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Dr. Hive - Persistent deep leg pain


skimomma
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I am dealing with a persistent and annoying pain in my leg and google is failing me.  Maybe someone has an idea?

I am a runner and run 5-10 miles, 4-5 times a week, mostly on gravel or trails.  I ran in my annual half marathon in mid-July and it went very well.  I took a day off and headed out for a normal 5 mile trail run.  I felt off the whole time and ended up tripping on a root and falling very hard about halfway through.  I brushed myself off and finished my run.  The next day, I came down with a nasty cold (multiple negative PCR covid tests), which is why I probably felt "off."  Between the fall and the cold, I took a whole week off of running.  When I started back up, both legs had a lot of tightness and pain from the fall.  Nothing bad enough to worry me but annoying.  I put up with it for over and month and it did improve but settled into a persistent dull pain in one leg that is present even when resting.  It gets worse right after a run and is most noticeable when sitting for long periods, which I do daily for my job.

So, I went to the chiropractor.  I needed some adjustments but he could see nothing that would be causing the pain.  He told me to rest, stretch, and ice and all the usual stuff.  I did and it did improve the pain while actually running.  But the ambient pain while resting as not improved and gets worse each week.  

It is so hard to describe what it feels like.  It started as general, all-over, leg pain that is pretty normal after a wipe out.  But this last persistent phase that I have been "stuck" on for over a month is a dull, throbbing, deep pain in my thigh.  It is not always in the same spot and I cannot pinpoint the location as it is deep.  No poking or stretching or repositioning makes it better or worse.  Almost like a very bad case of restless leg syndrome.  Advil does not touch it.  I am almost beginning to think it is in my head.

Now it is so distracting that it is hard to concentrate on my work.  Driving or riding in the car for long periods of time is also very uncomfortable.  Google tells me that I do not have the right symptom match for thrombosis.  No swelling or redness.  Although I do have a strong family history of blood clot issues.  I am up to date on my annual exam and bloodwork.  Nothing unusual there.  I have not had covid and am fully vaccinated with the Pfizer vaccine, well before this all started.

Anyone experience anything like this?  I'd really like to know if I can just safely ignore this and it will eventually improve.  I had a nasty shoulder injury that took 18 months to fully recover so I do know things like this can take time.  Or should I be more proactive in trying to get to the bottom of it?  If so, where would you start?  I don't think my PCP is going to take "annoying leg pain" very seriously.  And even if she did, what would the next step be?

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8 minutes ago, WildflowerMom said:

Get in to see the doctor.  They need to ultrasound it.  It sounds like how my blood clot began, before for the traditional symptoms set in. 

This! The same thing happened to my sister, it was a clot. Please Please go get it checked ASAP. Not to be the harbinger of doom, but she ended up with some in her lungs and it has been a huge deal

Edited by saraha
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I think there’s a 30% chance it’s a clot and a 70% chance it’s neurological or muscular.  Do you have a walk-in orthopedic or sports medicine urgent care near you? If not I’d honestly probably start at the ER because blood clots are very serious. 

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23 minutes ago, WildflowerMom said:

Get in to see the doctor.  They need to ultrasound it.  It sounds like how my blood clot began, before for the traditional symptoms set in. 

Agreeing with this.  A blood clot was the first thing I thought of.

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I hate to add to the pile, but my dad's blood clots (two DVTs and a PE) did not have typical symptoms, though I will note that leg swelling that would come and go (not necessarily with redness) were also major symptoms for him. He had a clot rule out within a week or tow of his first clot, symptoms persisted, and then that clot was really long--like half his leg long. I think it accumulated slowly and caused the fluid backup. If he was active, it was fine; if he had to sit at all, the fluid would back up (he walked miles per day).

His second clot was also fairly indistinct, and they checked him over basically only due to history, but there it was. Then he developed PEs from the same episode and had to go back to the ER.

I would push for a clotting disorder panel (genetics, can be done as a referral to a hematologist, etc.) and antiphospholipid antibody syndrome (APS) panel (needs to be done there, I think) if you have a clot. Genetics for clotting can be done anytime, but the APS panel needs to be done more than once a lot of the time because those antibodies can come and go, and I think they have to show as elevated twice more than 12 weeks apart for a diagnosis, though it might be that elevation plus clot at the same time also works. The ER people are not necessarily going to be well-versed in what to order--that's often done as follow-up, but with APS, again, it makes a difference.  

Other possibilities/things to try:

When I get restless leg types of symptoms, I have to take magnesium and potassium at bedtime. If I take it consistently, it almost always prevents the episodes, but even just one night of forgetting can make it come back. Eating potassium-rich foods didn't fix it, but potassium tablets did. Adding magnesium seems to help--I think they work together.

Deep varicose veins? Not everyone's are near the surface.

If it's close to the knee, maybe a cyst? 

Edited by kbutton
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I would see a doctor.  You could try your pcp and get a referral to a physical therapist if your doc rules out the blood clots.  I would definitely rule out a blood clot first.

Have you tried foam rolling it? Does that help the pain at all? If so, it might be a kind of strain.  I had a calf strain that I had to go to physical therapy to work out.  It felt like a pain deep in my muscle and was aggravated with movement but sometimes would hurt even when I wasn't moving. My muscles were basically really super tight and knotted.  

 

 

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I think the safe thing to do is get it checked to rule out a clot, but I had something very similar when I was younger and much more active. I'm pretty sure it was some sort of deep tendonitis. I babied it for several months and it finally got better. The not feeling comfortable/feeling like leg is restless and needs to move while sitting was an odd--and very annoying--feeling for me.

It's also possible you did something to your back and are feeling it in the leg. I have OA in my spine. My back rarely hurts (yet), but my hips and left leg--yes, yes they do indeed hurt, and the docs say it's from my spine.

I would hope if you mentioned being worried about a clot and having a family history your PCP would take you seriously! It's easy enough to order an ultrasound. It's not like it's a hugely invasive test, you know?

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