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

In My Humble Opinion
21

I got a physical therapy appointment on Wednesday. Although by that point, I was actually starting to feel a bit better anyway. I felt like the PT knew what he was doing a bit more than the doctor, as he asked me more questions about where I was feeling the pain and asked me to show him exactly what type of squats I had been doing when the pain started. He did various things like applying heating pads, massaging the legs, stretches, foam rolling, etc. He diagnosed the problem as tightness in the tensor. Although after looking it up online later, it looks like the tensor is not the same place where the pain is, so maybe I misheard. :confused: He said to make an appointment next week but I didn’t yet because I wanted to wait and see how I felt.

Today I actually didn’t feel so bad - similar to yesterday, I was able to walk around normally and even stand up for more than a minute or two. But later today, to make a long story short, I was in a situation where I bent my legs (just for a moment) in a squatting motion to duck under something, and I was back to the pain in my quads and the “wobbly” feeling of before - and now, hours later, it still feels that way, and I’m back to hobbling instead of walking. It seems like every time I almost think I’m getting a little better, I do something to set myself back. And the fact that a single squat did it (when I used to be able to do dozens at a time) shows that I am a long way from recovery.

I know there’s nothing that anyone here can do but I just had to vent because I’m getting so angry about this. Apparently I cannot do any physical activity but brief walking, because every Goddamn movement I make causes a setback. Maybe if I sat in bed and became completely immobile for a month, I would get better, but that’s hardly feasible.

Of course, the problem is that I don’t really have a valid excuse to avoid physical activity. If I had a broken leg then it would make sense, but I can’t just stop cleaning up after myself at home with the excuse that “my legs hurt”. And I still have to come to work and do things that involve getting out of my chair - I can’t very well tell my boss that I have to stay seated all day because “my legs hurt.”

So, I guess that’s where I stand. I may go back for more PT next week, and I guess in the meantime, try to minimize movement as much as is realistically possible. And I guess these are all questions for the PT as well - to find out what movement I should avoid, and what kind is safe to do.

22

PT isn’t a one-shot thing. While a muscle may spasm in a brief moment, it takes a lot to get it to let go. The therapist should also give you exercises you can do at home–BUT, if your initial injury and subsequent reaction are severe, you may need therapy for a week or more before you can work your way up to exercises. Ask questions. Make sure you understand what the therapist finds wrong and how he/she plans on treating it, and what your timeline for recovery is. DON’T push yourself.

Muscle/tendon/ligament damage is actually much worse than a broken bone. A bone can knit and heal and end up stronger than it was originally. Soft tissue damage can never return to the original condition, and you have to learn how to adapt to the resulting weakness.

Go EASY on yourself. It’s not necessary to “punish” your body for being “bad.”
~VOW

23

I’m thinking sciatic pain, based on the fact that it’s bilateral. It would be unlikely that you’d damage the same ligament or muscle on both sides of the leg at the same time. Does it get worse or twinge when you lift things?

If your new bike is heavier than the old, it’s possible that you did something to your back while lifting it (or doing the squats).

Also, note that ibuprofen does have anti-inflammatory effects, but generally only if you take far more than the recommended amount (which you should only do after consulting your doctor).

24

It is a really depressing feeling when every movement makes things feel worse and that in turn makes you despair that you’re never going to get better unless you can afford to be completely immobile.

Good news is that apart from being completely impractical to do a month’s bed rest, overwhelming modern medical opinion seems to be that that would be a very bad idea in any event. I’ve had to rehab a few injuries in the last couple years and contra to the old complete bed rest theory, the atrophy and loss of range of motion that result from total or near total inactivity for anything over a few days, for most conditions, are thought to be what will exacerbate the problems and delay recovery. I know it’s hard to believe when you’re in agony, but generally speaking, doing the PT and going about your normal activities as much as you can without undue pain will very likely lead to your waking up one morning (or over a couple of mornings) and realizing you’ve turned a corner (the best way one doctor put it to me was, “just don’t go out of your way to do anything that hurts.”). The body really does have remarkable self-adjusting curative capacity.

As to PT – yes, it is a process. Practically speaking you may need to go 2-3 days a week (and do any home stretches/exercises they tell you to do faithfully) to see improvement.

