- Arm and Leg Pain
- Lisa Jensen’s Blood Clot Story
- Summit Medical Group Web Site
- Pain in Upper Thigh
- Tired throbbing painful legs
- Treatment – what treatment will I be offered for venous hypertension / insufficiency?
- Healthcare advice for venous hypertension / insufficiency
Arm and Leg Pain
Our shoulder and hip joints are two of our most frequently used joints and are prone to a wide range of possible injuries. Oftentimes people are completely unaware of what caused their pain, maybe it is a weekend warrior who overused the joint in an athletic competition, an unfortunate participant in a car accident, a person lifting too much weight at work or home, or a grandmother who fell asleep holding their grandchild in one position all night. Typically, these situations cause almost an immediate pain or discomfort as a result of muscle, bone, or nervous system damage and irritation. Our chiropractic clinic can help.
However, many people have arm and leg pain that develops gradually over time, and are unaware of what may have initially caused it. Vertebral subluxations, arthritis, bursitis, tendinitis, and frozen shoulder are the most common causes of pain.
It has also been shown that arm and leg pain is often caused by “referred pain,” where pain in one area moves to another part of the body. This may be best known as the arm pain that is commonly reported during a heart attack. A less common example is the pain that an inflamed gall bladder often causes under the right shoulder blade.
We frequently see patients who complain of arm and leg pain that is being referred from nerve irritation at the spine. If the spaces where the nerves leave the spine are narrowed due to the vertebrae or disc being out of position, the nerve can become irritated and often produces pain down its entire path. The pain patterns associated with sciatica are a good example of this mechanism.
What Is Causing My Leg Pain?
Due to the complexity of the joints and the vast number of possible causes, it is important that you see someone who is trained in these areas. Typically, your healthcare provider will use a combination of a physical examination and advanced imaging to get to the root cause of your problems. This is done by finding the location of the pain, aggravating or alleviating factors, type of pain sensation, and other symptoms such as swelling, skin changes, and bruising as other tools to assist in the diagnosis.
Can a Chiropractor Help?
As with any condition, you want to start with treating the most common and typical cause of the pain and symptoms first. Misalignment (subluxations) of the vertebrae in the neck and lower back has been found responsible for the vast majority of reported arm and leg pain. When bones or discs are out of position and are unable to move properly, it can cause irritation to the surrounding tissues and nerves.
Many patients are surprised to see how extensively their nerves are spread throughout the body, from the spine all the way to the fingertips and toes. As a result, injuries to the vertebrae in the spine can create the sensation of pain anywhere along arms and legs. Through a careful pattern of treatment, patients at Access Health Centers have experienced high levels of success through chiropractic treatment. If you or a loved one is experiencing arm or leg pain contact us today to schedule a consultation.
A lumbar X-ray and/or an MRI scan can often help reveal the cause of the problem.
Scans may reveal:
- A disc herniation causing nerve compression
- Nerve compression from age-related arthritic changes causing spinal canal or foraminal narrowing (stenosis).
If the scans reveal one of these conditions, the pain management physician may consider treatment with a spinal injection.
These injections are a focal steroid treatment targeted to the specific area of compression or inflammation to calm the nerve root, rather than a systemic anti-inflammatory steroid. This process may only require one injection or might require additional injections.
Level four: surgical evaluation
If spinal injections provide some relief but it is not long-lasting, a surgical evaluation would be the next step.
“At that point, we would examine the patient and review the imaging. Then we would discuss surgical options, including the risks and benefits, and most importantly, the anticipated outcome, says Dr. Perry.
Some general guidelines to addressing this issue include:
- Consult your primary care physician when you experience persistent pain radiating down your leg.
- Consider using an over-the-counter anti-inflammatory medication such as ibuprofen. These anti-inflammatory drugs can help relieve some of the pain. There are also other prescription medicines available. You should discuss them with your doctor.
