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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35739
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I am 34, am not overweight, but have had leg swelling for a

Customer Question

Hello. I am 34, am not overweight, but have had leg swelling for a while and pain when pressing on my lower legs
JA: What seems to make the symptoms worse or better? Any redness or swelling in the leg?
Customer: no color change, but in my left leg, I can feel like a "nugget" under the skin near my calf bone
JA: Anything else in your medical history you think the doctor should know?
Customer: I take birth control, I do drink occasionally, and I do smoke about 5 cigarettes per day. Do I have blood clot(s) or why are my legs swollen and in pain upon palpation?
Submitted: 9 months ago.
Category: Health
Customer: replied 9 months ago.
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Expert:  Dr. Arun Phophalia replied 9 months ago.

Hello! My name is***** to JustAnswer. I'm reviewing your question now, and will post back with the reply momentarily.

Customer: replied 9 months ago.
actually, many area of body hurt to the touch, mainly my lower legs
Expert:  Dr. Arun Phophalia replied 9 months ago.

It is not likely to be blood clot. Blood clot swelling is sudden with pain, tenderness, redness and occur only on one side usually. A swelling in legs on both the sides can be due to;

1) Venous valvular incompetence

2) Obstruction of the lymphatic outflow

3) Dependent edema which can occur because of the prolonged standing or sitting.

4) Congestive heart failure

5) Kidney diseases

6) Protein deficiency

7) Hypothyroidism

8) Anemia

9) Medications; birth control pills can be responsible for it as they cause hormonal changes in the body.

Following measures are beneficial in decreasing or resolving the swelling:

1) Avoid prolonged standing or walking for long distances in a single stretch.

2) Whenever you sit; keep your legs elevated on a chair or a sofa or stool. Do not hang the legs, otherwise gravity will increase the swelling.

3) Exercises / physical therapy

a) Lie down straight and raise your leg and feet for 10-20 seconds. Repeat this for ten times (twice a day whole set).

b) When you sit; pull the feet towards you for 10-20 seconds. Repeat it for ten times twice a day.

4) Raise leg end of your bed by 6 inches.

Pain and tenderness can be helped by;

1) Analgesics

2) Acupuncture

3) A very mild massage; keeping the massage direction towards heart.

4) Electrical stimulation; this is a small device which physical therapy centers would give your for the home use.

Wish you a very happy, prosperous, healthy and safe new year 2017.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.

Please consider a positive rating if this interaction has been satisfactory, as this is the only way we experts are credited and compensated for the time and work. You are not charged again for giving a rating.

Thank you.

Wishing you all the very best in life.

Expert:  Dr. Arun Phophalia replied 9 months ago.

The pain in many areas to touch (tenderness) need investigations. One of the possibility of the diagnosis is fibromyalgia. Following investigations may be needed:

1) Thyroid-stimulating hormone

2) 25-Hydroxy vitamin D level: Low levels can cause muscle pain and tenderness

3) Vitamin B-12 level: Very low levels can cause pain.

4) Iron studies including iron, total iron binding capacity, percent saturation, and serum ferritin

5) Magnesium: Low levels can lead to muscle spasms, which are common in fibromyalgia; magnesium supplementation can also improve symptoms in some fibromyalgia.

6) The erythrocyte sedimentation rate (ESR)

7) Antinuclear antibody (ANA)

8) Rheumatoid factor

9) Sleep studies

10) Antipolymer antibody assay; present in approximately 50% of patients with fibromyalgia. This biologic marker may provide conclusive evidence for a subgroup with fibromyalgia.

The treatment of fibromyalgia is comprehensive and a single guideline for an individual is difficult to make. The treatment has to be individually tailored;

1) Aerobic exercise; low-impact aerobics, walking, water aerobics, stationary bicycle.

2) Heat, massage, and other treatments like sauna, hot baths and showers, hot mud, and massage.

3) Trigger-point injections,

4) Acupuncture,

5) Chiropractic manipulation,

6) Myofascial release

7) Neural pulse stimulation (CNP) device

8) Cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT)

9) Relaxation training and biofeedback

10) Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen

11) Opioid analgesics (hydrocodone, oxycodone, fentanyl, morphine),

12) Anxiolytics/hypnotics

13) Estrogen receptor modulator raloxifene

14) St. John's wort, ginseng, valerian, botanical oil, melatonin, magnesium, dehydroepiandrosterone

A combination of above is tried for an individual to relieve the symptoms.

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Expert:  Dr. Arun Phophalia replied 9 months ago.

Thank you for the opportunity to answer completely your Question. Please make sure to rate me because that is how I am credited and paid for my work.

Now, I will provide an Additional Service offer so that you have this option available on your question list to get a hold of me directly in the future.

This additional service offer can be used for

- if you would like to schedule a new, private email session or to ask me directly a new question. It's up to you.

Thank you.