Another good thing about PT is (as you noted) good PTs (or even PT assistants – I learned in a thread I did that I was being treated by paraprofessionals with some modest training but not the extensive training necessary to be a licensed PT) know a lot about the body and about pain and muscle/tendon/ligament/joint soreness. They’re very practical. Another bonus (especially given your initial sort of blowoff by your GP) is that I’ve found PTs actually like people and are respectful and solicitous to patients who are in pain. Plus – and I don’t know what the PT population is where you are – I picked up a few phrases of Tagalog.

25

VOW,

Thanks for the reply. About the PT, I forgot to mention this in my previous post - I was originally hesitant to go back, in case the PT left me in more pain than before, so I didn’t want to make an appointment until I saw how I was feeling the next day. Since it looks like it didn’t cause any problems, I guess I will continue.

It gets worse any time I bend my legs or do a squat - so far I’ve been able to avoid lifting anything large or heavy. If I’ve had to lift something, I just try to lean over without bending my legs. I know this isn’t great for my back, but if I ever had to pick up something heavier I would probably ask someone else to do it. It also seems to get worse if I tense my legs. For a while I had been continuing to workout in the gym, just doing upper body and core. But I think that was contributing to my delayed recovery, because I may have been tensing my legs. The last time I was at the gym, I was doing chinups, and my legs were hurting afterward, so I am now avoiding the gym entirely. In general, if I can limit myself to just walking, and absolutely no squatting or knee bending, it seems okay.

Good point. I did ask the PT yesterday if I should keep taking it, and he said that this is not a case of inflammation, so there was no need to keep doing it. So tonight, just for the hell of it, I took some hydrocodone instead (leftover from a previous issue that was not leg-related) because it’s relaxing and helps me not feel as stressed, if only temporarily.

26

I would also note that a typical course of PT will be at least six weeks. With one of my problems, I did it for probably double that. I wanted not only to get the muscle/ligaments un-painful, but to get things both limber and strong enough to correct the weaknesses that the injury both caused and was caused by. I still sort of habitually go through some of my PT exercises at my desk.

27

Here’s a couple of final tips:

(a) sleep as much as you can. Every time I’ve had a significant injury, I’ve just felt like sleeping hours longer than usual. That’s your body talking to you, and as one PT told me, pain, being clenched up all day, is really tiring. Obviously you can’t sleep the workweek away, but even if you can only manage to sleep in on the weekend, do it as much as you can. Don’t feel like you’re wasting time; you’re investing in being pain free.

(b) if it helps to vent on this board, go for it early and often. One of the downsides to being sick or in pain is that it becomes your sole focus (it’s natural). So either you end up bending the ear of your friends and family, who can’t possibly empathize 100% with your real but non-terminal pain, and will get tired of listening to you; or, if you’re really conscientious about not bugging people like this, you’ll just end up bottling it up out of the knowledge that when people ask how you are, they don’t really want the catalogue of symptoms that’s foremost in your mind. The way I put it was, “Even I’m tired of talking about it, so don’t ask, I’m getting by.” Here, by contrast, there’s more ears to spread the bending around, and no one has to listen or feign sympathy if at any given moment they don’t feel like it or have time.

28

It’s time again for the Whining Lauren Show:

I think I was starting to feel a bit better on Sunday/Monday. Then last night while watching TV, I was starting to doze off. Without thinking about it, I pulled my legs in toward me in that “hugging the legs to the body” motion, and it was probably about 5 minutes before I woke up and realized what I was doing. I noticed a few weeks ago that this kind of bending of the leg was painful when I got a massage through Groupon and the guy moved my legs in this way (he stopped as soon as I told him it was hurting).

So today my thighs are more sore than yesterday. Sigh. I know this sounds melodramatic but I’m really starting to wonder if this is ever going to go away. It has now been over 6 weeks since the pain began. I have cut out all exercise, am only walking when necessary, and still I keep doing things that make the pain worse, just when I thought I might be getting better, AGAIN. Maybe I will try calling the doctor to see if he can prescribe something for me, since Advil or Hydrocodone is doing nothing. (Well the Hydrocodone is doing something, but it doesn’t have anything to do with relieving pain, hehehe.)

I actually called a local maid service to look into getting someone to clean the house weekly, because I can’t stand up long enough to get the house vacuumed or the toilets & tub scrubbed (okay, I can stand up, but it becomes painful after a few minutes). We’ve actually had mold in one of the toilets and the tub because it’s been so long since I cleaned them. However, their price for a weekly cleaning was way more than I’m willing to spend.

