Name That Ailment

Patient: 64 year old male, smoker
Symptoms: Burning, cramping sensation in both calves.
Pain sometimes shoots UP the legs.
Pain is blinding and lasts for 10 to 15 seconds. Patient cannot move and frequently has to lean against something until it subsides.
Pain happens sometimes when bending, sometimes when standing and sometimes (though not often) when resting.
Duration: a month

Patient is under doctor’s care. Prescribed anti-inflammatory drugs and vicodin. Has been on meds for a little over a week.

What’s going on here?

Sounds like the pain is radiating from a lumbar injury. Herniated disk, maybe… Does he have low back pain too?

No, no low back pain. The x-ray showed a couple “close” vertebrae that the doctor wasn’t concerned about in the slightest.

Circulatory problem, maybe?

I thought about that, but no coldness, numbness or discoloration of the extremities.

He could have venous insufficiency with no obvious objective medical evidence, I think- at least, AFAIK it’s more likely than arterial insufficiency without discoloration or coldness. You can do a quick at-home test for arterial insuffiency by elevating a foot and squeezing the big toe- normal color should return in less than 3 seconds. Might want to get him an ultrasound either way.

For a 64-year-old smoker I’d actually be surprised if he didn’t have atherosclerosis.

I’m not a doctor, FTR.

I agree with you on the probability of it being circulatory. However the doctor doesn’t think it is, either. It’s really strange. It will stop him dead in his tracks a few dozen times in a day, and then completely disappear until the next episode.

I just can’t think of anything else other than radiation from a spinal issue or a circulatory problem that would affect both calves.

Well, I guess he could have separate but matching injuries to both legs, but that’s kinda unlikely.

Sounds like a deficiency. Specifically a deficiency of second opinions. If his PCP hasn’t come up with either a diagnosis or a referral, then getting someone elses thoughts (besides ours) is the way to go, IMHO.

My mother had horribly impaired circulation, but her feet remained normal in color with no numbness up until about two months before she died, so it’s possible to have impaired circulation with no overt symptoms.

Not a doctor, btw - just reporting what’s possible, not what is.

My first thought was sciatica.

He’s with a specialist already. Which makes the suck suck even harder!

The doctor said it might be some one-off version of sciatica, but isn’t it rather rare to have it in both legs, with the pain shooting down to up rather than the reverse?

Hyperkalemia. Or lupus. It could always be lupus.

Spontaneously occurring bilateral DVTs?

Growing pains? I hear that Kirk Cameron is a sneaky bastard.

it is never lupus …
except for that one time it was

It’s not uncommon for sciatic pain to radiate into both legs, but it’s generally more severe on one side or the other.

Okay, this makes me feel a little better about the diagnosis. I’ve never known anyone who had both legs and reverse radiating pain. We’ll see how these meds go for another week or so. Thanks!

That makes me think of Claudicationsbut that’s usually a symptom of something going on.

The key should be to separate if it could be nerve pain vs. vascular pain.

He describes it as intense cramping/burning. It almost sounds muscular to me.