Leg Swelling and Muscle Twitches: When to Seek Medical Help

Twitching and pain in the thigh area?

The doctor would like to ask you: Last year, after injuring the bottom of my left foot, I experienced swelling in both legs up to my thighs.
A subsequent CT scan revealed that I have narrowing of the lymphatic vessels in my legs, but the doctor mentioned that the blood vessels appeared to be normal.
I also had a nerve examination of my legs, which showed no issues.
At that time, my weight was 81 kg, and my blood test indicated that my glycated hemoglobin was slightly above the normal range, but it did not meet the criteria for diabetes.
Later, I successfully lost weight through exercise and dieting, reaching 61 kg.
However, I stopped exercising and gradually lost control over my diet, drinking almost a cup of bubble tea every day.
In the past two months, my weight has increased to 72 kg.
Over the past six months, I have experienced twitching in parts of my legs almost daily, similar to eyelid twitching, which is not painful.
However, this week, when I stand up or walk, I feel a cramping pain in certain areas of my legs, even though I haven't exercised.
Additionally, for the past two days, I have felt a slight sharp pain in a specific area on the back of my left thigh when I sleep and accidentally press on it, which is different from the general pain in other areas.
I am very concerned that I may have a serious illness, so I would like to consult a doctor.
Which specialty should I make an appointment with? Thank you.

jill, 30~39 year old female. Ask Date: 2023/05/17

Dr. Li Jian reply Internal Medicine

Please schedule an appointment with the neurology department for an examination.
Thank you for your inquiry.

Reply Date: 2023/05/17

More Info

Based on your description, it seems that you are experiencing a combination of leg swelling, muscle twitches, and occasional pain, particularly after a previous injury and subsequent weight fluctuations. These symptoms can be concerning, and it’s important to understand their potential causes and when to seek medical help.

Understanding Your Symptoms
1. Leg Swelling: The swelling in your legs could be attributed to several factors, including lymphatic issues, venous insufficiency, or even weight gain. Given your history of lymphatic narrowing, it’s possible that this condition is contributing to the swelling. Lymphatic obstruction can lead to fluid accumulation, which may cause discomfort and affect mobility.

2. Muscle Twitches: The muscle twitches you describe, similar to eyelid spasms, can be benign and often result from stress, fatigue, or electrolyte imbalances. However, if they are persistent or accompanied by other symptoms, they may warrant further investigation.

3. Pain and Cramping: The cramping sensation you experience when standing or walking could be related to muscle fatigue, dehydration, or even early signs of peripheral vascular disease, especially given your previous weight loss and subsequent regain. It’s crucial to monitor these symptoms, particularly if they worsen or become more frequent.

4. Localized Pain: The specific pain in your left thigh when you sleep could indicate a muscle strain or tension in that area. It’s essential to differentiate between muscular pain and pain that could suggest a more serious underlying condition, such as nerve compression or vascular issues.

When to Seek Medical Help
Given your symptoms and medical history, it is advisable to seek medical attention, especially if:
- The swelling persists or worsens.

- You experience significant pain that interferes with daily activities.

- You notice changes in skin color or temperature in your legs.

- The muscle twitches become more frequent or are accompanied by weakness.

- You have any new symptoms, such as numbness or tingling.

Which Specialist to Consult
For your symptoms, it would be appropriate to consult a vascular specialist or a physiatrist (rehabilitation physician). A vascular specialist can evaluate the blood flow in your legs and assess for any venous or arterial issues, while a physiatrist can help with rehabilitation strategies and managing pain.

Additional Considerations
- Weight Management: Since you have experienced fluctuations in weight, it may be beneficial to develop a sustainable diet and exercise plan. This can help alleviate some of the swelling and improve overall health.

- Hydration and Nutrition: Ensure you are adequately hydrated and consuming a balanced diet rich in electrolytes, as imbalances can contribute to muscle spasms.

- Physical Activity: Gradually reintroducing physical activity, focusing on low-impact exercises, can help improve circulation and reduce swelling. Activities like walking, swimming, or cycling may be beneficial.

- Monitoring Symptoms: Keep a journal of your symptoms, noting when they occur and any potential triggers. This information can be valuable for your healthcare provider.

In conclusion, while some of your symptoms may be benign, the combination of leg swelling, muscle twitches, and pain warrants a thorough evaluation. Seeking the appropriate specialist will help you get a clearer understanding of your condition and the best course of action for treatment.

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