Having Severe Pain In Leg, Joint And Muscular Pain. History Of Gout. What Is Wrong?

Posted on Sat, 21 Jul 2012

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 21 Jul 2012 Answered on

Fri, 10 Aug 2012 Last reviewed on

Question : Severe pain left leg, less pain right leg, this happens more intensely whenever I lay down sometimes it feels as if a tonne weigh is sitting on them? Skin sore to touch in hip areas, and warm. Joint and muscular pain. Numerous muscle twitches, especially in calf area of both legs. Toes also, very deeply reddened, plus left foot deeply reddened. Also, recent difficulty using right hand, very painful. Forgot to mention in medical history, was diagnosed with gout several years back, through a blood test. As I have suffered from dvt and superficial blood clotting in the past, constant fear of more blood clotting. I was told to stop taking 11mg of warafin daily, 2 weeks ago??? Went to AandE last week fearing a blood clott, it was clear??? Went to family doctor, he cannot or will not tell me what is happening, gave me some pain relief cream. As I suffer from depression and anxiety problems, not knowing whats wrong with me, is getting me down. If I knew, I could begin to accept and deal with it. Very frustrating. Also, seem to have circulation problems, which seems to be obvious from my previous blood clotting.

Answered by Dr. Shanthi E (6 hours later)

Hi,

Thanks for posting your query.

It is very clear from your history that you had a DVT last year. The current symptoms mostly seem like manifestations of the same ongoing process.

I have a few things to say to you:

1. You seem to have had the first event of DVT last year, and superficial clotting in the recent times. You are also type 2 Diabetic. This puts you in the category of - Recurrent idiopathic venous thromboembolic disease or continuing risk factor. Duration of anti-coagulation in you should be for a minimum of at least 12 months.

2. The goal of anticoagulation should be to maintain an INR between 2 to 3.

3. Your treating doctor would have taken the decision of stopping the drug depending on your INR status and no repeat episodes of the clot.

4. To confirm regarding the absence or presence of the clot, you need to get a colour Doppler vascular scanning of the lower limb blood vessels. You can get this done on an elective basis after discussing with your treating doctor.

5. Pain relief cream will only relieve pain. It will not treat the cause.

You have already accepted your disease and are dealing with it. We only need to rule out secondary clots and an assessment to decide on whether warfarin needs to be re-started or not.

I appreciate your courage and strength to fight this. Do not be frustrated. Discuss about these with your doctor and go ahead.

Do write back for further discussion on this.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanthi E (5 hours later)

I forgot to mention, Dr Shanthi it was to take many weeks, before my INR range was stable, and once it was stable, I was told to stop????? Thank you.

Answered by Dr. Shanthi E (3 hours later)

Hi,

Thanks for writing back.

You were asked to stop the drug only after the INR was stabilized. I think you have been treated adequately for the DVT by your doctor. It does not seem necessary for you to take the drug now.

However, it is better to get the Doppler study done as I mentioned in my earlier reply.

I hope to have been of some help to you. If you do not have further queries, you may close the discussion, rate the answer and write a review.

I wish you good health.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar