[51F] With chronic sharp, throbbing leg pain and swelling

What might be happening

Based on the symptoms you’ve described—sharp, throbbing pain on the outside of both legs extending to your feet for 5 years, worsening at night, along with swelling, light purple discoloration, and tightness that started 6 months ago—here are some possible explanations:

1. Chronic Venous Insufficiency (CVI):
   This condition occurs when the veins in your legs have trouble sending blood back to your heart, leading to pooling of blood. Symptoms often include swelling that worsens throughout the day, leg pain, tightness, and discoloration (such as purple or reddish skin).

   • Testing: A doctor may perform a physical exam and order an ultrasound to check blood flow in your veins.
   • Treatment: Compression stockings (which you’re already using) are a key part of managing CVI. Elevating your legs, staying active, and avoiding prolonged sitting or standing can also help. In more severe cases, procedures like vein ablation or sclerotherapy may be recommended.

2. Peripheral Neuropathy:
   This condition involves nerve damage, which can cause sharp, throbbing pain in the legs and feet. It’s often associated with conditions like diabetes, but it can also occur due to other causes, such as medication side effects or nerve compression.

   • Testing: A doctor may perform nerve conduction studies or blood tests to identify the cause.
   • Treatment: Medications like Lyrica (which you’re already taking) are often used to manage nerve pain. Physical therapy and addressing the underlying cause (if identified) can also help.

3. Lymphedema:
   Swelling in both legs and feet, along with tightness, could indicate lymphedema, which occurs when lymph fluid builds up due to poor drainage. This can sometimes cause skin changes, including discoloration.

   • Testing: A doctor may assess your lymphatic system with imaging tests like an MRI or lymphoscintigraphy.
   • Treatment: Compression therapy, manual lymphatic drainage (a type of massage), and exercises to promote lymph flow are common treatments.

4. Deep Vein Thrombosis (DVT):
   While less likely given the chronic nature of your symptoms, DVT (a blood clot in a deep vein) can cause leg pain, swelling, and discoloration. It’s important to rule this out, as it can be life-threatening if untreated.

   • Testing: An ultrasound can confirm or rule out DVT.
   • Treatment: Blood thinners are used to treat DVT if diagnosed.

5. Other Possible Causes:

   • Varicose Veins: Enlarged, twisted veins can cause pain, swelling, and discoloration.
   • Post-Thrombotic Syndrome: If you’ve had a blood clot in the past, lingering symptoms like swelling and pain can occur.

What you can do

Here are some steps you can take to manage your symptoms and prepare for a doctor’s visit:

1. Continue Using Compression Socks: These are already helping you, so keep wearing them during the day to reduce swelling.
2. Elevate Your Legs: When resting, try to elevate your legs above the level of your heart to improve blood flow and reduce swelling.
3. Stay Active: Gentle exercises like walking or ankle pumps can help improve circulation. Avoid sitting or standing for long periods without moving.
4. Track Your Symptoms: Use MDandMe to journal your pain, swelling, and discoloration. Note any patterns, such as activities or times of day that worsen or improve your symptoms.
5. Stay Hydrated and Maintain a Healthy Diet: Proper hydration and a balanced diet can support circulation and overall health.
6. Prepare for Your Doctor’s Visit: Write down your symptoms, how long they’ve been occurring, and what helps or worsens them. This will help your doctor assess your condition more effectively.

What you should look out for

Seek medical attention promptly if you notice any of the following:

• Sudden worsening of swelling or pain in one or both legs.
• Redness, warmth, or tenderness in your legs, which could indicate a blood clot.
• Shortness of breath or chest pain, which could signal a serious complication like a pulmonary embolism.
• Rapid changes in skin color, such as darkening or ulceration.

It’s important to consult a healthcare professional to get a formal diagnosis and treatment plan. Your symptoms may require further evaluation, such as imaging or blood tests, to determine the exact cause and best course of action.