Lower leg pain

[fyrekrig]

Have had pain in my left leg for almost a year.
Mostly after walking and/or standing.
Tested for DVT which came out negative.
Have normal blood pressure in arm and above ankle.
Blood pressure on ankle higher than on the arm.
LDL cholesterol levels well below reference and
HDL cholesterol levels higher than reference.
Other blood test parameters within recommended range.
Age 75 years,no smoker, not over weight.
Excercise regularly, walking and swimming.
Have been to a number of doctors both Thai and farang
and neither can explain my conditions.

Now turning to the community to see if someone else have
have had a similar condition or maybe know someone who has.

[Sheryl]

Can you describe the pain and its location more?

 

And when you say BP at ankle higher, how much higher? What was the ABI?

 

Have you had an Xray or scan (other than Doppler) of that leg? It sounds like cascular causes have been excluded so one wonders about bone or soft tissue lesion.

[worgeordie]

Maybe just old age.

regards worgeordie

[JHolmesJr]

I know this will sound weird....have you tried standing in a bucket of (preferably) cold water.

Not icy. Not hot or warm....just cold water from the tap.

 

Try it and let us know if it gives some relief...then we'll talk more.

[RotBenz8888]

You should do a treadmill exercise test for possible peripheral arterial disease.

http://vascularcenterwf.com/treatments/treadmill-exercise-testing-/

 

another possible cause might be sciatic nerve irritation, which sometimes only give lower leg symptoms. 

 

If a doctor can't help you, i'd see a physiotherapist.

 

[Sheryl]

12 minutes ago, RotBenz8888 said:

You should do a treadmill exercise test for possible peripheral arterial disease.

http://vascularcenterwf.com/treatments/treadmill-exercise-testing-/

 

another possible cause might be sciatic nerve irritation, which sometimes only give lower leg symptoms. 

 

If a doctor can't help you, i'd see a physiotherapist.

 

Sounds like PAD already ruled put as ABI is over 1.0.

 

Sciatic nerve irritation possible if the pain radiates down but from the tests doctors have done I suspect it is calf pain.

[RotBenz8888]

47 minutes ago, Sheryl said:

Sounds like PAD already ruled put as ABI is over 1.0.

 

Sciatic nerve irritation possible if the pain radiates down but from the tests doctors have done I suspect it is calf pain.

With typical symptoms of PAD, and no cause has  been found, a stress test would increase the sensitivity. Can't be that expensive? Moreover, ABI index over 1.3 could indicate rigid vessles and requires blood pressure tests in toes for diagnosis.

[BigStar]

Tried physiotherapy? Thai massage? Stretching and foam rolling?

[simple1]

OP, are you diabetic? I had severe pain in lower legs due to insufficient blood flow caused by diabetes. Now resolved as diabetes under control

[fyrekrig]

Thanks to all of you for coming back to me.

 

23 hours ago, Sheryl said:

Can you describe the pain and its location more?

It is all over the place but not all at the same time,  below the knee, inside the knee but more often at the front.

Never really on the calf muscle.

23 hours ago, Sheryl said:

And when you say BP at ankle higher, how much higher? What was the ABI?

Basic blood pressure is around 120. ABI on left leg 1.2 on the right 1.3.

The right leg is feeling OK all the time. Always only the left leg.

Both legs looks and feels the same at touch and/or with light massage. 

23 hours ago, Sheryl said:

Have you had an Xray or scan (other than Doppler) of that leg? It sounds like cascular causes have been excluded so one wonders about bone or soft tissue lesion.

Only had a ultra sound doppler scan at Mission Hospital here in Phuket a month ago. Xray of the leg was done 4 month ago and no visual problem.

 

23 hours ago, worgeordie said:

Maybe just old age.

I am sure that plays a part, but my right leg is as old as the left!

It has always puzzeled me that one leg feels perfectly and the other painful.

23 hours ago, JHolmesJr said:

I know this will sound weird....have you tried standing in a bucket of (preferably) cold water.

Not icy. Not hot or warm....just cold water from the tap.

I will try this in the next couple of days.

 

23 hours ago, RotBenz8888 said:

You should do a treadmill exercise test for possible peripheral arterial disease.

http://vascularcenterwf.com/treatments/treadmill-exercise-testing-/

Will do!

 

23 hours ago, RotBenz8888 said:

another possible cause might be sciatic nerve irritation, which sometimes only give lower leg symptoms. 

I have done the scatia nerve excercise many times, no change in the areas of pain.

 

18 hours ago, BigStar said:

Tried physiotherapy? Thai massage? Stretching and foam rolling?

Not tried physiotherapy yet. Thai massage, yes. More painful after massage. Stretching, yes when I lay wake

at night

 

8 hours ago, simple1 said:

OP, are you diabetic?

 No, just tested negative.

 

 

Like to add also that I tried diffrent medications like Cilostazol, Daflon500 etc . None has any effect on pain.

Also I can basically function normally, only have to take a rest when the pain gets bad.

Would like to try CBD when/if it becomes available in Thailand.

[Sheryl]

34 minutes ago, fyrekrig said:

 

It is all over the place but not all at the same time,  below the knee, inside the knee but more often at the front.

Never really on the calf muscle.

 

 

Not at all typical of PAD then (which in any case ABI rules out).

 

From what you are describing I am inclined to suspect a musculoskeletal issue. Maybe a tight muscle (which can happen on one leg and not the other), maybe a chronic bursitis etc.  If a tight muscle,  possible that the right sort of stretches done regularly would sort it out.   Also sometimes orthotics help (for example if one leg is slightly shorter than the other)

 

There are  a couple of places that do physio in Phuket but I have no idea how good. Physio services in Thailand tend to be pretty weak. What you need is a really good physio who will take time figuring out whether the problem is muscular and if so exactly which muscle and then teach you appropriate.  stretches to do (and any to avoid), and tell you if orthotics might help.  Should not need more than 1-2 visits and then continue on your own.   Anyhow for what it is worth these are the places I know of, maybe others can give some feedback on them:

 

Mission Hospital has something - might be good place to start if your Xray was done there

https://www.phuketinternationalhospital.com/en/centers/rehabilitation-clinic/

http://www.citycarephuket.com/en/287_physical-therapy.html

https://www.theartofphysio.com/

https://www.facebook.com/HassamonPhysicalTherapyClinic/?rf=212366185474387

https://www.dowrungclinic.com/

https://www.facebook.com/myphysiobykanitta/

 

Should you ever have occasion to come to Phnom Penh there is a great US physio there who sorted me out a few years back perfectly.

 

If above doesn't help and it persists I would suggest you consider consulting this excellent  knee specialist in Bangkok  https://www.bumrungrad.com/doctors/Panya-Wongpatimachai

 

If you do (1) b ring your xray with you and (2), ask him if a scan might be indicated to rule out a soft tissue sarcoma. While this is unlikely it is pretty much the only remaining serious cause I can think of and worth excluding if physio doesn't help and pain persists. The exact type of scan varies so don't try to get one on your own, see what Dr. Panya thinks first.

 

 

https://www.facebook.com/physiofitphuket/