In constant pain for a month - don't know where else to turn

In My Humble Opinion
1

I have tried posting questions about this in other (non-Straight Dope) forums, and people seem to keep misunderstanding the issue, so I want to stress a few things right off the bat:

-I have been working out at the office gym on my lunch hour, Mon/Wed/Fri, for 3 years, doing strength training. I am no stranger to feeling sore after a workout.

-I have been bicycling to work, about 2 days a week, for the last 2 years (at least the spring/summer/fall of the last 2 years). I am not new to bicycling. However, I prefer to ride upright at a leisurely pace. I realize that many people prefer to ride fast, and I have nothing against that. My commute is 2.7 miles each way.

Last month, I bought a new bike, a Dutch bike, or omafiets. This bike was heavier than the cruiser I had previously been riding. I do not want to start a debate on the merits of different light bikes vs. heavy bikes. I only mention it because I initially thought the bike caused the problem, and it may have prevented me from getting treatment sooner.

What follows is an excruciatingly detailed account of what happened. I’m just trying to avoid what happened when I posted my question on the cycling forum, when I was dismissed as a newbie who couldn’t handle a little muscle soreness. I’m hoping if I can tell you exactly what happened, someone may have some advice.

The pain I describe has been constant for a month. There are ebbs and flows, times when the pain is lessened or stronger, but always there. Constant. Advil doesn’t help. Vicodin (which I had left over from an old injury unrelated to my legs) did not help. I have not had relief for a month and I am starting to go a little bonkers. If I were in a POW camp I would have told the enemy everything I know if they would just stop the pain. I feel it in my quads, from the center of the front my thighs to just above the knee. I hesitate to call it a “sharp” pain but it is definitely more intense than the “dull ache” you may feel from general muscle soreness. Sometimes it throbs. Lately it has almost felt like a "burning’ sensation in the muscle. It hurts when I just sit down. It hurts worse when I stand or walk. It is really bad when I go up and down stairs.

**
First week with my new bike : July 25th.** I rode to work MWF, with the idea I would do that for a few weeks, and then gradually work up to every day. I continued to work out at the gym MWF.

Second week with my new bike: August 1st. That Monday, I apparently did too many squats at the gym, or used dumbbells that were too heavy. I felt sore immediately. I decided to forego any more lower body strength training until I had recovered, but continued to ride on Wednesday and Friday. I noticed I felt sore after each ride. That weekend, I noticed that the soreness persisted throughout the weekend. Not super strong, but constant.

**
August 8th.** I assumed that my legs simply weren’t used to pedaling a heavy bike, and I just needed to keep at it. On Monday, I rode to work at a low gear and even lower than usual speed. I raised the seat to be sure that was not an issue, and rode again on Wednesday. My legs hurt as I was riding, so I stopped. Friday I did not ride. The pain persisted throughout the weekend, but lessened somewhat.

Saturday, I had to do an errand at the grocery store, 1 mile away. Although my legs were slightly better, they were still sore a bit, but I figured I should “work through the pain” and try riding to the store. Again they got sore, which persisted for days.

August 15th. Gave up riding entirely, waiting until I was feeling better. Going up/down stairs is extra painful, an even just walking is difficult
**
August 22nd.** Still didn’t ride bike. Still didn’t do any lower-body exercises. Constant pain, while somewhat lessened, continued. I made an appointment with a sports medicine specialist, who I saw on the 25th. He x-rayed my knees (even though I said my knees weren’t hurting), watched me take a few steps, do a single squat, and felt my quads. He declared that it was “just muscle soreness.” I expressed doubt that “just muscle soreness” would persist for 2 weeks after stopping all activity. Any soreness I’d ever felt in my workouts was always gone in day or two, or three days maximum. He said that once you get into your 30s (I’m 32) these things can linger, so he didn’t see it as unusual. He suggested trying to ride a mile that day, and if it felt okay, go back to riding to work. He suggested giving up squats entirely - he doesn’t have to tell me twice. I don’t think I can bring myself to do another squat as long as I live.

I was still feeling sore so I did not try to ride that day. 3 days later, the pain had lessened somewhat, so I tried another grocery store errand. Again the pain got worse. I assumed the bike was the culprit, and decided to just start riding to work on my old bike. I admit that this was a mistake.

