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Suggest Treatment For Severe Leg Pain
Question: Hello,
I am writing on behalf of a close relative (aged 53) who has been suffering from much leg pain on both sides. Sometimes one side will ease. However, she has now told me that she has noticed veins come up on the side of her hip. She isn't as active as she used to be and rests a lot. She also wears jeans most of the time. I don't know if it's a combination of things but I'm trying to give as much information as possible. She suffers from quite bad asthma and smokes a little. Please can you advise further. Thanks.
I am writing on behalf of a close relative (aged 53) who has been suffering from much leg pain on both sides. Sometimes one side will ease. However, she has now told me that she has noticed veins come up on the side of her hip. She isn't as active as she used to be and rests a lot. She also wears jeans most of the time. I don't know if it's a combination of things but I'm trying to give as much information as possible. She suffers from quite bad asthma and smokes a little. Please can you advise further. Thanks.
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome back on HCM!
I passed carefully through your concern and would like to explain that such leg complaints like vein prominence associated with leg pain seem to be causes by what is called varicose veins.
This is a condition due to structural vein changes, like vein walls and valves alteration leading to vein enlargement and loss of uniformity with the subsequent complications such as affected limbs pain and heaviness, underlying burning and itching skin, superficial prominence of affected veins, limbs edema, sometimes with trophic skin damages.
But, what is more serious and not rarely dangerous among these complications would be mentioned vein thrombosis, which when happening on an important vein may embolize (migrate with venous blood flow) and lead to life-threatening pulmonary embolism.
Coming to this point, it is necessary to perform a careful medical review composed by physical medical exam coupled with additional tests as follows:
- lower limbs vessels Doppler ultrasound,
- direct contrast venography,
- magnetic resonance venography
It is not rare that repeated pulmonary micro-embolism may lead to a chronic disorder of the right heart (cor pulmonale) and may also mimic the clinical symptomatology of asthma.
In such case, it would be advisable to check also the cardiopulmonary system with the following tests:
- cardiac ultrasound,
- pulmonary function tests,
- arterial blood gas analysis,
- pulmonary angio CT or pulmonary ventilation/perfusion scan (if required)
It is necessary a discussion with the attending physician on the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome back on HCM!
I passed carefully through your concern and would like to explain that such leg complaints like vein prominence associated with leg pain seem to be causes by what is called varicose veins.
This is a condition due to structural vein changes, like vein walls and valves alteration leading to vein enlargement and loss of uniformity with the subsequent complications such as affected limbs pain and heaviness, underlying burning and itching skin, superficial prominence of affected veins, limbs edema, sometimes with trophic skin damages.
But, what is more serious and not rarely dangerous among these complications would be mentioned vein thrombosis, which when happening on an important vein may embolize (migrate with venous blood flow) and lead to life-threatening pulmonary embolism.
Coming to this point, it is necessary to perform a careful medical review composed by physical medical exam coupled with additional tests as follows:
- lower limbs vessels Doppler ultrasound,
- direct contrast venography,
- magnetic resonance venography
It is not rare that repeated pulmonary micro-embolism may lead to a chronic disorder of the right heart (cor pulmonale) and may also mimic the clinical symptomatology of asthma.
In such case, it would be advisable to check also the cardiopulmonary system with the following tests:
- cardiac ultrasound,
- pulmonary function tests,
- arterial blood gas analysis,
- pulmonary angio CT or pulmonary ventilation/perfusion scan (if required)
It is necessary a discussion with the attending physician on the above mentioned issues.
Hope to have been helpful to you!
In case of any further uncertainties, feel free to ask me again.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Doctor your answer was very helpful.
My relative did mention that her legs have not been itching, however, she does get itching and redness on one of her arms and does not know if it is related or not.
Regarding her legs, she was wondering if she had strained her back which could cause pain, but since she mentioned about the big vein on her hip, it seems it may not be what she thought it was. And if she lies on that side of hip she gets the pain.
Any further comments would be welcome.
My relative did mention that her legs have not been itching, however, she does get itching and redness on one of her arms and does not know if it is related or not.
Regarding her legs, she was wondering if she had strained her back which could cause pain, but since she mentioned about the big vein on her hip, it seems it may not be what she thought it was. And if she lies on that side of hip she gets the pain.
Any further comments would be welcome.
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
The itching and redness on one of her arms could be a local allergic reaction. I don't think that it is related to her leg pain.
A strained back could cause leg pain, but in such case the pain would begin in the back and would irradiate in one or both legs, especially when walking. This usually happens only in discal herniation. But her symptoms are not typical of this disorder.
The fact that she is not active, predisposes her to deep vein thrombosis too.
I would recommend consulting with her attending physician for a careful physical exam and these tests:
- a Doppler ultrasound of the leg vessels to exclude possible chronic venous insufficiency
- a lumbar spine X ray study.
If suspicions of a discal herniation are raised during the physical exam and dhe Doppler ultrasound results normal (excludes a venous problem), further tests may be needed (a lumbar spine MRI coupled with a nerve conduction study).
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
The itching and redness on one of her arms could be a local allergic reaction. I don't think that it is related to her leg pain.
A strained back could cause leg pain, but in such case the pain would begin in the back and would irradiate in one or both legs, especially when walking. This usually happens only in discal herniation. But her symptoms are not typical of this disorder.
The fact that she is not active, predisposes her to deep vein thrombosis too.
I would recommend consulting with her attending physician for a careful physical exam and these tests:
- a Doppler ultrasound of the leg vessels to exclude possible chronic venous insufficiency
- a lumbar spine X ray study.
If suspicions of a discal herniation are raised during the physical exam and dhe Doppler ultrasound results normal (excludes a venous problem), further tests may be needed (a lumbar spine MRI coupled with a nerve conduction study).
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you Doctor for the additional advice.
I am sure she will find it very helpful.
I am sure she will find it very helpful.
Brief Answer:
You are welcome!
Detailed Answer:
I am glad to have been helpful!
Wishing good health,
Dr. Iliri
You are welcome!
Detailed Answer:
I am glad to have been helpful!
Wishing good health,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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