[43F] Experiencing persistent leg and sporadic hip and knee pain

Patient Description

A 43-year-old female has been experiencing constant, achy muscle pain in the left upper leg for approximately 2 years, with a severity rating of 6-7 out of 10. The pain is localized to the side of the leg, from the knee to halfway up to the hip, and is described as biting when transitioning from sitting to standing. Ibuprofen 800mg occasionally provides relief. The patient stands for extended periods at work, which exacerbates the pain, although walking seems to offer some alleviation. Additionally, there is sporadic deep bone pain in the hip area, described as achy, particularly noticeable when rising from a seated position, present for about 7 months. The patient also reports dull, achy pain on the side of the knee cap, which has been occurring for 2-3 months and is associated with increased leg pain. There is a family history of osteoarthritis, but the patient has no known allergies, is not on any medications, and reports no other symptoms.

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Arora's Assessment

What might be happening

Based on the information provided, possible explanations for your symptoms include:

  • Muscle Strain or Overuse: Given your long hours of standing at work, it's possible that you're experiencing muscle strain or overuse in your left leg. This can cause persistent pain and discomfort, particularly in the quadriceps muscle. Over time, this can also lead to compensatory pain in other areas, such as your hip and knee.

    • Treatment typically involves rest, physical therapy, and over-the-counter pain relievers like ibuprofen, which you've found helpful.
  • Osteoarthritis: This is a degenerative joint disease that can cause pain and stiffness in the joints. Given your family history of osteoarthritis and your description of deep, achy pain in your hip, this could be a consideration. Osteoarthritis can also cause referred pain to other areas, such as the knee.

    • Treatment typically involves physical therapy, weight loss if overweight, and pain relievers. In severe cases, joint replacement surgery may be considered.
  • Patellofemoral Pain Syndrome (PFPS): Also known as "runner's knee," this condition can cause pain around the kneecap, particularly when standing up from a sitting position or when running. It's possible that this is contributing to your knee pain.

    • Treatment typically involves physical therapy, particularly exercises to strengthen the muscles around the knee, and pain relievers.
  • Sciatica: This is a condition caused by irritation or compression of the sciatic nerve, which runs from the lower back, through the buttocks, and down the legs. It can cause pain, numbness, or tingling in these areas. However, your symptoms don't fully align with typical sciatica, as you haven't mentioned any back pain or numbness/tingling.

    • Treatment typically involves physical therapy, pain relievers, and in some cases, surgery.

Please note that these are potential explanations based on the information provided, and it's important to consult with a healthcare professional for an accurate diagnosis.

What you can do

Here are some suggestions you can consider while waiting for your doctor's appointment:

  1. Rest and elevate your leg when possible. Avoid activities that exacerbate your pain.
  2. Continue using over-the-counter pain relievers like ibuprofen, as long as they are providing relief and you are not exceeding the recommended dosage.
  3. Consider using a warm compress on the painful areas to help relax the muscles and alleviate pain.
  4. Gentle stretching and strengthening exercises may help, but should be done under the guidance of a physical therapist or other healthcare professional.
  5. Maintain a healthy weight to reduce stress on your joints.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe pain or swelling in your leg, hip, or knee
  • Sudden increase in pain or change in the nature of your pain
  • Difficulty walking or bearing weight on your leg
  • Signs of infection, such as redness, warmth, or fever

Remember, it's important to consult with a healthcare professional to receive an accurate diagnosis and appropriate treatment.

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10 mo ago

People Also Ask


What are the common causes of persistent muscle pain in the leg?

Persistent muscle pain in the leg can be caused by muscle strain or overuse, especially if you stand for long periods. Other causes might include conditions like osteoarthritis or sciatica, which can lead to referred pain in the leg.


How can osteoarthritis be managed, especially with a family history?

Osteoarthritis management typically involves physical therapy, maintaining a healthy weight, and using pain relievers. In severe cases, joint replacement surgery might be considered. A family history of osteoarthritis can increase the risk, so early intervention and lifestyle modifications are important.


What is Patellofemoral Pain Syndrome and how is it treated?

Patellofemoral Pain Syndrome, also known as 'runner's knee,' is a condition that causes pain around the kneecap, often exacerbated by activities like standing up from a sitting position. Treatment usually involves physical therapy to strengthen the muscles around the knee and pain relievers.


When should I seek medical attention for leg pain?

You should seek medical attention for leg pain if you experience severe pain or swelling, a sudden increase in pain, difficulty walking or bearing weight, or signs of infection such as redness, warmth, or fever.


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