Right leg swelling at knee and below.

Posted by knseven @knseven, May 23 11:08am

Hello, I’m 45 years old and have had right knee swelling off and on for two years since an injury to my right knee while working in my yard, which I let heal on my own without seeing a doctor initially. The knee has remained swollen with physical activity off and on since then. The knee got better or worse initially, which was dependent on if my knee would twist a certain direction and “pop” which would make it feel much better.
In the last 6 months it has gotten much worse with swelling from the knee down to the foot and constant pain walking or exercising. Was sent to physical therapy for 6 weeks and was signed off as being good to go because it helped a little with the swelling. Again the swelling began, but worse this time and was sent for 9 weeks Physical therapy. At my 1st PT appointment, the physical therapist refused to see me until they ruled out DVT in my calf due to massive calf swelling, tenderness, and redness.
Got an ultrasound and was fine. Went through another 9 weeks PT before insurance would allow an MRI but my therapist said my range of motion improved greatly so I was not sent for an MRI and there hasn’t been a follow up.
Now (3 weeks later after PT) my knee and calf are in a lot of pain. I had my wife massage my calf deeply with a roller because it felt like a constant contracted calf muscle that wouldn’t release. After this deep massage of my calf , my entire leg from the knee down had filled with fluid and I am no longer able to get a shoe on at night. It is quite painful and I have bruising on the sides of my feet and red, hot, tenderness on the calf and knee. I went to ER (at my primary’s request) and got an ultrasound which ruled out dvt. I now must wait three more weeks for another appointment with my primary who said I may get a referral somewhere depending on how it looks when my appointment comes. I feel like this might be serious and it’s greatly affecting my otherwise active lifestyle. Just looking for suggestions or thoughts as to what might be going on as I feel I am getting nowhere by going to physical therapists over and over. I will attach photos of my leg as well.
For comparison, the last bottom pic is my lower leg without swelling after I had it raised for 9 hours straight while taking Tylenol/ibuprofen. Once I put my leg down and started moving again, it almost doubled in size within 4-6 hours. This fluid everywhere in my lower leg has been constant since that massage and has been like this for a week now with no sign of it relenting. Quite painful to even a light touch. I must wear a compression sock so that I can get my leg through my pant legs on a daily basis. Any input would be greatly appreciated. Thanks

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Had to post the leg pics in a comment because they didn’t seem to go through on the post. 4th pic down is without swelling for comparison

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Hello @knseven, Welcome to Connect. I had similar swelling in the legs with my right leg being the worst and much like your photos. I also was checked for clots and none were found. When they were diagnosing me I saw a cardiologist who ran some tests to check for clots in the legs and then scheduled a lymphoscintigram to check for blockages in the lymph system. More information on the tests can be found here: https://www.mayoclinic.org/diseases-conditions/lymphedema/diagnosis-treatment/drc-20374687. I was diagnosed with lymphedema and have been wearing compression socks since being diagnosed a little over 4 years ago. I do buy the kind with side zippers to make them easier to put on and take off.

Did the cardiologist mention edema as a possibility?

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Hi, thanks for the input. That’s something I will ask them to look into. I have not seen a cardiologist. Just my general primary care Dr. who keeps sending me to physical therapy and has been linking it to my knee injury a couple years ago. No other possibilities or causes have been suggested so I just keep going back to the PT appointments and then just told to continue the stretching exercises on my own until it gets better, but it has been getting worse. Thanks

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@knseven

Hi, thanks for the input. That’s something I will ask them to look into. I have not seen a cardiologist. Just my general primary care Dr. who keeps sending me to physical therapy and has been linking it to my knee injury a couple years ago. No other possibilities or causes have been suggested so I just keep going back to the PT appointments and then just told to continue the stretching exercises on my own until it gets better, but it has been getting worse. Thanks

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Hi, I also forgot to mention I had a knee injury playing softball back in the 70s and had to have some cartilage removed. The knee always gave me trouble until I finally had a knee replacement. Around 2007 I also had severe swelling much like yours along with extreme joint pain. I think they removed about 6 cc's of fluid from around my knee cap using a needle and gave me Colchicine to help remove uric acid because they said I had gout in the right foot. I'm not sure if gout is a possibility but it's something else to ask your doctor about. 🙂

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I will also ask them about this during my appointment. Thanks a ton for this info. It’s very much appreciated as I feel that I’ve been getting nowhere with this. Thank you!!

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One of my legs was greatly swollen and I had to wear a compression sock, keep my leg raised when possible, etc. Finally, I learned that a prescription medicine I was on was the cause. It took awhile but gradually the swelling did go down when I quit taking that med with my doctors knowledge, and now I no longer need to wear a compression sock. This info might not apply to others, but I decided to share it just in case.