For the last couple of weeks I’ve been trying to make dinners that are simple, or reheat leftovers, or go out. I told Mr. Ipsum that tonight I’m heating tv dinners because I don’t want to deal with cooking (not only the time spent in preparation but the cleanup afterward). I know he doesn’t really care what we eat - I have cooked dinner almost every day of our marriage because I want us to be healthy and I like cooking. He appreciates it, but I know he wouldn’t mind just eating TV dinners if we had to. So I assumed he would be okay with this. And he is, but he did make a passing comment about me “wussing out” by not cooking tonight. And that hurt. I know it’s not about the dinner - he doesn’t mind TV dinners, and that’s all he ate as a bachelor. But he seems to think that I should be able to just put the pain out of my mind, and stop whining so much, and get on with life as usual. Easy for him to say, when he’s never had to deal with being in pain for 6 weeks. And maybe he’s right that I should try to do all my normal activities, but when I’m afraid that any pain during my normal activities will just lead to a delayed recovery, it’s hard to push myself.

I know that in the big scheme of things, this is not a tragedy. The recent 9/11 anniversary shows that there are/have been many worse things than chronic pain. But it’s hard to be optimistic like people are telling me to, when I feel like this is never going to get better.

And of course, now I’m starting to put on weight from lack of exercise. Again, not a tragedy, but I feel like my figure was all I had going for me. I don’t have an attractive face, and I am a shy person with poor social skills. About the only thing I was able to do to improve my attractiveness was learn how to use makeup properly, and to get a decent-looking figure through diet and exercise. And now I’m not even going to have the figure. I have tried cutting carbs when possible, but am hesitant to “diet” too much since I know my body needs calories for repair.

I have another PT appointment tomorrow, so maybe he can give me some more answers.

29

PLEASE DON’T LET THIS SCARE YOU.

Your situation sounds very much like a good friend of mine experienced a few years ago. He was in his late 30’s and had taken up cycling a few years prior. He was also a college baseball player and relatively fit. He started experiencing pain in one of his shoulders and thigh. He initially wrote it off as the reemergence of an old rotator cuff injury from college and possibly doing a more strenuous work-out on the bike. But it didn’t get better. The pain persisted which it normally would not. He eventually went to his physician at the prompting of his wife. His doc was curious about the two spots of injury and they did and MRI. They discovered tumors in the two places he was feeling pain. They turned out to be malignant. The doc decided to get very aggressive. And scheduled an appointment in two weeks to excise the tumors and start radiation treatment. The next weekend, my friend became violently sick and he and his wife rushed to the emergency room, where they advised the ER docs about the recent cancer diagnosis. They did a full body MRI and discovered that his internal organs were full of the same type of tumors. He died within 2 weeks.

You need to have your doc do a more thorough exam on the areas where you are feeling pain.

30

Lauren,
I’ve been following your thread and am concerned that you are attributing your pain to an injury and there is a chance that there is something more serious going on, as Omar previously posted.

Of the information that you have provided, what stands out to me is the fact that you take birth control pills. I am not a medical professional, but I am married to a RN. I mentioned your thread to him, and he thought that you should call your medical doctor about your pain.

Several years ago at the age of 41, after taking BCP for a few months, I started experiencing a deep pain in my calves and lighter pain in my thighs so that even the weight of jeans bothered me. I basically freaked out and thought that I had deep vein thrombosis and called my ob/gyn. She told me to stop taking the pills, and I felt better in just a few days. I didn’t follow up to see if I had a blood clot forming, but paranoia made me decide to never take them again. (I didn’t need them for birth control)

I don’t know your age or if you have other factors that would make the pill be more of a risk for you, but I just thought I would share my experience for what it’s worth.

I’m a runner and weight lifter so I can understand your frustration of not being able to work out as you normally do. :*(

Good luck to you and I hope you feel better soon!

31

This was almost exactly my experience, except that I did end up getting blood clots. I woke up one day and got out of bed, and when I hit the ground, immediately collapsed because the pain in my knees and thighs was so great. At first I thought I had a muscle or nerve injury since I practice trapeze and running, but it didn’t get better after a week. I could barely walk.

