize for the length of my post but I wanted to give you as much information as possible.
About 2 weeks ago I began developing pain in the back of my left calf and behind my knee. In particular it hurt to straighten my leg fully while standing up. In addition it felt sort of prickly/itchy behind my knee and in my upper calf. I went to the doctor, who ordered an ultrasound for suspicion of DVT, although I did not have any of the associated redness/warmth or significant swelling. (I had just flown round trip from Boston to Hawaii and the doctor indicated that long trips can sometimes lead to clotting.) The ultrasound was normal, and the doctor suggested it could be a ruptured baker's cyst.
The pain started to subside a bit, and yesterday I did some walking around, more than I had done since the leg pain started. My left leg became very achey and I could see a brownish/bluish streak (like a vein, but browner, about 4 inches long) on the inside of my calf, with a small, soft tender little bump right at the top. Even after sitting with my feet elevated for several hours afterward the ache continued and the little bump reappeared whenever I stood up or sat with my feet down instead of elevated. I had a similar little bump on my ankle.
I am wondering if this could be a varicose vein? I am a 31 year old woman and have never had one before. Would this have caused the pain from 2 weeks ago as well? I have never noticed symptoms before, what would cause it to appear suddenly? Or could this be related to a baker's cyst? Another thing I turned up on the internet while looking up my symptoms is superficial phlebitis, which scared me to death after the previous blood clot suspicion, even though the ultrasound was negative. Would superficial clots show up on an ultrasound? Is there any risk of them becoming DVTs?
Additionally, while I was at the doctor for the leg pain, she took some blood from my arm for routine testing. My arm just above the inner elbow has become very very sore since then. The test was 10 days ago. It feels like a strained muscle and it is very painful to straighten my arm fully and to the touch. It is painful enough to wake me up when I roll over in bed. There are some superficial veins that have become fairly prominent in that area, but no redness, swelling, etc. Perhaps I am just hyper-sensitive now to the idea of blood clots, but it is rather worrisome to me considering that it has been 10 days since I had blood drawn and the symptoms are actually getting worse.
One more symptom - this may not be relevant but I thought I would mention it. For the past 4 weeks my toes and the bottoms of my heels have been very tingly when I first get out of bed. I do not notice it at all until I put my feet on the floor, and then it goes away in a few seconds. This is in both feet.
Any insight at all would be very much appreciated.
Regards,
Jackie
Doctor's Answer
by Forum-M.D.-DT, Jun 04, 2002 12:00AM
Hi Jackie,
Thanks for visiting the Family Practice Forum.
Well, I am happy to hear that your Ultrasound "ruled out" a deep venous thrombosis (DVT). I have to say that what you describe really sounds like superficial thrombophelbitis. Superficial Thrombophlebitis (ST) is a condition where there is inflammation and swelling of the veins of the legs. The term “superficial” means that they are just beneath the surface of the skin. (vs. Deep Venous Thrombosis). Certain risk factors preclude one to developing superficial Thrombophlebitis. These include immobilization, obesity, high blood pressure, pregnancy, oral contraceptives, previous surgery and infection to name a few. In some cases the veins can have a thrombus form inside of it, this will commonly cause pain, swelling and occasionally bruising to the leg. With ST these clots do not move. They will cause localized pain and occasionally may become infected however are not capable of forming a clot which can migrate to the heart and lungs (as is seen with deep venous thrombosis.) Initial measures to treat ST include elevation of the leg and warm compresses. If there is no evidence of infection (changes seen on a blood test, fever, redness, swelling), the condition can be treated on an outpatient basis and is known as an “aseptic” ST. A “septic” (infected) ST commonly follows a procedure where some time of surgery and/or IV catheter has been used and has caused inflammation of the vein. The septic ST commonly involves the need for hospitalization and treatment with IV antibiotics. Occasionally, if there is severe infection and/or evidence of a clot surgical intervention may be necessary.
Superficial clots may show up on an ultrasound, but commonly they don't. The important factor to note is that a DVT has the potential to migrate to the lung and cause significant problems, whereas the ST does NOT go anywhere, but may cause local inflammation of the area surrounding it.
I hope this makes sense to you ... if you have further questions, please let me know.
Thanks for visiting the Family Practice Forum.
Well, I am happy to hear that your Ultrasound "ruled out" a deep venous thrombosis (DVT). I have to say that what you describe really sounds like superficial thrombophelbitis. Superficial Thrombophlebitis (ST) is a condition where there is inflammation and swelling of the veins of the legs. The term “superficial” means that they are just beneath the surface of the skin. (vs. Deep Venous Thrombosis). Certain risk factors preclude one to developing superficial Thrombophlebitis. These include immobilization, obesity, high blood pressure, pregnancy, oral contraceptives, previous surgery and infection to name a few. In some cases the veins can have a thrombus form inside of it, this will commonly cause pain, swelling and occasionally bruising to the leg. With ST these clots do not move. They will cause localized pain and occasionally may become infected however are not capable of forming a clot which can migrate to the heart and lungs (as is seen with deep venous thrombosis.) Initial measures to treat ST include elevation of the leg and warm compresses. If there is no evidence of infection (changes seen on a blood test, fever, redness, swelling), the condition can be treated on an outpatient basis and is known as an “aseptic” ST. A “septic” (infected) ST commonly follows a procedure where some time of surgery and/or IV catheter has been used and has caused inflammation of the vein. The septic ST commonly involves the need for hospitalization and treatment with IV antibiotics. Occasionally, if there is severe infection and/or evidence of a clot surgical intervention may be necessary.
Superficial clots may show up on an ultrasound, but commonly they don't. The important factor to note is that a DVT has the potential to migrate to the lung and cause significant problems, whereas the ST does NOT go anywhere, but may cause local inflammation of the area surrounding it.
I hope this makes sense to you ... if you have further questions, please let me know.
Member Comments
by skybaby, Aug 06, 2002 12:00AM
i am having severe pain in my legs it seems to hurt worse when i lay down i feel like my legs have to be moving so that they dont hurt.i have took everything you can imagine just to try to make it stop so i can sleep and there is no over the counter medicine that helps please tell me what your oppion is on this.
by Sachel, Sep 02, 2002 12:00AM
I have a question that I was hoping someone could answer. A couple of weeks ago I had a couple of large boxes fall onto my left arm and shoulder, in the back. Day by day these symptoms are getting worse and I am getting scared about what they might be. Some one told me it sounded like a blood clot to them and I,ve been scared to death ever since. I have pain starting a my shoulder going down all the way to my forearn. I have numbness and tingling in my entire hand and some parts of my fingers I can,t feel at all. My hand is swollen enough that I can't take my rings off.It hurts the worst between my shoulder and my elbow in my upper arm. If I press on it even gently my hand goes numb. When I am sitting in a chair and I let my arm relax I feel pain in the entire arm and my hand starts to go numb. It had triggered a couple of killer migraines and for these I take Maxalt. I took one the othr day thinking that a headache was comming and it made the symptoms in my arem a bit better for a while. There is a lump about the size of half a lemon directly over the muscle. To make a long story short (I know too late) This is very painful and is scaring me if someone has any Idea what this might be or If I should seek emergency medical care for this please write back. Thanks Janis
