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Lower leg

What can cause the lower part of my legs to feel so tired to where it hurt to walk?
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547368 tn?1440541785
Hi General,

Welcome to the Pain Management Community. I am sorry to hear about your leg pain induced by ambulating. Is this new for you? Do you have this or a similar feeling at rest?

How long as this been occurring? Were you inactive for awhile and just began walking again? Are you lower extremities swollen or red... or do they just feel heavy and tired? Do you have any other symptoms?

Is your heart healthy? Do you have diabetes or have you been diagnosed with circulatory problems? It could be that your legs are not getting enough nutrition and/or oxygen when you ambulate which would also indicate a circulatory compromise like PAD (Peripheral Vascular Disease).

It could be as simple as your calf (gastrocnemius) muscles are just out of condition. Additional information would be very helpful with our suggestions. Obviously you should consult your PCP. He/she will have the best answers for you.

I'll watch for your updates.

Take Care,
~Tuck
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Avatar universal
Yes my lesg hurtmost of the time, even at rest.  They are not red.  This has been going on for some time.  Exactlly how long, I do not know.  My feet do swell but go down at night.  They only feel that tired feeling with pain when I walk.  I had knee relpacemen years ago in which I was placed on my back for weeks.  I was not allowed to walk for quite awhile.  My knee feels like it has a tight rubber band that is quite wide around it.  It does not bend well.  On the inter side  of my right leg about a half hand from my ankle, there is a roung blue spot that feels like a knot and lokes like a cluster of blood vessels.  What it is, I don't know.  I do have an appointment for my doctor on the 5th. of July.  My  chemical stress test last  year was fine.  I do not have diabetes.  I wondered if this could be a circulatory problem or clots. Mu feet are very tender.  No matter what shoes that I wear, my feet hurt.  My legs have hurt for quite awhile.  It seems like they are getting worse.  I feel like if nothing is done, I may be in a wheel chain in a year.  I do not walk much because of the pain in my legs.  My gate is bad due to the knee.
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Avatar universal
Hi general0,

I'd like to join Tuck in Welcoming you to the PM (Pain Management Forum).  I'm so happy that you have found us!!

I'm sorry that you are experiencing these problems with your legs.  I was wondering if this is one leg or both of them?  If it is only one, is it the one with the TKR (Total Knee Replacement) or is it the other one?    

Your second post, in answer to Tuck's insightful questions, has shed a lot more light on your condition.  I have had 3 THR's (Total Hip Replacement) so I know what it's like to live with an implant.  You definitely could be experiencing some circulation problems, as I did with my THR's.  I keep getting "bruises", with knots under them, that "pop" up, for lack of a better term, without anything causing them at all.  My Orthopedic Surgeon and PCP are at a total loss as to what is causing them.  These bruises are "popping" up on both of my legs, even though all 3 THR's have been done on the left hip.  I, also, have swelling in my ankles from time to time that goes down when I lay down at night, just as you do.  I have had an angioplasty done on both of my legs and yet nothing was found, which surprised them.  Because of that I stopped one of my Celebrex capsules and believe it or not that slowed down the bruising.  Seemingly, I was getting to much blood-thinners in my system and the bruises were "popping" up constantly.  Now they "pop-up" much less frequently. Do you take any blood-thinners such as Plavix or coumadin or for that fact any aspirin or Celebrex or anything along that line of medications?

May I ask if you completed all of your Physical Therapy after your TKR?  With your knee feeling as if it has "a tight rubber band around it", it sounds as if your muscles have tightened up quite a bit.  That must be extremely uncomfortable for you.  :(  

Which Doctor are you going to see on July 5th?  Is it your PCP or is it your Orthopedic Surgeon?  If it's not your Orthopedic Surgeon, may I recommend that you make an appointment with him and get some more follow-up x-rays done of your TKR and see if everything still looks as it should?  He needs to be aware of what your legs are doing, especially your operative leg, as well as what your TKR is feeling like.  So many things can happen after the type of surgeries that we have had.