I went to the Dr. and he said it sounded like I just had a pulled muscle in both legs, attributed to too much trapeze work. We did the usual routine, it didn’t get better, so he tested for lyme/arthritis. No dice. A month went by, and I went back to the doctor because it wasn’t getting better. He was about to suggest PT, but by chance my leg started swelling that day, and he immediately sent me to the ER to get a ultrasound of my leg looking for clots. It was positive.

I would at least bring this up with your doctor. Your pain sounds almost exactly like mine. Birth control pills were thought to be the culprit for me.

I am sorry about your pain - it really is terrible and hard for other people to understand just how incapacitating it can be. But I would really not stop bugging your Doctor, even if you have to find a new one, to help you with this.

32

Yes, please get second, third and fourth opinions if possible. I’m sorry you’re still in pain, and I’m worried about you. Like I said before, this does not sound like normal injury pain.

33

Thank you for all the comments. I will try calling my doctor tomorrow, but I’m wondering if I should go back to the sports medicine / orthopedic doctor, or call my primary care physician?

I’m thinking if I call the sports medicine doctor, he will not consider other any diagnosis that’s out of his area of specialization. On the other hand, my primary care physician is a humongous bitch, and after the last time I saw her, I swore I would change doctors but never got around to it.

Last year, I started developing severe headaches. Excruciating when standing or sitting up, but going away when I laid down. I went to my doctor, and by this point I was quite upset as I had been suffering these headaches for 3 days. She was incredibly rude, acting like I was being a drama queen over “just a headache.” She examined my nose/throat/ears and immediately diagnosed the problem as allergy-related and just told me to take some Advil. When I told her that it hadn’t helped and insisted that it was something more than an ordinary headache, she got downright nasty to me (as if she were a teacher and I was a misbehaving student), and finally referred me to a neurologist only because I kept insisting something was wrong.

Well, that neurologist was pretty useless, because after lots of different treatments, nothing was better and he still had no explanation for the problem. I finally saw another neurologist for a second opinion, who diagnosed me with a spinal fluid leak and said it would eventually go away on its own (and it did). How I wished I had seen that guy first!

So anyway, I am still with this bitchy primary-care-physician, so I’m thinking maybe I should try to find a different doctor and have them be my primary instead.

So, should I see the sports medicine guy, my primary care physician (or find a new one) or maybe my OB/GYN?

The only reason I’m still leaning toward thinking it’s exercise-related is because this happened the week after I got sore from doing too many squats at the gym, while also doing a lot more bike riding than I had previously (and that I feel it equally in both legs). And it seems like more activity makes it worse. I was actually feeling not so bad on Wednesday/Thursday. Unfortunately at work on Friday I had to be more active. I had to package up a bunch of things to mail, so I did a lot of sitting on the floor and rolling/folding things, taping up boxes, standing up to get more boxes, sitting on the floor again, etc. And since then I have been hurting again. It just all seems like an incredible coincidence if it’s not movement/injury related, but I will take everyone’s advice and try to get other opinions.

34

Probably should add one more thing. As I mentioned, I feel the pain in my thighs/quads equally in both legs. However, about 2 weeks ago I noticed a bump about 1 inch by 2 inches, above my left knee, and it feels tender to the touch. I mentioned this to my physical therapist, and without even looking at it, said that it was nothing to worry about. Could that be a symptom of a clot? (Although it wouldn’t explain why the other leg doesn’t have it, but still has the thigh pain.)

35

If you aren’t happy with your GP, you absolutely should change. Having a GP you don’t trust and don’t get along with is not a medical solution to anything. Maybe a friend or coworker can suggest someone better.

In your situation I’d be seeing my orthopedic. A good ortho or sports medicine doctor should understand what you’re going through. You say you’re concerned that a specialist might not see something outside of their specialty. I’d be worried that a generalist won’t see something because they don’t know the area you’re having trouble with. If necessary, that doctor should be able to refer you to someone even more specialized.

Ask the doctor specifically if he thinks there could be an underlying condition causing the problems. If he says no, ask him for details - what conditions could be similar, and how did he rule them out? If he has good answers to those, you can probably believe it. If he doesn’t, then you can follow up on your own, possibly with a rheumatologist.
As far as the PT is concerned…yes, you need to give it time to work. I have a problem with my right knee - I don’t use one of the muscles properly to keep the cap in alignment, and I have tight tendons on the other side that tend to pull against it. The result is instability and pain, especially when running. It took about a month of therapy to get to where I can walk without it almost collapsing on me randomly. I do something called McConnell Taping when I exercise, to help keep things in alignment. This helps train my body to use the muscles the right way, effectively reteaching me on how walk. My ortho says it may be 6 months before I can exercise without the tape. It can be a long, annoying process. And like your situation…one day I was fine, the next day I started having trouble…and we haven’t been able to pin down anything in particular that triggered it.

