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Muscle sprain.

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Hello,

I have had an occasional sharp pain in my left thigh for around a month. It started up near my groin, and I thought it was a pulled muscle, but it has gradually changed to a shooting pain that works its way down my thigh, toward my knee.

It doesn't feel like this all the time, and I haven't been able to identify a pattern - it might happen while I'm sitting, or standing, (rarely) while I'm walking, and day or night doesn't seem to matter. It actually woke me up at 5:30 this morning.

Around the same time a month ago, I noticed that a spot near my knee itched, and looking at it, a blue vein is more noticeable there than on my right leg. I haven't had much, if any pain at that site, as most of it is higher.

My thigh is swollen noticeably, but not to any extreme. My calf is slightly larger, but I think that's typically the case because of a car accident I was in 14 years ago where I broke my right hip and favored the leg for a long time after.

I have anxiety issues, but I'm trying to stay calm and look at it rationally. I know that this fits several of the criteria for a DVT, but I don't have any discoloration, and I didn't know if there might be something more innocuous causing it.

Do you think this warrants an ER visit?

Thanks,

--Matt

Category: Family Physician-GP

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Category: Diabetologist
 31 Doctors Online

Hello Matt and thankyou for approaching DoctorSpring with your query.
I have gone through your case and understand yuour concern.
Please can you answer a few questions so that I can give you an informed opinion.

1) Besides the surgery 14 years back, have you had any recent surgery or trauma?
2) Have you been on prolonged bed rest, or had sat in one position for hours at a stretch?
3) Are you overweight?
4) Are you on any medication? If so please can you tell me which ones?
5) Have you noticed any loss of appetite, weight loss ( without an apparent cause)
6) Do you feel like you can feel/palpate a vein in your left thigh like a cord?

Please reply as a follow up and I will guide you accordingly.
Thankyou



Patient replied :

Dr Sebastian,

Thank you.

1) No, my last surgery was over a year ago, when I had my gallbladder removed

2) No, a week prior to when I started feeling the pain, I had been on an hour-long plane ride, but that's not unusual for me. Although I'm relatively sedentary in terms of exercise, I have a standing desk at work, and I spend roughly half my time standing and half my time sitting, with frequent short walks.

3) I am overweight. I'm 6'0", and weigh 265lbs, with a large chest and neck size, similar to a football player's build.

4) I am on lansoprazole (50mg) for acid reflux, and occasionally doculax as needed. I usually take a baby aspirin a day, although I've fallen away from that habit in the past few months (excepting the last week or so, when I've been taking aspirin to see if it would help with the pain, but it hasn't)

5) No, my appetite is normal

6) There's not really anything I would describe as a cord (except what I think is a hamstring behind my knee). How deep should I be probing to feel this? There's a slight increase in resistance (though I wouldn't call it a bump) on the spot near my knee which itches and has the more prominent vein, but it doesn't feel distinct, like a cord.

Sorry I can't give you anything better to go on. Thanks!

--Matt


Hello Matt,
Thankyou for the additional details.
I have gone through them and it less likely to be deep vein thrombosis since you do not have redness and increased temperature in your left thigh or calf muscle. No investigations are required right now.

It is more likely to be due to a pinched nerve or musculoskeletal pain.
I would advise you to take the OTC drug Ibuprofen 400 mg thrice a day for 3 days after a meal. This should help relieve your symptoms.

However I would advise to look for the following signs like calf or thigh pain, swelling of the affected leg along with increased temperature of the leg, redness, pain on touch, or if you notice superficial venous dilation. In that case I would advise you to go to the ER.

I hope this has helped.
Thankyou


Dr. Jaydeep Tripathy
Category: Diabetologist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Senior Residency in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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