- Continue to exercise and do back-strengthening exercises. Also continue with your normal activities as you are able. If your muscles become unused and atrophy, that will weaken the body’s structural support system for your spine and make recovery more difficult.
Lisa Jensen’s Blood Clot Story
The personal story below is intended for informational purposes only. The National Blood Clot Alliance (NBCA) holds the rights to all content that appears on its website. The use by another organization or online group of any content on NBCA’s website, including the patient stories that appear here, does not imply that NBCA is connected to these other organizations or groups or condones or endorses their work. Please contact [email protected] with questions about this matter.
Lisa Jensen was an active 27 year old woman, when her active life was interrupted by blood clots in both her left leg and her lungs that she found out were related to May Thurner’s Syndrome. My name is Lisa Jensen and I am a fortunate survivor of both a deep vein thrombosis (DVT) and pulmonary embolism (PE).
I was busy starting a new school year as a high school English teacher and a graduate student at Western Michigan University in September 2011. I noticed that I felt out of shape, which irritated me, because I live a pretty active life. I run on a regular basis, and even once completed a marathon. I also participate in a co-ed soccer league, and walk my dogs routinely. However, these activities kept getting harder to do, and I felt out of breath even when I walked my dogs.
One night, while I was getting ready for bed, I felt a sudden sharp pain in my upper left thigh. Given that I was a healthy 27 year old, I figured I pulled a muscle. I went to bed, but the pain kept worsening. The next morning, I made an appointment to see my doctor.
At that point, I could no longer walk normally. It felt as if I pulled every muscle in my upper left leg. My doctor said not to worry, that it probably was just a pulled muscle, but that she wanted to do a blood test (D-dimer) to check for the possibility of a blood clot.
My doctor called me the next morning to say that my blood work was abnormal, and ordered an ultrasound on my leg. I set up an appointment for the next day, but the pain became so excruciating that I could not sleep that night nor could I put any weight on my leg. I considered going to the Emergency Room (ER), but put it off, since I had a doctor’s appointment the following afternoon.
I had my husband (then fiancé) take me to the appointment, because the pain made it impossible for me to drive. While they were doing the ultrasound, the nurse discovered that I had a deep vein thrombosis (DVT) that stretched from my groin to my knee and was completely blocking blood flow in my left leg. The nurse stated that I had to be admitted to the hospital immediately, because the clot could break off and travel to my lungs as a pulmonary embolism (PE) and possibly cause sudden death. I was in utter shock, since I didn’t know anybody in my family with a history of blood clots, and I certainly didn’t know how serious blood clots were until I had one.
Two pulmonary emboli (PE) were discovered while I was in the hospital; one in each of my lungs. I realized they were the cause of my recent shortness of breath and lack of energy, as well as my sense that I was out of shape. The doctors said that the cause of my DVT was May Thurner’s Syndrome, a syndrome in which my artery was compressing my vein, which caused the clot, because blood could not flow freely. I was also taking hormonal birth control pills, which added to my risk for blood clots, so I stopped them right after I was diagnosed.
My left leg became twice the size of my right leg and I was on a heparin drip and warfarin to treat the blood clots, and pain medication to relieve the pain. A filter was placed in my inferior vena cava to prevent any more clots from entering my lungs. A stent was placed in my vein to open it up and stop it from being compressed, and the clot was removed from my leg. This surgery has allowed me to live a normal life and prevented me from dealing with lifelong severe leg swelling and pain.
After five days in the hospital, I was sent home to heal. I was put on injectable low molecular weight heparin, and took warfarin for six months. After three months I was able to have the filter removed. I still experience swelling in my left leg during heavy exercise, but the fact that I can exercise is a gift. I recently passed the one year anniversary of my ordeal, and am now training for a half marathon. I can now run seven miles. I took my ability to run for granted before my clots, and I am no longer on warfarin or low molecular weight heparin!