Keep at it. It might be useful to ask your therapist if there are standard ways to measure progress for your situation, instead of just feeling like you aren’t getting any better.

-D/a

36

I am still doing the PT. However, if the problem is related to blood clots or something else like that (as others are suggesting), then it sounds like all the PT in the world wouldn’t fix it.

[If I gave the impression in my other post that I thought PT was a one-time thing that would cure everything, I apologize. I just want to make this very clear since VOW, in an earlier post, also thought I was saying this. I merely meant to say that I waited to see how I felt after my first appointment before making the second appointment, simply because I was nervous that the PT might have made things worse - since every move I make seems to make things worse. I never had the expectation that a single appointment would be a miracle cure. As of this writing, I am still going to PT.]

Last year when I had my headache issues (see my previous post), the first neurologist was out of ideas - he had given me infusions of some kind of medication for migraine, cortisone injections in the neck, and saline injections in the spine. So I asked if I could get PT in case it was a neck issue, and he let me. The PT (who is actually the same guy I’m seeing now) came up with a very plausible sounding explanation that I had a “classic tension headache” brought about by poor posture while sitting in front of the computer. I even told the PT that the headaches started within a few hours of riding on a bumpy roller coaster at an amusement park, but he shrugged it off as coincidence, and was sure that my posture was the only problem. (I had also told the neurologist about the roller coaster, and he also didn’t know what to make of that.)

After giving the PT time to work (several weeks) and having no improvement, I went to the second neurologist who gave me the diagnosis of spinal fluid leak, and even gave me some research showing that this could be caused by rough roller coaster rides. He said that PT could actually be detrimental and I should just leave the area alone, and lay down as much as possible, and it would go away on its own. And it did.

So I’m just thinking, if you go to a PT with some kind of issue, naturally they are going to give you a diagnosis related to joints/weakness/posture, etc, because that’s what they know. Last year, the PT came up with an explanation related to posture, which turned out to be completely off-base. And now he’s got an explanation for my legs, which for all I know could be wrong too. At my first visit, he just said I had tightness in the tensor. At the second appointment, he now said that I had chondritis in the knees, caused by wearing shoes with poor arch support. So, as he suggested, I will wear shoes with arch support, and I got some arch support inserts for my shoes that don’t have it. And I am keeping up with the PT appointments. But I still have my doubts.

37

You’re screaming blood clots to me also - but I’m predisposed to think of any thigh pain as potential clots due to my own family history.

Please ditch the evil primary care person. Does your job have a preferred/in network list? If so, find a co-worker or two (pick ones who seem most like you) and ask them whether they like their primary. Call those immediately and say that you’d like to set up a new patient exam, and that you have some health concerns you’re bringing in also. Whoever can get you in earliest gets you as a new patient (at least for the first visit).

I would absolutely pick a primary care doc rather than a sports doc to check out the possibility of other reasons for the pain - in my experience, most sports docs are more attuned to male bodies than female ones, in addition to the bias of considering activity/strain as the cause most times. There are exceptions, of course.

Please get this checked out soon - if there are clots in your legs, then you will be in excruciating pain until they are gone, and there’s always a chance you’ll have a clot migrate to somewhere where it does a lot worse than cause pain.

If it isn’t a clot, at least you will have ruled out something, and can be relieved that you checked on the possibility.

38

Is it possible to get blood clots in the same place in both legs simultaneously? Some cursory googling isn’t giving me a good answer on that.

I had actually been considering switching to an IUD. Maybe now is the time to start doing that. OK, I will try a new PCP tomorrow and see whoever can get me in ASAP.

39

Find a sports guy who is Family Practice based, NOT orthopaedic surgeon based. You need someone who will have in depth knowledge of musculoskeletal problems as wqell as GP stuff - they can and do overlap.

40

You might also ask about Compartment Syndrome, which is more common in the calf muscles, but can occur in other areas, including thighs.

(stupid edit window :smack: )