Is this a blood clot?

October 29, 2010 6:42 PM

So I swore to myself that I would never ask a medical question on AskMe, and yet I find myself here anyway. Any tips on how to tell the difference between a pulled muscle and deep vein thrombosis?

So, the symptoms. Two nights ago, severe leg cramp at night. This is not frequent for me but also not unusual. Today, sudden onset pain a few inches below the knee in the back of my leg. Pain is worse when standing or walking. No red or white discoloration of the leg, no swelling, no feeling of warmth. No injury or recent surgery. No long periods in bed or sitting for hours without moving. Risk factors for thrombosis: smoking (moderate) and birth control pills (very low dose).

Complicating factors: leaving the country on Sunday for a seven day business trip. Already have a morbid fear of getting a blood clot. Tend to freak out and assume the worst from minor symptoms.

So it is safe to wait and see if this goes away? Or do I go to the ER tonight? Or urgent care tomorrow? If I go to ER or urgent care, can they figure it out right then, or will I have to cancel my business trip?

posted by twiggy32 to Health & Fitness (14 answers total)

My uncle is prone to clots in his legs for a variety of reasons. This kind of thing freaks me out to, so I asked him how he knows it's happening. He told me it's an excruciating pain and when it happens, all you think about is going to the hospital.

This isn't any sort of advice, I'm sure it happens with little pain to other people, just a data point. If I were to guess, I would say strained muscle.
posted by sanka at 7:20 PM on October 29, 2010

Does your health insurance have a nurse line to call? It's hard to interpret these things, more so when you are anxious.
posted by Brent Parker at 7:35 PM on October 29, 2010

My husband has had 2 DVTs and they both caused swelling, redness, and warmth. He also couldn't fully extend his leg because of the pain. However, my mother worked with a 31-year-old woman (who also took a low-dose BCP) who thought she had pulled a muscle and two days later collapsed in her kitchen with a double pulmonary embolism and died the next day.

Go ahead and get it checked out at the ER. They can do an ultrasound on your leg to make sure there are no clots. If it does turn out to just be a pulled muscle, they can let you know how to treat it so that it has a minimal effect on your trip. Better safe than sorry.
posted by georgiabloom at 7:50 PM on October 29, 2010 [1 favorite]

My mother had a blood clot in her leg last year. She too said the pain was excruciating (and the swelling was obvious to the eye), so there was no doubt in her mind at all. But it's still probably a good idea to see a doctor anyway. Clots are things you don't want to screw around with.
posted by lollusc at 8:00 PM on October 29, 2010

As to the second part of your question, I also had a friend who suspected a blood clot and went to the ER. It only took a few hours to rule it out, so no, you probably won't have to delay your business trip if it turns out to be nothing.
posted by lollusc at 8:01 PM on October 29, 2010

Get it checked. My husband had what he thought was a pulled muscle which turned out to be a pulmonary embolism.
posted by leahwrenn at 8:03 PM on October 29, 2010

Get it checked, please.

I had what I thought was a pulled muscle in my upper leg in college - had recently started a low-dose pill. It didn't swell, didn't look red - was just somewhat sore, especially when I stood or walked around. Progressively got worse over the course of about five days - I saw the campus doctor, even went to the emergency room one night because it had started seriously hurting, but no one thought it was anything more than a pulled muscle, and I didn't get a work-up for a possible DVT. The next day (~ six days from the start, as best as I can tell) I saw an orthopedic specialist and my leg had finally started swelling. By then I had both my major veins in my leg completely clotted up from ankle to somewhere in my torso (they couldn't track it past a certain point). I was in the hospital for a week and in a wheelchair for another ten weeks.

Now, some seven years later, my leg is still damaged by that one major clot, and I have to be on blood thinners for life - combination of that damage (causes me to clot easier now) and the fact that I have a couple of genetic clotting disorders that no one in my family had ever had symptoms for. It sucks donkey balls, to be honest, even if it's not as nasty a chronic condition as some people get stuck with.

