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DVT and trigger point pain
Started by Bob D
Posted: November 13, 2007 at 18:34
Hi, has anyone else had trigger point type pain with a DVT? By this I mean a localized knotting muscle pain with each of the first steps in the morning or after prolonged sitting pain which can be strong enough to cause limping, which disappears as weight is shifted to the other non-DVT leg during walking, tends to diminish with continued walking, and is not present at rest. There is often localize tenderness when pressing on the painful site This trigger point type pain seems different than the cramps, aches, claudications, and prolonged standing pains that have been so well described in other threads. Is this what some people mean by charley horse?

I ask because that is how the pain started in my lower outer thigh after having a groin to ankle DVT. I got the DVT during my 5th week of being on crutches and started getting the pain as I began using my leg again after the crutches were discontinued on the 6th week. My docs do not seem to know much about it. Because the pain and tenderness was so localized, one diagnosis was trigger points. I would appreciate hearing of your experiences. Thanks.

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Re: DVT and trigger point pain
Reply #1 by Sharon
Posted: November 16, 2007 at 06:17
Bob--

I never heard it called that before, but yes, I had that kind of pain when my Dvt started in my thigh. The vein had searing, burning pain and the muscle had what felt like cramping and 'charlie horse' pain--though there was really no contraction in it. My DVT then grew down to my ankle while I was on anitcoagulant in the hospital! Again, in the calf, it felt the same way. It gets better and goes away over time as the peripheral veins expand and begin to accomodate additional blood flow. The feeling is bcs the muscle is not getting as much blood or oxigen as it needs to work. This same effect happens as you walk on it--that's why it hurts more when you first get up, but the pressure on smaller veins makes them expand, hurting at first and it gets better. It goes away pretty quick in the calf, but takes longer in the thigh for some reason. At least that is how it worked w/ me. Hope this helps.


My only question is about the pain being on the outer thigh. I had some pain there, but was told there was not a deep vein--only superficial ones there. Course, who knows if we're talking about the same area. Mine happens about 3-4 inches above the knee on the outer thigh area. Also same leg that I had groin to ankle DVT. Interesting.
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Re: DVT and trigger point pain
Reply #2 by Bob
Posted: November 16, 2007 at 18:30
Hi Sharon,
Thanks for your helpful reply. Like yours, my pain is about 3 to 4 inches above the knee and I have a DVT in my deep thigh vein. Did you have muscle wasting when you were hospitalized? I ask because I had thigh muscle wasting and weakening at the time of my DVT. Even without a DVT, pain in this area of the thigh can occur when fully using the leg again after a period of muscle wasting (sometimes called atrophy). Perhaps there is come connection between the DVT, muscle wasting, and pain when stepping on the leg.

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Re: DVT and trigger point pain
Reply #3 by Bob
Posted: November 16, 2007 at 21:20
Oops, I left out the perhaps crucial connection. Wasted and weakened muscle with normal blood flow rebuilds and strengthens normally and becomes pain-free. Might wasted and weakened muscle with abnormally low blood flow and oxygen due to a DVT have problems rebuilding and strengthening? If so, could this result in long-term problems that continue to produce pain during walking?
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Re: DVT and trigger point pain
Reply #4 by Sharon
Posted: November 17, 2007 at 05:59
Bob--

Yes, I had significant muscle atrophy. All together, I was in the hospital 40 days between May 22 and Sept. 24, 2007 w/ recurrent DVT. I think you have a very good theory about mucle regeneration, but there is also a well known cause of the pain--and that is post-thrombitic syndrome, also called post-phlebetic syndrome I think. We have valves in our veins just like we do in our hearts to keep the blood flowing up and to prevent reflux back down the leg. When our bodies begin to dissolve the clot and recannalize the vein, the valves in our veins are also eaten away along w/ the clot in which they are embedded. This causes pain throughout the leg, often swelling as blood refluxes and pools in the lower part of the leg, and sometimes even leg ulcers where the circulation is not feeding the skin and muscle adequately in certain areas. So, I think this known syndrome certainly concurs w/ your hypothesis.

