Mystery knee pain + tenderness everywhere. Lymphedema or what?
February 17, 2014 12:04 PM   Subscribe

My knees began to hurt suddenly two months ago and aren't much better regardless of my attempts to fix them. Also, my knees and thighs are tender to the touch almost everywhere. Make it stop?

It's both knees, better in the morning and worse as the day goes on. The pain is both achey and creaky, focused on the back and sides of the knees, and symptoms include some cracking noises and sometimes feeling like a knee is unstable and hyperextending. There's little pain if I don't move the knees. The pain is worst during the first few steps I take after having sat for awhile.

My thighs also have a mild burning pain in the backs or sides and they feel as if they're swollen, though they don't look swollen. Almost everything below my waist is tender to the touch, but especially the sides (inside and outside) of my thighs and knees.

I've had total-body tenderness most of my life and suspect my lymph system is unenthusiastic. If I lie down and lightly rub my knees and thighs in one-way strokes going toward my heart, the surface tenderness goes away for awhile. But it always comes back, and the knee pain is severely limiting my life, since it's painful to walk more than a few blocks.

The knee pain started when I got home after a lot of traveling. I had ocean-crossing flights, but I was in business class with a comfy flat bed and exercised my legs. When the knee pain started the day after I returned from my trip, I also had pain in the joints of my hands, and I attributed both to having eaten a lot of wheat during the trip, which seems to mess with my system.

What I've done since then: lymphatic massage (inexpert), alternating standing and sitting at my desk, trying to walk just enough but not too much, drinking a lot of water, bouncing gently on my mini-trampoline, doing careful and very restricted quadricep and hamstring exercises (made it worse), and avoiding all wheat and dairy. Ibuprofen helps.

Possibly relevant: 52 years old, tall, about 30 pounds overweight, formerly muscular and in good shape but working at a desk a lot in recent months, ovaries removed and not on hormone replacement, and taking thyroid meds and Valdoxa, which can mess with the liver, or so I'm told. History of endometriosis and costochondritis (inflammation of the cartilage in the rib cage). I travel a lot. Unhappy guts in recent years due to frequent food poisoning ("third world" location) and suspected sensitivity to gluten and maybe dairy.

Finally, my question: I have an appointment with an orthopedist but I suspect this isn't orthopedic. Does this sound like something related to lymph or circulation in general to you? If so, which type of doctor should I see? Is there anything else I can try at home in the meantime? Thanks!
posted by ceiba to Health & Fitness (10 answers total)
Do you have a GP? I would go to her/him first, so you can get a full exam, especially if you have someone you've been seeing for awhile and who has some knowledge of your history.
posted by xingcat at 12:13 PM on February 17, 2014 [4 favorites]

Lymphedema means edema. Meaning, swelling that is visible. So, likely not that.

See your primary care doctor as soon as you can. This sounds like it is significantly impacting your life and there are numerous diagnostic possibilities for your various and nonspecific symptoms.

It's most likely not a DVT (blood clot in your leg) either, but given that you had lower extremity pain starting just after a transatlantic flight, I would have advised going to see a physician right away about that issue, and you need at least a thorough history and physical exam to rule it out, if not further workup.
posted by treehorn+bunny at 12:22 PM on February 17, 2014 [2 favorites]

52 is not too young for arthritis, FWIW. I would keep the orthopedist appointment.
posted by DarlingBri at 12:23 PM on February 17, 2014 [2 favorites]

The knee pain started when I got home after a lot of traveling
I travel a lot. Unhappy guts in recent years due to frequent food poisoning ("third world" location) and suspected sensitivity to gluten and maybe dairy.

Sounds like reactive arthritis from a bug you picked up traveling:
Reactive arthritis is a painful form of inflammatory arthritis that develops in reaction to an infection by bacteria. In the past, it went by the name "Reiter's syndrome." Now it belongs to the family of arthritis called "spondyloarthritis."

Reactive arthritis can affect the heels, toes, fingers, low back, and joints, especially of the knees or ankles.
The infection that causes reactive arthritis usually presents (shows up) as diarrhea or as a sexually transmitted disease. But, it can have no symptoms (called asymptomatic).
Though it often goes away on its own, reactive arthritis can be prolonged and severe enough to require seeing a specialist.
I'd first try to get a doctor to prescribe a broad-spectrum antibiotic such as minocycline, then go to a Rheumatologist if that doesn't do the trick.
posted by jamjam at 12:30 PM on February 17, 2014 [1 favorite]

Could be vascular/DVT as suggested up thread. In that case the legs could be painful upwards from clot. Sitting / inactivity is also a risk factor. If you have increased resting pulse rate or shortness of breath you should go to emergency for ultrasound. Varicose veins are another possibility.

Knee pain and instability can be caused by weakness in the quads as this is primarily responsible for extension of the knee. Soft tissue injury in that area is a possibility. Creaky pain and popping sounds are no big deal, it's that pain and weakness in the quad that's the problem.

If you've had GP do blood work and rule out vascular and general system failure, I would think physio is better than ortho since ortho does bones and acute pain. A good physio versed in sports medicine and rehabilitation should be able to direct you further.
posted by crazycanuck at 12:55 PM on February 17, 2014

An early symptom of hepatitis is joint pain. Please see a doctor, this can be many many different things.
posted by SyraCarol at 3:11 PM on February 17, 2014

Reactive arthritis is one of many possibilities for your diagnosis. I just urge you not to go to any appointment with a physician requesting treatment for something a person on the Internet thought you may have. That sort of approach would probably be greeted with skepticism. Inform your doctor of all the symptoms you have been experiencing and let them proceed through an appropriate workup process. You should be comfortable enough with your physician to ask them about why they think certain diagnoses are more or less likely based upon this workup, if they do not explain their decision asking process up front.
posted by treehorn+bunny at 5:51 PM on February 17, 2014

Thanks, everyone, for your ideas. I'll report back on what the doctor says.
posted by ceiba at 6:19 PM on February 17, 2014

Good luck with this. Just make sure your history and questions are all complete when you go in. This sounds like it may need some sleuthing, and you want to have everything in place.
Hope you feel better.
posted by BlueHorse at 6:55 PM on February 17, 2014

Knee pain is a symptom of colitis.
posted by bq at 7:53 AM on February 18, 2014

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