[43F] Experiencing leg pain, urinary and bowel incontinence, and tingling in fingers

Patient Description

A 43-year-old female presents with several months of aching leg pain, rated 6/10, predominantly in the calf area, which worsens with stillness and improves slightly with heat and movement. The patient also reports recent onset of urinary and bowel incontinence, with difficulty holding it when feeling the urge to go. Additionally, she experiences occasional tingling in her left hand, particularly affecting her pinky finger, described as a cramp-like sensation but tingly. The patient has noticed a significant but unquantified weight loss attributed to mental health medication and appetite changes, as well as a decline in close-up vision over the past six months, necessitating bifocals. Past medical history includes a hysterectomy, appendectomy, and reconstructive surgery on the right heel bone. Current medications include Straterra, Vyybrid, Premarin, and Simvastatin. No allergies or adverse reactions to medications have been reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be considered:

  • Restless Legs Syndrome (RLS): This is a condition that causes an uncontrollable urge to move your legs, usually because of an uncomfortable sensation. It typically happens in the evening or nighttime hours when you're sitting or lying down. Moving eases the unpleasant feeling temporarily.

    • Treatment often starts with lifestyle changes (like quitting smoking or avoiding triggers), and if those don’t help, medications can be used.
  • Peripheral Neuropathy: This is a result of damage to your peripheral nerves, often causing weakness, numbness, and pain, usually in your hands and feet. It can also affect other areas of your body.

    • Treatment involves managing the condition causing the neuropathy. Pain and physical therapy can also help.
  • Urinary and Fecal Incontinence: This could be due to a number of reasons including nerve damage, weakened pelvic muscles, inflammation, or certain medications.

    • Treatment depends on the cause and could include pelvic muscle exercises, medications, or possibly surgery.
  • Vision changes: This could be due to normal aging, but also could be a sign of conditions such as presbyopia or cataracts.

    • Treatment could range from glasses or contact lenses to surgery, depending on the cause.

Please note, these are potential explanations for your symptoms, but there may be other causes. It's important to discuss these symptoms with a healthcare provider.

What you can do

  1. Schedule an appointment with your primary care provider to discuss your symptoms. They may refer you to a specialist, such as a neurologist, urologist, or ophthalmologist, for further evaluation.
  2. Keep a symptom diary noting when your symptoms occur, what you're doing when they happen, and what makes them better or worse. This can be helpful information for your doctor.
  3. Continue to take your prescribed medications as directed by your healthcare provider.
  4. Try to maintain a healthy lifestyle. Regular exercise, a balanced diet, and adequate sleep can help manage symptoms of many conditions.

What you should look out for

Seek immediate medical attention if:

  • Your symptoms significantly worsen or you develop new symptoms
  • You experience sudden or severe pain
  • You have difficulty walking or moving
  • You experience sudden vision loss or changes

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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11 mo ago

People Also Ask


What are the common causes of restless legs syndrome (RLS)?

Restless legs syndrome (RLS) can be caused by a variety of factors including iron deficiency, kidney failure, diabetes, certain medications, and pregnancy. It can also be idiopathic, meaning the cause is unknown.


How is peripheral neuropathy diagnosed and treated?

Peripheral neuropathy is diagnosed through a combination of medical history, physical examination, blood tests, nerve function tests, and sometimes imaging studies. Treatment focuses on managing the underlying cause, relieving symptoms through medications, and physical therapy.


What could cause sudden changes in vision, such as needing bifocals?

Sudden changes in vision, such as needing bifocals, can be due to presbyopia, which is a normal age-related change in vision. Other causes could include cataracts, diabetes, or other eye conditions. An eye examination can help determine the cause.


What are some potential treatments for urinary and fecal incontinence?

Treatment for urinary and fecal incontinence depends on the underlying cause and may include pelvic floor exercises, medications, lifestyle changes, or surgery. A healthcare provider can help determine the most appropriate treatment plan.


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