August 29th. Rode to work on my old bike. Felt so-so on the way in. On the way home, my legs gave out. While pedaling in slow motion on the lowest gear, I felt as though I were pedaling through glue. Unfortunately, since my husband was at work, I couldn’t ask him to take me home, and as it was raining, I didn’t want to just sit there, so I kept going. The pain was terrible that evening, and persisted for the next few days.

The next day I called the doctor, and spoke to his secretary. I said I had taken his advice and the pain was worse. I asked if I could get physical therapy. She said that the doctor would have to wait until he got the transcription back from my other visit (or something like that) and when that happened they would call back.

Yesterday she called back. The doctor gave me a prescription for physical therapy. I immediately called a PT place I had used in the past (for the non-leg injury I mentioned earlier) but they must have closed early for the holiday weekend, and I left a message.

That same day I did an upper-body workout at the gym, as I’ve been continuing to do all this time. I can only assume I am somehow involuntarily clenching my whole body when I do chinups, because since then, my legs hurt worse than ever. I am now hobling around the house like an old lady, taking teeny steps, having to hold onto chairs in order to hoist myself up when I get up, or to help lower myself when I sit. Going up stairs is brutal.

And of course, when I went to pick up my PT prescription, the doctor had written on it “for leg strength,” so clearly he misunderstood the entire situation. I didn’t come to him because I was trying to build strength. I came to him because I was looking for pain relief. I just hope I can correctly explain the situation to the physical therapist.

But since Monday is a holiday, I assume I won’t hear from them until at least Tuesday, and who knows when they can book an appointment for.

So that’s where I stand. I don’t know what I’m looking for here. I guess I’m just looking for some words of comfort that somehow there is a way out of this. I can only assume that I really messed up my quads from those squats, and then messed them up further by continuing to bike ride. The fact that the pain continued even when riding my old bike makes me think (hope) that my new bike is not the problem.

As of this point, I have completely given up all physical activity, and have no plans to go back to the gym, even for upper body stuff. All I do is sit in a chair and read or surf the internet, and get up when I have to do house cleaning or cook. As I said, I am starting to feel like I am going bonkers from the constant pain (as well as the forced inactivity), and I am crying several times a day. Mr. Ipsum is trying to be sympathetic, but I think he’s sick of hearing about it from me.

Please, can someone tell me if they’ve gone through a similar thing, or if there is anything I can do to relieve the pain? I took a friend’s advice (who has suffered from sports injuries) that I should use a warm compress on my legs in the morning and a cold one at night, but it doesn’t seem to have helped.

2

I’m so sorry and I’m glad you’re going to the doctor (not that they seem like much help). This doesn’t sound like normal overuse pain or an injury.

I get weird muscle pain of this sort (but not so severe I don’t think, definitely not so long-lasting). For me it’s usually dietary in cause… have you changed anything there recently? Do you eat plenty of nutritious foods? Good sources of potassium in your diet? Plenty of protein? Deficiences in several vitamins and minerals can cause severe muscle pain; so can ODing on supplements.

Do you take any medications? Especially statins - they can cause this degree of muscle pain.

It could really be a symptom of so many things, a lot of them quite serious. :confused: In fact from what you’ve described, I’d be concerned it’s the onset of some form of polymyositis (or another myosistis). Do you have any rashes?

3

I am a runner and have been training for my second half marathon. About three weeks ago, I did my long run (7 miles, in case you were wondering) prior to leaving for a trip to Valleyfair (an amusement park about eight hours away).

When I got home from the run, my right foot felt a little achy, but not bad.

For the three days at the park, my foot went from a little sore, to horribly incapacitating. It was agonizing and I was living in dread that I had done something to my foot that would keep me from the race (that I am flying out to run, BTW).

I got back and rested and iced and prayed. It felt better after a few days, so I went out for a slow 6 miles. I could barely finish walking it, it was so painful. That night, I hopped around and was crying from the pain. I could not do anything, everything hurt. That Wed, I finally got into see the doctor and he felt around and said he thought it may be a stress fracture.

Game over, if that was the case, no half marathon for me.

He said it was either that, or I had inflamed “bone sheath”. I went on Naproxyn and rested, iced and prayed some more.

I went for my first test run Thursday, it was okay. Ran again yesterday and it was good again. I am cautiously optimistic.

All that to say, try some anti-inflammatories and have some hope for the physio. I would also try an RMT or a chiro that uses ART - I have had good luck with both of these.

