Questions Your Doctor May Ask - and Why!
During a consultation, your doctor will use various techniques in his assesment of the symptom: Leg pain.
These may include a physical examination or other medical tests.
Your doctor may ask several questions when assessing
your condition. It is important to remember that your consultation is a two-way process and any extra information
you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
- How long have you had the leg pain?
Why: to determine if acute or chronic e.g. if sudden and severe calf pain not related to trauma must consider acute lower limb ischemia (sudden obstruction of blood supply) from thrombosis (clot) or embolism (plug). An acute onset may also suggest cellulitis or deep vein thrombosis.
- Where exactly do you experience the pain?
Why: e.g. thigh, calf, shin, hip, knee, foot or ankle. If deep and very localized and not generalized must consider bone tumor, fracture or rarely infection; if superficial must consider muscular pain.
- Did the pain follow trauma or activity?
Why: if not must consider a vascular cause of leg pain e.g. vein or artery blockage or rupture. If there is a history of trauma, this would suggest a fracture, sprain or torn ligament.
- Is the site of the pain the same as the site of the trauma?
Why: if not the leg pain is referred e.g. from spine or hip.
- Is the pain related to movement?
Why: if pain is related to movement may be due to bone or joint problems; if pain is not related to movement the pain must arise from a soft tissue lesion e.g. artery or vein blockage.
- Is the pain related to posture?
Why: e.g. worse with sitting may suggest spinal cause; worse with standing may suggest a local problem related to weight bearing e.g. varicose veins; worse lying down may suggest peripheral vascular disease.
- Is the pain related to walking?
Why: e.g. immediate onset with walking suggests stress fracture; delayed onset with walking suggests intermittent vascular claudication or sciatica.
- Age of patient?
Why: children can experience "growing pains" which are usually related to excessive exercise or trauma from sport. The pains are intermittent and symmetrical and deep in the legs, usually in the front of the thighs or calves. They typically occur at night in bed and last for 30-60 minutes.
- Past medical history?
Why: e.g. anemia can precipitate peripheral vascular disease.
- Risk factors for peripheral vascular disease?
Why: e.g. cigarette smoking, high blood pressure, high cholesterol, diabetes, atrial fibrillation, family history - may indicate intermittent claudication as cause for leg pain.
- Risk factors for varicose veins?
Why: e.g. female sex, family history, pregnancy, increasing age, standing occupations, low fiber diet.
- Exercise history?
Why: may help determine risk of overuse injuries such as stress fractures, shin splints.
- Medications?
Why: beta-blocker blood pressure medications can worsen peripheral vascular disease.
Questions your doctor may ask about related symptoms:
Sometimes, other symptoms may be present and may help your doctor analyse
your condition. These may include:
- Fever?
Why: may suggest osteomyelitis, cellulitis, spinal cord infection.
- Symptoms of sciatica (spinal canal stenosis)?
Why: e.g. may be a long history of back pain, back pain radiating down into the buttocks and legs, weakness, burning, numbness in legs, may be associated with bowel and bladder symptoms if severe.
- Symptoms of acute lower limb ischemia?
Why: e.g. sudden severe leg pain, pallor of skin, paresthesia or numbness of lower leg, paralysis or weakness of leg.
- Symptoms of chronic peripheral vascular disease?
Why: e.g. pain in buttock, thigh and calf, especially when walking up hills and stairs; persistent fatigue over the whole lower limb; impotence is possible. If severe, pain may occur at rest especially at night.
- Symptoms of varicose veins?
Why: e.g. swelling of feet, leg fatigue, leg heaviness, itching.
- Symptoms of deep venous thrombosis?
Why: e.g. diffuse leg swelling; ache or tightness in calf; leg warmth; ankle pitting edema.
- Symptoms of Diabetes mellitus?
Why: e.g. frequency of urination, excessive thirst, weight loss, fatigue, increased infections. Diabetes may be complicated by a painful peripheral neuropathy with a glove and stocking pattern paresthesia.
- Symptoms of meralgia paresthetica?
Why: e.g. occurs mostly in middle aged people and presents with a burning pain over the outer thigh with associated numbness and tingling. It is associated with obesity, pregnancy, collection of fluid in the abdominal cavity (ascites) or local trauma due to corsets or belts.
» Next page: Types of Leg pain
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