I hope that you will keep us informed of what your Doctor tells you and what, if any, type of further testing he/she will order for you.

I'm keeping my fingers crossed that you will get the answers that you need so that you can remain "out" of that wheel chair for a very long period of time.   You and I are basically the same age.  I will be 65 on the 12th of July, so I don't know if our age is playing a part in any of this or not.  It sure seems that the older we get the more problems come up, doesn't it.  :(

Just know that I have you in my Thoughts and Prayers and we'll be looking forward to your updates...........Sherry  :)
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Avatar universal
It is mostly my right leg that does this with the knots.  I do have a large bruise on the left one.  Both feet and legs swell, mostly feet.   I am going to my PCP on the 5th.  I do not feel good about the Orthopedic Surgeon that did my total knee replacement.  He kept me on my back way to long,  This knee has never bent well since the surgery. It went way down before they did the surgery.  They had to sit on my knee to get it down flat. I kept falling before surgery.  I take one baby asprin a day since both parents had heart problems that lead to their death.  I did complete all the PT after my TKR.  I try to stretch out the tendons in my feet at night while I lay in my bed.  T tried to bent my leg up that has the TKR and had a bad charlie hourse.  At times I walk better than others.  If I have to sit very long, my feet and legs swell so bad that I can hardly walk at all.  This is when I have my feet down.  Thanks for the comment



Both feet sweel and so do my legs
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Avatar universal
You know I'm wondering if they attached your tendons back to your knee incorrectly, and they are to tight.  In other words, did they give you enough flexibility around your knee.  Did they shorten them in some way?  I hope I'm making some sort of sense here to you.  

I'm just like you, in that both of my feet would swell as well as my legs from my knees down.  They still do that at times, but it is beginning to get a little better.  

The reason that my Doctor's took me off of one of my Celebrex to try to correct my bruising and knot problems, was that they felt that my blood may have been just a little too thin and that was causing the bruising.  It did help me, but since you aren't on as many "thinning" medications as I am, that shouldn't be a consideration as far as you are concerned.  I'm on Plavix 1 x day, .81 mg aspirin 1 x day, Celebrex 200 mg. used to be 2 x day now 1 x day.  Fortunately, that simple solution has helped the bruising for me.  However, it has caused my arthritic fingers to cramp up and stay in a frozen position when I clench my fingers.  :(  Seems like if it's not one thing it's another.  LOL

Did the Therapist notice anything different about the tightness of your tendons when you went to PT?  Was anything ever mentioned about it to you?

Will you let me know what the PCP says after your appointment?  I'm really concerned about you!!  TKR is really a difficult surgery.  In my opinion, I think it's the most difficult of all the replacement surgeries to rehabilitate from.  I think that you are remarkable to be hanging in there as you are.  

My doctor had me on my back for a very long time also as I had a break in my Femur and wasn't allowed to be weight bearing at all.  However,  they had a machine that they attached to my feet (that drove me crazy) that would pump up and massage my feet every few minutes to keep the clots from forming.  Did your surgeon have anything like that for you?  I can understand you not wanting to go back to your surgeon that you don't trust.  I hope that you will consider getting a second opinion from another surgeon that knows nothing about your case.  Sometimes a "fresh set of eyes" will make a world of difference.  Hopefully, they might see something that everyone else has missed!!

Do you mind telling me how many years ago your surgery was?

The thing that really concerns me is the fact that your legs are hurting as well as your feet and that could be indicative of clots in your legs.  Therefore, please be careful in everything that you do until you see your PCP.  Please insist that they do a CT Scan to see if you have blood clots.  As you know, this is crucial, as clots are life threatening!!!

I will be on pins and needles until we hear back from you after your Doctor's visit!!