Don’t give up hope. Sports/athletic injuries suck, and soft tissue is really hard to diagnose and can have a LONG healing time.

4

I’m glad you posted this in IMHO instead of GC!

Have you been tested for rheumatoid arthritis and Lyme disease? Seems you are trying to connect your pain to your bike-riding but correlation does not = causation. Severe joint pain could be arthritis, RA, Lymes, after-effect of over-exertion or accident.

I have mildly chronic lower back pain from two ruptured disks (L-3 & L-4, L-4 & L-5). It’s easily controllable most of the time but I often get a really nagging, persistent dull ache in my left buttock from sciatic pain.

I went through a period about ten years ago where my back pain was so unrelenting I was sometimes reduced to tears because nobody could tell me what caused it, until I got an MRI and validation it was a real thing. I think above-all and foremost, you need a proper diagnosis so you have a plan to deal with this.

5

Continuous pain with no obvious source is a pretty serious symptom, maybe of something that has no or very little relationship to the exercise regime. It might have just been coincidence that the pain began when it did. You might want to see another doctor, without assuming you have a sports injury.

6

What came to mind was that the new bike geometry is not right for you (meaning stop that bike entirely and make a coat rack out of it - don’t even think of peddling it even once till the condition is cleared ) or perhaps even Lyme.

Either way hoping it clears soon.

7

IANAD but IMO: You need to rest your legs. I’m guessing it’s the connective tissue more than the muscle, and that needs rest in order to heal. Stop working out for a week. And most especially don’t stretch those muscles. Increase the protein in your diet if it’s not already high.

I had a similar pain once, it was because I had grown and my bike seat was now too low. The angle of my thigh at the top of the pedal wasn’t right, my knee was reaching too high. So the best I can explain is that my thigh muscle was pulling against my knee instead of oushing down on it to get the pedal over and moving down again.

I had stretched, irritated and paritlaly ripped the connective tissue that attaches the thigh muscle to the knee. It took several weeks to heal, and I couldn’t plie for months.

8

Women (of any age) are generally far more prone to stress fractures than men when doing exercises that overload their muscles. IMO you need to see a specialist in orthopedic medicine and get a full suite of lower body X-rays or MRI taken before you wind up doing permanent damage to yourself.

9

This is obviously reckless guesswork on all our part, but you know IANAMD and the stuff we’re throwing out here is more just educating you to possibilities/options.

So the above, coupled with chiroptera’s note, has me thinking:

“Sounds like possibly either/both a herniated disk or inflamed sciatic nerve.” A pinched sciatic nerve (possibly pinched by general exercise such as heavy squats, or by a disk, or by something I’ll mention in a moment) can easily cause both shooting pain and significant muscle spasm (which only makes everything worse) in both the hamstring and the hip/buttock.

A particular form of pinched or trapped sciatic nerve that can lead to lots of pain is called piriformis syndrome. It’s caused by a muscle deep within the hip (the piriformis muscle) spasming so as to pinch the sciatic nerve.

If any of these things turns out to be the culprit, the good news is that there may be non-surgical alternatives that will work to de-compress the nerve.

Here would be my suggestions for how to proceed:

–Ice the affected area. That’s almost never going to do anything bad, and may help with spasming/pain.
–Find a new doctor (orthopedist, neurologist, sports medicine, or just a more cooperative GP) and – if you think my tentative hypothesis might be on track – ask if he thinks an MRI on your lower back might be in order to check for herniation of any discs.
–PT works but you want a prescription for “all modalities,” and this (if your doctor and PT agree) will probably involve massage of the affected area to break up any adhesions as well as stretching and mild exercises.

Check out this article and see if any of this rings a bell.

10

Thanks for the comments so far.

To answer the question about diet, I generally have a very healthy diet. I eat lots of whole grains, fruits and vegetables, fish, and very little processed food. I always try to eat a lot of protein, and have eating even more since this started, in an effort to help muscle repair.

The only medication I take is birth control pills. I also take Ambien occasionally for insomnia. I take fish oil pills once a day, although lately I’ve been taking 1 with each meal since the label says you can take 3, and I’ve heard it can help relieve inflammation. I’ve also been taking Advil 3 times a day since it has ibuprofin, which is supposed to help inflammation, although it doesn’t seem to be making much difference. Today I tried taking Vicodin instead (even though it has acetominphen, which isn’t anti-inflammatory), just to see if it would relieve the pain. It didn’t, although it did give me a pleasant buzz that helped to sort of take my mind off of it.

