Leg Pain

[doreen]

I am a 53 year old woman, previously in good health, who had a massive pulmonary embolism in Oct,2000.  I spent 4 days in hospital on Herarin (insufficient dose given) & am now on Coumadin.  Diagnosis was made through VQ scan.  No Doppler was done as there was no swelling of my legs so the source the the PE is unknown but assumed to be legs.  I have no family history of clots.  At the time the only risk identified was that I had been on HRT for 6 months.  

Blood tests have now established that I have Antiphospholipid antiboides (I do not know the titer) & elevated Homosysteine.  I believe I am being tested for Lupus (tests for C3, C4 complement, Antinuclear & CH50 were done but results not known).

PROBLEM
Ten days after the PE I started getting small trobs in both calves which are not painful.  They do not feel like cramps.  They come & go but are most often felt while sitting or laying down.  Generally around mid day my calves become rigid (the muscle does not release when relaxed).  This only goes away if I put my feet up or lay down for about an hour.

At my request, my doctor prescribed compression stockings.  These help prevent the rigidity but I can still feel the thobs.  If I stop wearing the stockings for a few days, the rigidity starts again.  

I have no swelling or changes to the skin surface.  I do feel a crawling feeling under the skin, generally in the morning before I get up.  My doctor has no idea what this is and has ruled out post thrombotic syndrome.  Any idea on what this could be?
Doreen

[CCF Neuro[P] MD, RPS]

Dear Doreen:

I am sorry to hear of your PE and antiphospholipid syndrome.  I hope you are taking your vitamin B12 and folic acid (to lower the homocysteine level).  I am not sure if I can help.  One thing is that with the pressure stockings you are having less symptoms.  This suggests that venous return from your legs might be compromised.  This would also go along with your presumed etiology of the PE (your legs; blood stasis can increase the formation of emboli).  Maybe a doppler of your calves might help sort out things.  We were always taught in medical school that DVTs in the calves (I am not suggesting that is what is occurring) is something we watch very closely but usually do not begin treatment with coumadin for.  While they are doing dopplers on your calves it might be wise just to check the thigh areas.  Sorry, I am not much help.

Sincerely,

CCF Neuro MD

[Doreen PS]

P.S.  I have had two ultrasounds of my legs and no blockage was found.

[dean]

Hi, I have been watching this Forum for some time. You have the nearest symptoms to those I have been experiencing for the last 2 years. Unfortunately, I have not been able to post my own questions due to the daily limit on those accepted. I have no previous medical history. I am in my early 30's. My pain is usually concentrated in my left thigh muscle or both but occasionally occupies a calf or a buttock. It only appears to be in one place at a time.

It is very difficult to describe the pain or discomfort that I feel almost constantly when I am sitting or generally at rest. I think its characteristics change. Sometimes I think it is a mild burning sensation, other times muscle numbness or acheing and sometimes a feeling of being bruised. Guess this could also be described as a crawling feeling. My thighs become semi-rigid (the muscle does not release fully when relaxed). Massage and hot baths do not provide relief. It is bad is enough to keep me awake at night.

I started to notice that something was wrong when I started to play Soccer after years of doing little or no sports or other strenuous exercise. When I ran, it felt like my thigh muscles were being overstretched. Then, when I kicked the ball !!**??!!##. This pain felt like I pulled the thigh muscle, only it was significantly sharper. Eventually, I realized that I could almost eliminate the pains during sports by doing muscle-building exercises on my thighs and warm-ups directly beforehand. Sports seem to be my only temporary escape now. Maybe exercising the muscles will give you temporary relief. Guess I should go see a doctor. Never seem to have time and scared of what it might be.

Hope you get better.