[27F] Experiencing back pain, abdominal discomfort, and leg swelling

Patient Description

A 27-year-old female presents with a one-hour history of dull aching pain in the lower left side of her back, which worsens with sitting or standing. She also reports a dull pain in the mid-abdominal area and exhaustion. Additionally, the patient describes her calves as hard and swollen, with slight swelling in the feet, causing pain upon walking. The patient has a medical history of Type 2 diabetes, diagnosed in 2017, and a previous leg clot six years ago. She is currently using a Mirena IUD for birth control and takes Tylenol (500mg twice daily as needed) and Benadryl (25mg once daily). She has allergies to iodine, penicillin, and NSAIDs. No recent changes in medication, no chest pain, shortness of breath, or fever have been reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several possibilities:

  • Kidney Stones: These are hard deposits made of minerals and salts that form inside your kidneys. They can cause severe pain in the back or side below the ribs, pain that radiates to the lower abdomen and groin, and pain during urination. However, you haven't reported any changes in urination which are often seen with kidney stones.

  • Musculoskeletal Strain: This is a common cause of back pain and can occur as a result of poor posture, lifting heavy objects, or sudden movements. This would not explain your swollen legs and feet, however.

  • Deep Vein Thrombosis (DVT): Given your history of a previous clot, swollen, painful legs could suggest a DVT, which is a blood clot in a deep vein, usually in the legs. DVTs can cause leg pain or swelling, but may occur without any symptoms. This is a serious condition as the clot can break loose and cause a pulmonary embolism.

  • Venous Insufficiency: This is a condition in which the veins have problems sending blood from the legs back to the heart. It can cause pain, swelling, and fatigue in the legs.

  • Peripheral Edema: This is swelling caused by excess fluid trapped in your body's tissues. It can be caused by a variety of factors, including prolonged standing or sitting, heat, diet, medication, and hormonal changes.

What you can do

Given your symptoms and medical history, it's important that you seek immediate medical attention. Specifically, the combination of your leg symptoms and history of a previous clot is concerning for a possible DVT, which can be life-threatening if not treated promptly.

In the meantime, try to rest and elevate your legs. Avoid standing or sitting for long periods of time, and try to move around as much as you can without causing pain or discomfort.

What you should look out for

Seek immediate medical help if you experience:

  • Severe or worsening pain
  • Chest pain or shortness of breath
  • Changes in color or temperature in any of your legs
  • Symptoms of a urinary tract infection, such as burning during urination, frequent urination, or cloudy, strong-smelling urine

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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10 mo ago

People Also Ask


What are the symptoms of a deep vein thrombosis (DVT)?

Symptoms of a DVT can include swelling in one or both legs, pain or tenderness in the leg (often starting in the calf), a feeling of warmth in the affected leg, and changes in skin color (such as redness). However, some people may not experience any symptoms.


How can Type 2 diabetes affect the risk of developing blood clots?

Type 2 diabetes can increase the risk of developing blood clots due to factors like poor circulation, damage to blood vessels, and increased levels of certain clotting factors in the blood. Managing blood sugar levels and maintaining a healthy lifestyle can help reduce this risk.


What are the potential side effects of using a Mirena IUD?

The Mirena IUD can cause side effects such as irregular bleeding, headaches, breast tenderness, mood changes, and in some cases, ovarian cysts. It is generally considered safe, but any unusual symptoms should be discussed with a healthcare provider.


How can peripheral edema be managed or treated?

Peripheral edema can be managed by elevating the legs, reducing salt intake, wearing compression stockings, and staying active to improve circulation. In some cases, medication may be necessary to address underlying causes. It's important to consult a healthcare provider for a tailored treatment plan.


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