Helped Over 500,000 patients with 98%+ satisfaction.

Connect & Get Personalized 1-to-1 Answers from Expert Doctors

DoctorSpring > Question Home

Severe pain in legs making walking difficult. Treatment?

Resolved Question:

I am asking on behalf of my daughter who is 11 years old patientold. Ever since she was much younger she has experienced pain in her legs whenever she has a fever and/or flu. There were a few times where it was so severe that she didn't want to walk. However, over the past 6 months or so the pain has occurred when she has no other symptoms. It's hard to ascertain from her whether it feels more like a muscle pain than a joint pain but it sounds more like the latter. She has been experiencing it again since yesterday and the worst pain seems to be around her knee and at the front of her leg from midway between her knee & ankle down to her foot. The arch of her foot is also painful.

She doesn't have any other known conditions. I have wondered if it is diet related as she eats very little meat - mainly cheese with a bit of chicken or beef maybe once/twice a week and ham about once/twice or week.

Category: Pediatrician

Ask Your Own Question

Category: ICU/ Critical Care Specialist
 22 Doctors Online

Dear parent,
Thank you for your query at DoctorSpring.com
I can understand your concerns and empathize with her situation.
Kindly answer a few of my questions for me to fully comprehend the clinical scenario:
1. You say that she has been having pain over the last six months... How frequently did it occur? Daily? Alternate day? Once or twice in a week??
2. Over the last 6 months, how often did she cry because of the pain? Were there times when she refused to stand or walk because of the pain? How often did she wake up in the night from her sleep with pain??
3. Over the last 6 months, has the pain changed locations or has it always been in these three sites ( knee, shin and foot)?? Has she ever had pain in any other bone or joint??
4. Have you noticed any swelling, redness, warmth or tenderness (pain to touch) in any of her muscles or bones or joints??
5. Has she had any loss of weight or appetite over the last 6 months? How is her overall well being?
6. Once the pain starts, how long do these painful episodes last typically?
7. Has she ever had any stiffness of joints or rash or skin nodules??
8. What are the factors that typically relieve the pain and what are the factors that aggravate it? Eg: does exertion increase her pain??
9. Have you ever got her serum calcium, phosphate, alphos and vitamin D levels tested?
10. Have you ever obtained X rays of her lower limbs and knee joints?
Regards
Dr. Saptharishi L G


Patient replied :

Please find my answers below.
1. You say that she has been having pain over the last six months... How frequently did it occur? Daily? Alternate day? Once or twice in a week??
Once every 2 weeks or so
2. Over the last 6 months, how often did she cry because of the pain? Were there times when she refused to stand or walk because of the pain? How often did she wake up in the night from her sleep with pain??
Probably a few times each time it occurs she has cried and not wanted to stand up. She doesn't seem to be in pain at night.
3. Over the last 6 months, has the pain changed locations or has it always been in these three sites ( knee, shin and foot)?? Has she ever had pain in any other bone or joint??
Yesterday I pushed her to be more specific about where the pain is but I don't think it is always in the same place.
4. Have you noticed any swelling, redness, warmth or tenderness (pain to touch) in any of her muscles or bones or joints??
No
5. Has she had any loss of weight or appetite over the last 6 months? How is her overall well being?
No loss of weight or appetite. She is generally well although she has occasional headaches and dizzy spells.
6. Once the pain starts, how long do these painful episodes last typically?
1 or 2 days
7. Has she ever had any stiffness of joints or rash or skin nodules??
No
8. What are the factors that typically relieve the pain and what are the factors that aggravate it? Eg: does exertion increase her pain??
Massage makes her feel better but I don't think it really relieves the pain. It hurts more when she is standing but other than that there doesn't seem to be anything else that aggravates it.
9. Have you ever got her serum calcium, phosphate, alphos and vitamin D levels tested?
No
10. Have you ever obtained X rays of her lower limbs and knee joints?
No


Dear parent,
Thank you for responding to all my questions. Your explanations have definitely thrown some additional light on her problems.
We need to start evaluating her thoroughly. As a first step, personally meet a paediatrician to get a detailed physical examination. This unfortunately cannot be done over the internet. Multiple findings on clinical examination can give valuable clues to the localisation ( muscle, joint or bone) as well as the etiology.
Get the following tests done:
1. Complete hemogram with RBC indices and peripheral smear
2. Metabolic profile including LFTs, RFTs, calcium, phosphate and alkaline phosphatase
3. Serum vitamin D levels
4. X rays of bilateral lower limbs including knees and ankles. AP view and lateral view
5. ANA testing
Till we get these tests done and try to identify the cause, she can take Tab Naproxen to relieve the pain whenever it is severe or impairing her activity.


Dr. Saptharishi L G
Category: ICU/ Critical Care Specialist
Experience: 
Senior Residency: DM,  Pediatric Critical Care, PGIMER

Residency: MD, Pediatrics, Postgraduate Medical Education & Research (PGIMER), Chandigarh, 2013

Internship: JIPMER, 2009

Medical School: MBBS, Jawaharlal Institute of Post-graduate Medical Education & Research (JIPMER), Puducherry, 2008
Dr. Saptharishi L G and 4 other Medical Specialists are ready to help you

Users who read this, also read:

Make informed and better medical decisions.

Join the 500,000 people who found a smarter, quicker way to get Answers, Recommendations & Expert Opinions.

Expert Doctors at fingertips

Recommendation on next step. Second-opinion.Multi-specialty.

Save Time

Average time for answers: 6 hours.

Save Money

$35 for typical specialist consult vs. $120 for a local appointment.

Free Follow-ups

Clarify, ask further questions for free in private conversation.

100% Satisfaction

Money back guarantee for the 1st reply. MEDNET Quality Board.

Start My Consultation

CHAT NOW

About DoctorSpring.com

Doctor Spring is a novel online Doctor consultation platform where you can get your medical questions answered by leading Doctors. Just Submit your question and rest assured that you will consult a Doctor easily. Once you submit the question, the Doctor from the concerned specialty will reply within hours. You can always ask more questions or add details with follow-up question options and make it an online doctor chat. You may use this service to consult a specialty or for getting medical second opinion. All paid services come with a MEDNET quality assurance and 100% money back guarantee.

DoctorSpring in news