Long-Term Widespread Leg Pain

[SFinDC]

I am a 25 year old caucasian female, 5'3", 120 lbs, used to be very active with no history of health problems. In August 2009, I began experiencing pain in both my legs. My doctor examined me, ordered a long list of blood tests, and asked me to keep a pain journal to track my symptoms and looks for patterns. All my tests were normal and monitoring my pain revealed no patterns - the nature, severity, and precise location of my pain seemed totally random, and I couldn't connect it to time of day, point in my cycle, activity, or even any food or drink. She suggested stretches and insoles for my shoes, as well as going back to the gym, and my muscles or whatever it was would eventually heal. It has been over a year, and I am still experiencing chronic leg pain. The pain can be sharp, stabbing, or achy, ranging in severity from a 1 to a 7 (out of 10). It usually only occurs in one place at a time, but sometimes is in both legs. It affects the backs of my thighs and calves, the front of my thighs, my shins, and all around my knees (basically any point between my hip and my ankles). The muscles in my legs also spasm rather frequently - not painfully, just a spasm or twitch. My quadriceps and calves sometimes feel tender to the touch, or will become tight, stiff and sore as though I worked out too hard. I recently went to another doctor (having moved and changed insurance carriers) and saw the Physician's Assistant, who had no new theories. For the second time, I had blood tests done for everything from a basic panel and cholesterol reading to thyroid function, creatine, vitamins, minerals, lupus, and even Rocky Mountain Spotted Fever. ALL my tests were normal/negative. Stretching, yoga, and ibuprofen do not help, and it is just as bad standing and walking as sitting or lying down. The only medication I take is a birth control pill and I have been on the pill (albeit several different versions) for most of the last 9 years. I have no family history of nerve or muscular conditions, and no recent injuries (I had surgery to remove torn cartilage in my left knee but that was 6 years before the onset of this pain and wouldn't explain the pain in my RIGHT leg as well). I have anxiety issues, but managing them has dealt with all the other aches and pain issues I have had except this one. Has anyone else every experienced this? ANY ideas what could be causing it? I am getting desperate for answers and am tired of hurting every day.

[SFinDC]

Thank you both for your input.

The issue of circulation has been a concern with me for a while too. However, the first physician I saw about this absolutely dismissed the idea of blood clots because I am young, active, a healthy weight and have no immediate family history of any of these kinds of problems. The PA I saw last month did in fact order the dopplar test, but I have not yet had it done because my insurance will not cover it and I cannot afford it - it will cost me almost $1000, and I am currently unemployed. I was hoping, when the PA ran all the blood tests, she would request a D-dimer test, but to my astonishment and frustration, she did not.

This is really frustrating because I look at all the solutions being suggested here and I feel that I either do not have any of the risk factors for them or they have several symptoms and I only have leg PAIN and nothing else. My cholesterol, blood sugar, and blood pressure are great. And my calcium levels were very good on my recent tests, as were all the vitamins and minerals she tested for.

I am looking for another physician to go to as I was very unhappy with the office I tried last month. Any further suggestions about which issues to eliminate first? Should I start with the vascular issues and if that turns up nothing, then issues like sciatica and arthritis? Lastly, has anyone ever heard of another patient with an issue like this?

Thank you so much for your advice!

[caregiver222]

As drnee pointed out, the highest liklihood is a vascular disorder. That is to say an oxygen deficiency in the tissues secondary to diminished blood flow through the arteries. And this is often caused by a blockage. Arterial blockage is quite serious.

The first thing I would do is to to general quarters regarding the birth control medication. Go to the Physician's Desk Reference and look up the side effects of the specific medication. Contact the FDA and ask to speak to the individual responsible for this medication. If you are concise and don't waste their time, they are happy to hear about possible side effects. I wrote them an e-mail once regarding a side effect and they telephoned and answered me promptly.

As doctornee stated, you need a dopplar test. This involves reflecting sound waves off your body structure. It is painless. The reflected sound waves provide an image on a CRT screen.

I am somewhat concerned that your personal physician has not ordered such a test. It is really square one, except for three villages in a remote mountain range east of Kabul in Afghanistan.

Another (remote) possibility is a calcium deficiency. This is unlikely, but can cause muscle spasms and pain. Try drinking two glasses of milk a day.

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
The various causes of leg pain are atherosclerosis, deep vein thrombosis - (A blood clot in a deep vein), Leriche syndrome (block in abdominal aorta and/or main leg artery), limb ischaemia (low oxygen to limbs), sciatica, spondylitis of lower vertebrae and peripheral vascular disease (arteries of limbs are involved).
Yes, since you are on birth control pills you must get yourself investigated for deep vein thrombosis. A color Doppler test will rule out the possibility of involvement of an artery or vein and its blockage by a clot.
Do discuss with your doctor and get yourself examined. Hope this helps. Take care!