Go to the ER, tell them your worries, insist on a doppler/ultrasound. If you're wrong, you might feel embarrassed and be out some cash. If you're right, though, you could be saving yourself from more pain, minor or major physical disability, and, well, death. Blood clots are serious things.
posted by Gori Girl at 10:00 PM on October 29, 2010

I have seen people with DVTs who had nothing more than soreness. You are on the pill and you smoke. Get it checked. It won't take long.
posted by jennyjenny at 6:56 AM on October 30, 2010

You have the symptoms, you have the risk factors, you ought to go get an ultrasound. You didn't mention your age, but >35, smoking +birth control..... is a bad combination. You really should not be on birth control pills if you are an over 35 smoker, and if you are not willing to quit smoking. (here's an interesting article on the problems it creates in medical care)

At my ER, when people like you come in, the nurse orders the ultrasound from triage so that when I (the doctor) come to see you, I can tell you what the results show and discharge you promptly. Please go during daytime hours. If you go at night (i.e. after 5pm, and assume you might have to wait 1-2 hours or more from your arrival to get in), the ultrasound techs will generally not come in just to ultrasound your leg. This may also be an issue because it's the weekend, but at least if you go in during prime time the ultrasound techs may be there anyway doing other ultrasounds and they can fit you in.
posted by treehorn+bunny at 7:21 AM on October 30, 2010

Keep in mind if you go to a ER, they may not always have doppler ultrasound capabilities at all times, especially on weekends. I don't know if you can call to check. You can always calculate your Well's Score and risk stratify yourself.

Alternatively if you're that worried about clots you can ask to be treated prophylactically with enoxaparin (Lovenox) - although it's a blood thinner and carries its own serious side effects.
posted by ruwan at 9:38 AM on October 30, 2010

Yeah, you need an ultrasound. Urgent Care will not have this.

Agree with the above, you may not be able to get one at night or over the weekend. (And @ruwan, thanks for linking to my site!)
posted by gramcracker at 1:47 PM on October 30, 2010

When in doubt about something that could be serious, do not ask the Intertubes; call the nurse hotline at the nearby hospital (most major hospitals have one, these days).

But you knew that...
posted by IAmBroom at 6:11 PM on October 30, 2010

So did you ever go to the doctor? Curious to hear how this resolved...
posted by otherwordlyglow at 10:39 PM on December 20, 2010

Also curious to see how this resolved.

I am going to post my experience here in the event someone else has similar symptoms but dismisses the possibility of having a blood clot because their leg looks fine and they can still walk around on it:

I also had what I assumed was a pulled calf muscle about a year and a half ago and the symptoms were similar to some of those stated above: onset of pain that got worse and worse, although my leg at no time looked swollen and never became discolored. It began waking me up at night and after a few days the only thing that relieved the pain was staying in constant low level motion (which sounds counter-intuitive).

After close to a week I finally headed into an orthopedic surgeon's office, thinking that I had a compensatory injury related to other chronic lower leg injuries I suffer from. The subway ride there was excruciating, and by the time I was in the examination room I was ready to gnaw my leg off. During the examination the Dr. also noted there did not seem to be any swelling or discoloration, but the amount of pain I described having set off warning bells for him since he works with a lot of distance runners and is familiar with our aptitude for remaining in denial about how much pain we really feel.

Long story short- he ordered an emergency ultrasound just to be safe, and within an hour I was being admitted into the hospital with a major clot. I am female, over 40, and was on low dose birth control pills. I've never smoked, and the clot did not present itself after a long period of inactivity such as a plane trip or car ride. I was hospitalized for a week and then released once I was able to self-inject with thinners. I had to inject myself for about 7 months (warfarin was not working for me) at which point my doctor and I decided that I'd try going off thinners with the caveat that if I clot again I'll be on them for life. So far, so good.

If anyone else finds this question because they have similar concerns, please get it checked out. Blood clots are deadly. One of the things that kept me from getting a proper diagnosis was that my old running coach had come down with a clot about year earlier and I assumed I was being a hypochondriac because my symptoms did not match his. (Also please no EPO jokes- if I'd been on the juice I'd have hopefully run a lot faster than I did).

Better safe than sorry.
posted by stagewhisper at 2:05 PM on January 1, 2011