It is crucial that people become informed on the seriousness of blood clots, DVTs, and PEs. Such knowledge can save lives! Symptoms can be severely underestimated, and I am lucky to be alive today as a DVT and PE survivor, because I checked out what I thought was a muscle pull right away, and my doctor responded appropriately
Take Home Messages
- Three months is usually the best time to remove filters that are placed to prevent blood clots from entering the lungs.
- Lisa’s doctor recognized the symptoms of a possible blood clot (pain, swelling, sense of a muscle pull) and ordered the appropriate tests
- Exercise is a healthy choice before and after a blood clot
- Hormonal birth control pills add to risk for blood clots
The National Blood Clot Alliance’s mission is to advance prevention, early diagnosis and successful treatment of blood clots, clotting disorders and clot-provoked strokes through public awareness, advocacy and patient and professional education.
Summit Medical Group Web Site
Studies have not yet shown that herbal medicine treatments work well in the treatment of pain. Acupuncture or acupressure have also been studied and don’t work very well. Some people might get wonderful relief, but that is not common. Capsaicin cream does work better than placebo creams, but the relief is not total.
Try hard to avoid taking narcotic pain medicine for neuropathic pain. As your body gets used to the medicine, you may need higher and higher doses to get the same effect. This can become a serious long-term problem if you are taking the medicine for a chronic pain condition. Narcotic medicine may also cause sleepiness and other unpleasant side effects, such as constipation. In high doses the medicine may cause trouble breathing and even death, especially if combined with alcohol. If you do start taking narcotic pain medicine, your healthcare provider may ask you to sign an agreement about how you will and won’t use this addictive medicine.
How long will the effects last?
Some chronic pain problems do not go away. Other problems hurt for awhile, and then the pain mostly goes away. Often the pain goes away because the nerve is so damaged that it stops working altogether. When this happens, the pain starts to feel like cold or numbness.
How can I take care of myself?
You can improve your quality of life even though you have pain. The key is to take an active role in managing the pain. This means doing things every day for your pain condition. It also means working as a partner with your healthcare provider, physical therapist, and others providing care for you. This can help you be in control of your pain, instead of the pain controlling you.
Here are some things you can do to manage your pain.
- Use your pain medicine correctly.
- If you are taking pain medicine just when you need it, take it when the pain starts getting worse unless it has not been long enough since your last dose. If you wait until the pain gets really bad, it is harder to control it.
- If you are taking pain medicine around the clock, make sure you take your medicine even if you don’t feel you need it. This helps keep pain under control.
- Get some physical exercise or activity on most days. This will build your strength. Even on “bad days” do something, such as a short walk. Ask your provider to help you plan an exercise routine that works for you. Depending on your type of pain, regular exercise may be a good way to help you feel better without needing to take more medicine.
- Keep a healthy weight. Especially if your pain is in the joints, being overweight can make the pain worse. Losing weight can lessen joint pain.
- Pace your activities. Try to do about the same amount of physical activity each day. Even during the day, spread activities out more evenly with rest periods in-between. Break tasks down into small steps that are easier to manage.
- Be social. Even when you don’t feel like it, get out and be with people. Spend time with friends and family who are supportive. Share your thoughts and feelings with others. Make time for fun activities.
- Learn ways to cope with stress and anxiety, such as exercise and relaxation, and get treatment for depression. Do things to relax and reduce tension, such as deep breathing, meditation, and yoga. Managing your stress can help you be more in control of your pain.
- Use positive self-talk. Teach your friends and family the important of positive talk. Negative thoughts can increase your stress.
- Focus your attention on something else to relieve even bad pain for a short time—for example, by doing things such as counting backwards, listing things such as flowers or types of cars, or doing an activity or hobby that interests you, such as watching a funny movie or a sports game or listening to music. Give your attention to things that you enjoy and make you feel satisfied instead of focusing on pain.