I also read that ginger and turmeric are anti-inflammatory, so for the last 3 days I’ve tried drinking a glass of water mixed with powdered ginger & turmeric.

To answer some other questions, I do not have any rashes. Also, the pain is not actually in my joints, but rather the front of the thigh. It starts just above the knee and extends halfway up the thigh. (Or would “just above the knee” still be considered part of the joint?)

I guess if I cannot get a PT appointment soon, or if they also aren’t able to help, I will try seeing another doctor. Is there anything else I can do in the meantime? Anything else that will help reduce inflammation? Should I continue taking my friend’s advice of warm compresses in the morning and cold compresses before bed?

11

I’m guessing torn or pulled quads though doing both at once would be highly unusual. Did both legs go bad at the same time?

12

Thanks. The article didn’t seem to be quite the same as my situation, as I have no pain in my lower back or buttocks. But I will try to continue icing the area.

13

Yes, the pain is fairly symmetrical. Both started hurting at the same time, and in the same place on each leg. At any given moment, one may hurt slightly more than the other, but it is generally the same.

14

Well I’ve suffered from sciatic nerve pain and if it’s that

1 - It was for (me) usually somewhat asymmetrical along the side of the leg not in the quads

2- Normal pain meds (aspirin, Aleve, hydrocodone, oxycodone etc) did little if anything for sciatic never pain

3 - I tried docs and chiropractors etc. The ONLY thing that worked in the end was a massively intense back and leg stretching program to pull the nerve back out from between the pinching disks. I’ve had a few further sciatic nerve attacks over the years and the intensive stretching is the only cure (for me).

15

Another characteristic of sciatic pain (for me) was that it was progressive during the day. You could wake up in relatively good shape, and as the day wore on it would get worse and worse and by evening it would be absolutely excruciating. Like a river of fire running up your leg.

16

an old girlfriend of mine who loved cycling had the same problem and it turned out to be a side effect of birth control pills. dump the sports doctor, you need to find a women’s clinic run by a female osteopath for your healthcare. also do a little online research on balancing the supplements potassium, calcium, and magnesium, this can be helpful for the sort of cramping and fibrillation you’re having. switch from a fish oil blend to 100% salmon oil, for generalized pain and circulatory health it’s the best there is. you don’t have the symptoms for sciatica, which is great, just be sure to find a doc who understands women’s health issues (and throw away that ambien shit and try a few drops of tincture of passionflower before bed).

17

In my opinion you injured your muscles at the gym on that day when you first felt it. Everything after that was just additive. That’s the funny thing about injuries. When you have an injury, everything you do hurts. You tend to look for more distant causes. You will work through this in time. Taking complete rest for some time should set the healing process in motion. There’s a point in every injury when you can begin working out even with pain and the recovery process won’t be stopped. The secret is finding that point. I never want to take any more time off then necessary. This injury proves to you that you do need the time off. I would guess at two weeks and then see what you can do.

18

Thanks. Although I think it will take more than that. My initial break was 15 days - from the time I stopped bicycling and all lower-body exercise to the time I tried to ride again on my doctor’s advice, which just resulted in more pain. At the rate I’m going, I’m thinking it may be a month (and this is assuming that it’s just muscle soreness and not something more serious).

19

Some of the worst pain I’ve ever had, I agree with this. I’ve never found any meds that reduce the pain, either.
Sciatic pain can involve the quads and the front of the leg; mine does. It depends on which nerves are compressed.

I’m not sure how common it is for both legs to be affected, though. Mine’s just the left leg. Also, while the pain originates in the lower back, during a bad sciatic pain episode, there’s sometimes no back pain, just the excrutiating leg pain.

If it turns out to be a back thing, definitely start and adhere to a back exercise regimen. I think that’s the only reason my back hasn’t become progressively worse.

20

Although it’s completely in the wrong area of the leg, your pain sounds horribly like shin splints I had several years ago. And with that, you get a whole lot of NUTHIN’ from everybody, except to have them say, “It will eventually go away.”

Yeah, if you don’t kill yourself first.

PT is probably the best answer. Frankly a good PT knows more about joints, muscles, day-to-day activity, and PAIN than most doctors. Try to hang onto your sanity until you can get to the PT.

Talk to a pharmacist about different OTC antiinflammatory drugs. Sometimes its a matter of finding the right one.
~VOW