Leg Pain: Causes, Symptoms, and Treatment Options

Q: Leg Pain: Causes, Symptoms, and Treatment Options

Hello： Based on the symptoms, it appears to be a vascular issue. <br>"Both legs have been persistently aching, from the thighs to the soles of the feet, especially more pronounced after walking a certain distance." Clinically, it is necessary to consider the possibility of PAOD (

Bilateral leg pain?

Hello: For the past month, I have been experiencing persistent soreness in both legs, from my thighs to the soles of my feet, which becomes more pronounced after walking for a while.
This symptom started occurring after the Lunar New Year last year.
About 20 years ago, I developed red spots on my arms and calves; initially, there were 1-2 spots that were neither painful nor itchy, but over time, they increased in number, affecting my forearms, calves, and even thighs.
The color of the spots deepens in cold weather, becoming more pronounced in winter, while they appear lighter in summer.
However, when transitioning between air-conditioned rooms with significant temperature differences, they can also appear dark red.
I have consulted both traditional Chinese medicine and Western medicine, and they all indicated poor blood circulation, but since the spots were not painful or itchy, I did not pay much attention to them.
However, since last year, when my legs started to feel sore, these spots have also become painful, especially around the ankles.
I consulted doctors at Keelung Tri-Service General Hospital, but they could not identify the issue.
Later, I went to Chang Gung Memorial Hospital in Keelung and was referred to several departments, eventually seeing a dermatologist who performed a biopsy and diagnosed it as vasculitis with inflammatory spots that cannot be treated.
They prescribed some medication, but it did not have much effect.
I continued to experience soreness, but due to a busy work schedule, I did not address it.
It seemed like there was a period of about six months where the soreness was not significant, but recently, it has started again.
I would like to know if there are any related medical treatments available.
Thank you!

vanessa, 40~49 year old female. Ask Date: 2009/03/28

Dr. Lai Junlong reply Family Medicine

Hello: Based on the symptoms, it appears to be a vascular issue.
"Both legs have been persistently aching, from the thighs to the soles of the feet, especially more pronounced after walking a certain distance." Clinically, it is necessary to consider the possibility of PAOD (Peripheral Arterial Occlusive Disease).
Additionally, the red spots may be caused by peripheral vasodilation.
It is recommended that the individual consult a specialist in vascular medicine or a rheumatologist for further evaluation.
Thank you, Dr.
Lai Junlong.

Reply Date: 2009/03/28

More Info

Hello,
Thank you for sharing your concerns regarding the leg pain and the history of your symptoms. Based on your description, it seems that you are experiencing a complex interplay of symptoms that may be related to vascular issues, inflammation, and possibly other underlying conditions.

Understanding Your Symptoms
1. Leg Pain and Discomfort: The pain you are experiencing in your legs, particularly after walking, could be indicative of several conditions. Given that you have a history of red spots on your arms and legs, which have been diagnosed as inflammatory vascular lesions, it is possible that your leg pain is related to these vascular issues. Conditions such as peripheral artery disease (PAD), venous insufficiency, or even chronic venous disease could contribute to pain and discomfort in the legs, especially after exertion.

2. Red Spots and Vascular Inflammation: The red spots you mentioned, which worsen in cold weather and improve in warmer conditions, suggest a possible vascular or dermatological condition. The fact that they have been described as inflammatory and have not responded well to treatment could indicate a chronic condition such as vasculitis or another form of vascular inflammation. This could lead to compromised blood flow, resulting in pain and discomfort during physical activity.

3. Symptoms of Circulation Issues: The symptoms you describe, including the pain in your ankles and the history of red spots, may suggest that there is an issue with blood circulation. Poor circulation can lead to muscle fatigue and pain, especially during activities like walking. Additionally, if there is inflammation in the blood vessels, it could exacerbate these symptoms.

Recommended Actions
1. Consult a Specialist: Given the complexity of your symptoms and their persistence, it would be advisable to consult a vascular specialist or a rheumatologist. They can perform a thorough evaluation, including imaging studies such as Doppler ultrasound, to assess blood flow in your legs and identify any vascular abnormalities.

2. Further Diagnostic Testing: Since you have already undergone a skin biopsy, it may be beneficial to explore additional tests that can assess your vascular health. Blood tests to check for inflammatory markers, autoimmune conditions, or clotting disorders may also provide insights into your symptoms.

3. Pain Management: In the interim, managing your pain with over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen, may help alleviate some discomfort. However, it is essential to consult with a healthcare provider before starting any new medication, especially considering your medical history.

4. Physical Therapy: Engaging in physical therapy may also be beneficial. A physical therapist can design a tailored exercise program that focuses on improving circulation, strengthening the muscles in your legs, and enhancing overall mobility without exacerbating your pain.

5. Lifestyle Modifications: Incorporating lifestyle changes such as regular, low-impact exercise (like swimming or cycling), maintaining a healthy diet, and avoiding prolonged periods of inactivity can help improve circulation and reduce symptoms.

Conclusion
Your symptoms are multifaceted and may require a comprehensive approach to diagnosis and treatment. It is crucial to work closely with healthcare professionals who can guide you through the process of identifying the underlying causes of your leg pain and developing an effective treatment plan. Please do not hesitate to seek further medical advice, as timely intervention can significantly improve your quality of life.

Take care, and I hope you find relief soon.

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