- Get enough sleep and eat healthy foods. Follow a regular sleep schedule. Talk to your healthcare provider about any problems you have with sleep. Sleep problems can make it harder to control pain.
- Limit your use of chemicals that can increase stress or heighten feelings of anxiety, such as nicotine (smoking), caffeine (coffee, colas, chocolate), and alcohol. Avoid using recreational drugs.
- Don’t smoke. Nicotine narrows blood vessels, which reduces blood flow. When there is not enough blood to an area, it doesn’t heal as well and there can be pain. Smoking can trigger headaches and increase back pain. Smoking can also make you more tired and your muscles weaker, which can worsen pain.
- Practice good posture. If you have had pain in your back or other part of your body for a long time, you most likely have made changes to your posture and the way you move. Pain causes you to move with caution and to tense muscles that are normally relaxed. You may have learned ways to control pain by bracing your body, limping, or standing differently. These postures may have helped at first, but over time, they cause more stress on your joints, spine, and muscles. Standing and sitting straight, and lifting and moving properly, can lessen the stress on the spine and muscles and help prevent injury or flare-ups of pain. It helps your treatment for pain work better because you are not continuing to irritate your muscles and spine. It’s also important to avoid activities that increase stress on the spine and muscles such as lifting heavy objects, twisting or bending while lifting, or sitting without support for a long time.
- Keep a pain diary. It can help you learn what helps your pain and what makes it worse. Rate your pain on a 0 to 10 scale. Record where the pain is, when it occurred, and how long it lasted. Note what you did to relieve the pain and how much it helped. Also note your activities or feelings. You may notice a pattern of things that increase or decrease your pain. Consider sharing what you have learned from your diary with your healthcare provider or counselor.
- Talk with your healthcare provider if you do not have good pain control. Describe the location and intensity of your pain, anything about your pain that has changed, and to what extent medicines and other treatments relieve the pain. Changes to your treatment plan may be needed.
- Learn about ways to manage pain. You can get more information about this from:
The American Chronic Pain Association1-800-533-3231http://www.theacpa.org/default.aspx
Pain in Upper Thigh
There are numerous conditions that may contribute to upper thigh pain. They include:
Caused by pressure on the lateral femoral cutaneous nerve, meralgia paresthetica (MP) may cause tingling, numbness, and a burning pain in the outer part of your thigh. It typically occurs on one side of the body and is caused by compression of the nerve.
Common causes of meralgia paresthetica include:
- tight clothing
- being overweight or obese
- scar tissue from a past injury or surgery
- diabetes-related nerve injury
- carrying a wallet or cell phone in the front and side pockets of pants
- lead poisoning
Treatment involves identifying the underlying cause, then taking measures such as wearing looser clothing or losing weight to alleviate pressure. Exercises that reduce muscle tension and improve flexibility and strength may also help alleviate pain. Prescription medications and surgery may be recommended in some cases.
Blood clot or deep vein thrombosis
While many blood clots aren’t harmful, when one forms deep in one of your major veins, it’s a serious condition known as deep vein thrombosis (DVT). While deep vein clots appear more frequently in the lower legs, they can also form in one or both thighs. Sometimes there are no symptoms, but other times they may include:
- a warm sensation
- a pale or bluish discoloration
As a result of DVT, some people develop a life-threatening condition known as pulmonary embolism in which a blood clot travels to the lungs. Symptoms include:
- sudden shortness of breath
- chest pain or discomfort that worsens when you take a deep breath or when you cough
- lightheadedness or dizziness
- rapid pulse
- coughing up blood
Risk factors for DVT include:
- having an injury that damages your veins
- being overweight, which puts more pressure on the veins in your legs and pelvis
- having a family history of DVT
- having a catheter placed in a vein
- taking birth control pills or undergoing hormone therapy
- smoking (especially heavy usage)
- staying seated for a long time while you’re in a car or on a plane, especially if you already have at least one other risk factor
Treatment for DVT ranges from lifestyle changes, such as losing weight, to prescription blood thinners, the use compression stockings, and surgery in some cases.