You are in my Thoughts and Prayers...........Sherry  :)





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Avatar universal
Yes, my Therapist did notice the tightness.  He put me on a slant board which felt like I was going to fall off besides hurting alot.  I did this at home also as my husband made me a slant board.  He also tries to br4eak my knee loose by pulling it up and over my bach and head.  He could not break it loose.  I cried my heart out because of the pain from that.  I was not a young woman any longer and not only did it hurt ny leg, it hurt my back.  The only place that felt good in PT was the warm swimming pool to do my exercises.  I even joined a fittness center that had a pool, hot tub, and sauna.  I went every day.  I did all the exercises that could be done at home also.  I was on the pump for three days after surgery, them moved to the rehab side for three weeks.  I could not lift my leg until a little machine was put on it to send charges to the muscles.  This surgery was either in 1997 or 1998.  I can't remember.  I rather have all five of my children over again than to have one of these surgeries.  It had gotten to the point that I would fall just trying to get out of a chair.  My arms and shoulders would not lift me any longer.  I had pulled and worked them half to death.  All my weight was being put on them.  I could hear the crushing in my knee at night in the bed and it would sometimes lock up on me as to where I could not move.  I cried in my bed at night.  I am concerned also.  This is why I write on this.  I hate to go to the doctor.  However, I am going to mine Tuesday morning.  I will let you know what he says.  The bottom of my legs are cooler that the upper part.  That concerns me also.  I am so limited to doctors because of insurance that goes with medicare.  I don't trust all surgerons.  I am sure that is mostly because of the experience that I had with with leg.  I am not saying that it is his fault.  I just don't know why it did not work so well for me.  I know others that have problems after replacement also.

Thanks for your thouhts and prayers.  I can use all I can get.  I certainly believe in prayer........
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547368 tn?1440541785
That tightness feeling may be due in part to the swelling as well as any muscle or ligament shortening or atrophy.  The amount of swelling concerns me. Your PCP may prescribe a diuretic to help get rid of the fluids in your lower extremities.

I would want to know what is causing the edema (fluid retention.)  When you press on the area of swelling does it indent and remain indented for a time? If so this may be what is called pitting edema. Something that may help is when sitting try to keep your feet at or above the level of your heart.  Do this several times through out the day.  

Don't massage your legs until you have consulted your PCP. Your symptoms don't sound like a clot to me but just to be certain don't do anything that would "move" that clot. Usually a thrombosis (clot) is unilateral rather then bilateral. It doesn't sound like a cellulitis either, for the same reason but I am not a physician and far from an expert so please be cautious until your consult.

You may also benefit from some additional physical therapy. Your far too young to be so sedentary and limited in your activities, even though you may not feel young some days. My heart goes out to you.

If you have good support stockings they may help with the pain and swelling too.  Apply them before getting out of bed. The rational behind that is to apply them before the fluid and blood supply has not had a chance to pool in your lower extremities.

I certainly understand your dislike of surgeons... but don't let one spoil your opinion of all. There are some great surgeons out there as Sherry, I and others can attest. It may behove you to consult another surgeon, not associated with your former one. I know you experienced extreme pain from the TKR but a little more pain for a short time may reduce your current levels and avoid further deterioration. Also remember that since 97 or 98, progress has been made in the procedures ... and a good surgeon (if surgery is appropriate) will do his/her best to assure you are more comfortable and have better results.  

"Bad knees" runs rampant in my family. Every female member in my immediate family has either had to have a TKR,  is facing one in the future or just plain has "bad knees" in some shape or form. I've been putting off knee surgery (patella) for two years now. So I can relate to knee pain, not as extreme as yours but I do know how it can effect your pain and acitivity levels

Please let us know the results of your appointment. I'll look forward to your update with great interest. I too will keep you in my prayers.

Blessings,
~Tuck
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Avatar universal
I do not have pitting edema.  That is most of the time.  Right now the swelling is down and I still have pain trying to get up and to walk..  Mu legs turn white when I press on them to check the edema.  It feels like my achillles tendon is way to tight.  I try to stretch it out with no luck so far.  I really have no idea what is wrong.... That is why I decided to go to the doctor tomorrow morning.  I feel like the quality of my life is taking a down spin.  It is hard for me to do anything.  I hate to go to the store anymore.  It takes all I have. I also have a skin disease  called letchin schrosis which gets worse with heat.. This prevents me from wearing anything that holds in heat.  I am not sure about the spelling.  That also can get quite painful and has no cure.  I will let you know what the doctor says tomorrow.

