Dear Ask The Doctor: I hope I'm just being dramatic, but what are the symptons of leg blood clots? For the last month I have been getting severe legs cramps in my left thigh from the knee to the hip. It is so achy and it takes my leg a little tingly. Sometimes it hurts down into my ankel and heel. I feel like I have to stretch it but that doesn't help. It is most painful at the hip-flexor area, bikini line. Advil or tylenol help a little. I also get a little nauseous and feel so drained when I get the leg cramps. I historically get leg cramps at night but this is different. Any ideas of what it could be? I don't have very good insurance so I hesitate to go get a bunch of tests. But, if it's a blood clot, I need to address it soon! THANKS Francine fdrossos(at)hotmail.com
Dear Patient: There are many causes of non-traumatic leg pain. Pain in the legs may be present because of several conditions that may affect joints, muscles, tendons, ligaments, blood vessels, skin or nerves. So as you see there is a vast array of diseases that can be causing the type of pain that you described, vascular causes have to be ruled out (PAD), deep venous thrombosis(if you have predisposing factors: lack of mobility, taking contraceptive pills, smoking) and also other important causes of leg pain: as nerve compression at the lumbar level of the spine, and also metabolic problems as Diabetes may cause a possible diabetic neuropathic pain. After your doctors rule out those causes, just remain if you can relate those pains with a physical stress that you might have done, give it a try with anti inflammatory medication for one week (“Advil”, “Motrin”). And finally if you are overweight, try to lose weight. If the pain in the leg is associated with low back pain, then a nerve compression has to be rule out. The back pain associated to a nerve compression can produce an inflammatory process that affects nerve roots (neuritis), and it manifests as traveling pain to the lower limbs and other symptoms as numbness. On the other hand this can be just a leg cramp. Muscle cramps are extremely common, and nearly everyone experiences a cramp at some time in their life. Cramps are common in adults and become increasingly frequent with aging. Cramps of the extremities, especially the legs and feet, and most particularly the calf (the classic "charley horse"), are very common. Muscle cramps are felt to be caused by excessively excited nerves that stimulate the muscles. This can occur particularly after injury to nerve and/or muscle; dehydration with low blood levels of calcium, magnesium, or potassium; from certain medications; and even at rest. The pain that is associated with muscle cramps that are caused by poor circulation to the legs that worsens with walking is referred to as claudication. Deficiencies of certain vitamins or minerals, including iron deficiency, thiamine (B1), pantothenic acid (B5), and pyridoxine(B6), can also cause muscle cramps.