A complication of diabetes, diabetic neuropathy occurs as a result of uncontrolled high blood sugar levels. It typically begins in the hands or feet, but it can spread to other parts of the body as well, including the thighs. Symptoms include:
- sensitivity to touch
- loss of sense of touch
- difficulty with coordination when walking
- numbness or pain in your extremities
- muscle weakness or wasting
- nausea and indigestion
- diarrhea or constipation
- dizziness upon standing
- excessive sweating
- vaginal dryness in women and erectile dysfunction in men
While there is no cure for diabetic neuropathy, treatment to manage pain and other symptoms may involve lifestyle changes and measures to maintain healthy blood sugar levels as well as medications for pain management.
Greater trochanteric pain syndrome
Greater trochanteric pain syndrome can cause pain in the outside of your upper thighs. It’s typically caused by injury, pressure, or repetitive movements, and it’s common in runners and in women.
Symptoms may include:
- pain worsening when lying on the affected side
- pain that worsens over time
- pain following weight-bearing activities, such as walking or running
- hip muscle weakness
Treatment may include lifestyle changes, such as weight loss, treatment with ice, physical therapy, anti-inflammatory medications, and steroid injections.
IT band syndrome
Also common among runners, iliotibial band syndrome (ITBS) happens when the iliotibial band, which runs down the outside of the thigh from the hip to the skin, becomes tight and inflamed.
Symptoms include pain and swelling, which is typically felt around the knees, but it can also be felt sometimes in the thigh. Treatment includes limiting physical activity, physical therapy, and medications to reduce pain and inflammation. In some extreme cases, surgery may be necessary.
While muscle strains can happen in any part of the body, they’re common in the hamstring and may cause thigh pain. Symptoms may include:
- sudden onset of pain
- limited range of movement
- bruising or discoloration
- a “knotted-up” feeling
- muscle spasms
Typically, strains can be treated with ice, heat and anti-inflammatory medications, but more severe strains or tears may require treatment by a doctor. You should see a doctor if the pain doesn’t get better after several days or if the area is numb, arises without a clear cause, or leaves you unable to move your leg.
Hip flexor strain
Hip flexor muscles can be strained with overuse, and can cause pain or muscle spasms in your thighs as well. Other symptoms of hip flexor strain may include:
- pain that seems to come on suddenly
- increasing pain when you lift your thigh toward your chest
- pain when stretching your hip muscles
- muscle spasms at your hip or thigh
- tenderness to the touch at the front of your hip
- swelling or bruising at your hip or thigh area
Most hip flexor strains can be treated at home with ice, over-the-counter pain relievers, heat, rest, and exercises. In some severe cases, physical therapy and surgery may be recommended.
Tired throbbing painful legs
Treatment – what treatment will I be offered for venous hypertension / insufficiency?
Compression therapy (support bandages or socks)
If your pain is caused by venous insufficiency, and there are no problems with the blood supply to your legs, then you might be offered compression therapy.
Compression therapy improves blood supply by applying pressure to the leg. This can be done by bandaging the lower leg or by wearing supportive socks, stockings or tights. Compression therapy is very effective at reducing swelling and healing or preventing sores or ulcers. There are lots of different types of compression therapy so ask your nurse to find something that is right for you. Compression can be a little uncomfortable when you first start treatment but any discomfort should reduce as the swelling goes down. You might find it helpful to take pain killers when you start compression therapy.
Healthcare advice for venous hypertension / insufficiency
Making healthy changes to your lifestyle can help reduce the symptoms of tired, throbbing, painful legs:
- Maintain a healthy weight
- Take light to moderate exercise, such as swimming or walking for about 30 minutes at least three times a week
- Avoid standing for a long time
- Wear compression socks or tights instead of ordinary socks/tights