Thanks,
general0
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Avatar universal
I scheduled an appointment for this morning to see my doctor.  They made it for the wrong doctor.  The office will call me back and let me know when I can go in.  They had a Temp. working and she messed it up.  Oh well, try again.  I let you know after I see him.
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Avatar universal
We'll be looking for your update!! I hope that they are able to make it "quickly" so that you can finally begin to get the answers that you need so desperately!!  I know how horrible it is to have to wait when you are having such sever pain after a surgery and it just won't let up or go away at all.  When you are having to languish in this pain, it saps all of your strength and leaves you totally helpless to be able to do anything at all!!

We're here for you!!...........Sherry  :)
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547368 tn?1440541785
I have a commitment myself and will be off the forum this afternoon. But I will check for your update later and pray that all goes well for you.

I am so glad you are having this checked out. :o)

My Best,
~Tuck
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Avatar universal
I have a doctor's appointment for Friday morning at 10:15.  I will let you know what my regular doctor says after I see him.
Thanks so much,
general0
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Avatar universal
Believe me I'll be keeping you in my Thoughts and Prayers a that you will be able to find the answers that you so dearly need and deserve!!

We'll be looking for your update with baited breath..........Sherry  :)
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547368 tn?1440541785
I am sorry that you didn't keep the appointment with whatever physician they had scheduled you to see today. Did you inform them of your symptoms? I am concerned that you have to wait until Friday.

If you didn't express your symptoms in DETAIL I would contact your PCP's nurse and explain your symptoms again.

Are you experiencing any shortness of breath or chest pain? If that should occur you need to be evaluated asap. Keep your legs elevated as much a possible and take it easy. In other words, REST!

I wish you the very best and will look forward to your updates.

~Tuck
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Avatar universal
     I want to thank both of you so much for your time, concerns, and prayers.  They really meam alot to me to know that there is someone out there that does not even know me that can be this concerned about my health and welfare.  Thank you.

I did not see the doctor that they made an appointment with since I did not know who he is and he does not know me.  I have gone to my doctor for years and consider him to be one of the very best.  I trust him alot.  I do not have chest pains. The only shortness of breath that I have is from my ashma.  I do elevate my legs as much as I can.  Believe me when I say I feel that I rest them alot.  It is hard for me to get around. My doctors nurse does know my symptoms and has informed my doctor by prhone.  He does want to se4e me Friday morning when he gets back in town.  The other doctor's office knows the symptoms also.  They went to my doctors nurse and had her call me right away.  I just feel better going to someome that knows me.  If my doctor can not answer my questions, he will send me in the right direction and even get the appointment for me.  Again, than you so much.  Both of you really touch my heart.  You have spent so much time on me.

Yours truely,
general0
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Avatar universal
I'm really glad that you are going to your Doctor as he knows everything about your symptoms, as well as your Health History and seems to be a really caring Doctor.  I'm sure that he is concerned about what you are going through and will send you in the right direction to get the answers and the help that you need.  It's definitely "no fun" when you've had surgery and it 's not feeling the way that it should.  I know it's been at least 113 or 14 years since your surgery, but it never should have given you this type of problems for all of these years.  They should have been there for you from the beginning to try to find out what was going on with the TKR.  

As I said, my 2nd THR was done incorrectly and was loose from the day of the surgery and I walked on it for over 4 years and it would go "in and out" of place at will.  I would have to lay flat on my back for the Hip to go back into place.  Like I said before, I'm not saying that yours was done incorrectly but you need to get some answers and quickly so that you don't have to be in this type of discomfort any longer.  

We will be anxiously waiting to hear what the next step is for you in your quest for answers about your pain!!