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@deanna2

One of my legs was greatly swollen and I had to wear a compression sock, keep my leg raised when possible, etc. Finally, I learned that a prescription medicine I was on was the cause. It took awhile but gradually the swelling did go down when I quit taking that med with my doctors knowledge, and now I no longer need to wear a compression sock. This info might not apply to others, but I decided to share it just in case.

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Hello deanna~
Thank you for your input to knseven. I have also had odd swelling in my lower limbs..and can't figure out why…but you mentioned a drug that you were taking that seemed to be the culprit..would you share what the drug was? I stopped a calcium otc supplement and found that the little bit of vertigo I was experiencing went away when I stopped taking that form of calcium.
The swelling in my legs has also resolved itself..now left with a bit of toe numbness..but that is getting better as well. Ahhhh…aging…a fun trip, right?!

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@knseven

Hi, thanks for the input. That’s something I will ask them to look into. I have not seen a cardiologist. Just my general primary care Dr. who keeps sending me to physical therapy and has been linking it to my knee injury a couple years ago. No other possibilities or causes have been suggested so I just keep going back to the PT appointments and then just told to continue the stretching exercises on my own until it gets better, but it has been getting worse. Thanks

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@knseven John brings up a good point about blood clots. That was my first thought. My mom has had deep vein thrombosis clots in her lower legs and is on Eliquis to keep the clots from reforming. It takes a few months for them to dissolve. She is at risk for this because she uses a wheelchair and doesn't walk. If your doctor has not suggested clots as a possibility, you could ask. It is easy to diagnose with an ultrasound. My mom has ultrasounds done a couple months later to determine if the clots were dissolved.

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@bunky44

Hello deanna~
Thank you for your input to knseven. I have also had odd swelling in my lower limbs..and can't figure out why…but you mentioned a drug that you were taking that seemed to be the culprit..would you share what the drug was? I stopped a calcium otc supplement and found that the little bit of vertigo I was experiencing went away when I stopped taking that form of calcium.
The swelling in my legs has also resolved itself..now left with a bit of toe numbness..but that is getting better as well. Ahhhh…aging…a fun trip, right?!

Jump to this post

The drug was Amlodipine, a blood pressure medicine. I had no idea there was a connection between a med I was taking and my swollen leg until I did extensive research online and finally learned that swelling was the most common side effect of that drug. That was nearly a year ago, and now in 2022 both my legs are again the same size, thank goodness! This experience reinforces my belief that we need to take an active role in learning about and solving our health concerns rather than simply depending on our doctors to know everything. As for aging, there's only one alternative, so we might as well be smart and enjoy it. 🙂

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Hi. They did an ultrasound before the physical therapist would work with me because he was convinced it was clots but it came back negative and they said everything looked great. I just recently had another ultrasound done after a 4 hour flight because my leg was very red and hot, as well as the typical swelling, but again they said it was negative for clotting. I’m pretty active when this leg isn’t swollen and I work on my feet all day and am constantly moving. About 30k steps per day according to my step tracking thing but have been averaging 6-8k steps with this recent bad swelling. The medication issue is also something I will look into as I take a couple of prescriptions regularly, as well as calcium, vitamin D, amino acids daily and melatonin at night occasionally. Thank you!

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Greetings @knseven. Thanks for the pictures. They present visual proof of what appears to be a pretty serious issue. I will cut to the chase and ask if you have experienced Myofascial Release Therapy (MFR). When I encounter swelling, my MFR therapist works to move the swelling material up my leg so that it finds its way out when I pass urine. Here is a reference https://www.myofascialrelease.com/about/problems-mfr-helps.aspx. I would also like to introduce you to @jenniferhunter who gave me this message a few years ago and to whom I turn for helpful suggestions.

What is the injury or medical intervention that you have in that knee?

May you be free of suffering and the causes of suffering.
Chris

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Hi, no I have never had MFR done. I began looking on here for suggestions as to what might be causing this issue. My primary Dr. thinks it’s from a knee injury a couple years ago and I have been sent to physical therapy twice for many weeks each time. The range of motion improves usually during PT and then that’s the end of it until it gets bad again and then I get sent back. It has been extremely bad lately. So much so, that I have been transferred at work as I am unable to do as much movement. There are a few suggestions I have relayed to my Dr’s office but have yet to hear back. I do have another upcoming appointment next week so hopefully they will look into it more but as of now, they are calling it an old knee injury. I have not had anything done to investigate except an X-ray and an ultrasound looking for clots. Both came back negative and they said I was fine. I was told to raise the leg at night and do my pt excercises but it has been much too painful and swollen for the exercises. Thanks

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