I truly believe that we are as anxious about your appointment on Friday as you are!!!  :)

We'll be here waiting to hear from you...........Sherry  :)
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Avatar universal
Thanks so much.

general0
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Avatar universal
  I went to my doctor today.  He believes that my problem is varicose veins.  He is sending me for a CT scan and then I see another doctor that specializes in veins.  They are checking my circulation.  He said that this new doctor may give me support stockings to wear.  This is where I am now.  The CT scan is on the 15th and the doctor appointment is on the 18th.  I go back to my doctor in two months.  He made these appointments for me.

Thanks so much for your prayers and concers plus all the time you have spent with me.

general0
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Avatar universal
YAY!!!!  I'm so very happy that he's going to take care of you and find out what's happening!!

Does he think that this is what is causing the knee to be so tight???  Be sure that they check that problem out too, if they think that's caused by something else.

We will be waiting anxiously for your scan and the next appointment in 10 days!!

We're very happy to be able to be of help to you.  Thank you for your kind words, we appreciate it.  :)

I hope that you are as pain free as possible until your appointments.........Sherry  :)
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Avatar universal
My doctor did not say what he thought might be caysing my knee to be so tight. I doubt if he knows.  He ordered the CT scan so I do not know if it will include my knee or not.  I will ask Dr. about it when I go after the scan.  I believe it has something to do with the knee replacement itself.  It has felt that way since I had the surgery.  It feels just like a wide rubber band is around my knee tightly.

Thank you.  My feet are so swollen and legs tonight that I can hardly walk.  I am going to bed and hope that they will be down in the morning so that I can go to church.  I did have a beautiful day today with my grand daughter for her birthday party.

general0 or Leah
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Avatar universal
   I had a phone call from the nurse of the doctor that I see tomorrow.  She said that the test that my doctor ordered was the wrong one.  He ordered a doppler and they want a lateral, I think that is what she said.  The test that I took was a ultra sound, but the wrong one.  After I see him tomorrow, he will let me know what I need for sure.

Just letting you know the news as I get it.  Thanks so much.
general0 or Leah
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Avatar universal
Oh Leah!  I'm sorry that they messed up on you.  This has happened a couple of times lately on here, I've noticed.  :(  

At least you will see him tomorrow and you can get all of this straightened out and get the correct one done.

Thank you so much for keeping us posted on what's going on with you. Are you knees, legs and feet any better when it comes to the swelling, than they were back on the 9th of the month?

I hope that they have improved some.  I think of you each night when I go to bed and wonder if you are having a "good" night with no swelling or a "bad" night with a lot of swelling.  

I'll be looking for your update tomorrow after your appointment. I'm sure that Tuck will be checking it out also!!

Good Luck tomorrow..........Sherry  :)
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Avatar universal
      I went to the vein spec. today.  He said that my problem were valves in my legs.  I go back Monday at 11 am and they will run the right kind of ultra sound, then go see him and he will tell me the plan of action.  He says he can help me.  I somtimes feel like my whole body is falling apart.  I go to bed every night with legs and feet swollen.  I wake up with my lowe back hurting.  He did look at that knot on my leg.  What he called it, I don't remember.  As far as the knee I am sure I would have to see an orthro doc.  I will know more Monday from this doctor.  I'll let you know.  At least I am getting answers.  He is really a nice older man.  I like him.  Thanks again,
general0 or Leah
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Avatar universal
Leah - Half the battle is finding a Doctor that you like and trust and you've managed to do that!!!  Good for you.  :)

My Dear, we all understand what you are felling about your "whole body" falling apart.  I seriously wish I had words of wisdom to give you about your legs and feet swelling each night.  I can't think of anything worse than that feeling when your body swells and you feel as if your skin is going to "burst" open.  I'm sorry, but there's nothing I can add to any of what you said about it.  The feeling of tightness that your swollen skin causes is beyond anything one can say.  It makes me feel like a balloon that's been blown up to the maximum and is going to Pop!!!  You feel like when it does Pop, that you will "fly around the room" and never stop!!

I'll be anxiously waiting to see what your Doctor says about your condition.  I'm hoping you will finally get the answers that you need!!

I'm thinking of you...........Sherry  :)
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