However, you should also be constantly vigilant for new clots that may also be causing the pain while walking. As I mentioned before, the peripheral veins should begin accomodating the blood flow and the pain from old clots should improve over time. You should talk to your doctor if there is any question. Some blood disorders can keep you in a hypercoagulative state even while on anticoagulant. Happened to me--many times. They kept telling me it was impossible to clot while on anticoagulant, but I kept doing it over and over. They stopped saying 'impossible' after about the 3rd time.
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Re: DVT and trigger point pain
Reply #5 by Bob
Posted: November 17, 2007 at 23:28
Sharon - -
That is what I was wondering, could post-thrombotic syndrome or similar processes result in the weight-bearing type pain I described? If so, then I would expect many people with DVTs to have this type of weight-bearing pain: pain when stepping onto and then disappearing when stepping off the DVT leg during walking, and, pain which decreases or stays the same with continued walking. If very few people have this type of pain, it would lead me to think of something more than simply the post-thrombotic syndrome (thus the atrophic muscle idea).

The weight-bearing pain I described in the start of this thread occurred during the first 2 months after the DVT. Now, over a year later, the pain has undergone changes but I still have essentially the same weight-bearing type pain. That is why I am trying to understand the origin of the pain. Your thoughts about preventing new clot formation are well heeded: I have a normal blood profile and upon my request my doc put me back on coumadin. Thanks for sharing your experiences and understandings.

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Re: DVT and trigger point pain
Reply #6 by Jackie
Posted: December 4, 2007 at 03:27
There is a medical term for exactly what you describe- it is called intermittent claudication. I t usually occurs in arterial problems, not venous problems, and occurs becuase your muscles are crying for blood ( which it isnt getting in an arterial insufficiency). However, you are most likeyl getting it because your blood flow just isnt what it shoudl be.
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Re: DVT and trigger point pain
Reply #7 by Bob
Posted: December 5, 2007 at 07:31
Jackie -
I wonder. My understanding is that the pain of claudication increases as activity continues or increases. With venous claudication, that pain is sometimes described as "bursting." In contrast, the pain I was having occurred during the first few steps as I applied full weight on the leg and the pain tended to diminish as I continued to walk.
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Re: DVT and trigger point pain
Reply #8 by chris jones
Posted: December 5, 2007 at 09:43
i too awake with a sort or cramping pain in my calf muscle,once i have had a few steps on the leg it subsides.i think its due to dehydration during sleep and also having the leg rested or elavated.i think it will last a while until the healing / venous areas are sorting them selves out somewhat.i dont know the medical terms but have mentally thought..'this is as good as it gets'....at least for a while,,take care,chris,
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Re: DVT and trigger point pain
Reply #9 by Bob
Posted: December 6, 2007 at 06:20
chris -
Thanks for sharing your experience. Perhaps the decrease in pain after the first few steps also results from stretching the muscles and from stimulating increased blood flow. The initial weight-bearing pain I had subsided after a few months - trust yours will too.
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Re: DVT and trigger point pain
Reply #10 by Jackie
Posted: December 13, 2007 at 02:40
Yes- Bob- you are right. claudication gets worse with muscle usage. I have no clue why it hurts then subsides;:0

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Re: DVT and trigger point pain
Reply #11 by Patty
Posted: December 13, 2007 at 14:00
Hi Bob - I have had this pain as well. I had a good deal of swelling in the left leg where the DVT is. That went away after a few weeks. And it's my right leg that has the pain you describe. It feels like a pulled muscle, hurts when I first get up in the morning, or up from sitting.
After a bit of walking it's better. I exercised yesterday on a recumbent bike and noticed laster that it was considerably better. I do believe it has to do with blood flow. I also had bleeding veins which were very sore but those are clearing up. Good luck!
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Re: DVT and trigger point pain
Reply #12 by Bob
Posted: December 14, 2007 at 17:51
Hi Patty -
Thanks for the info. Interesting that the weight-bearing pain was in your right leg. May improvement continue.
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Re: DVT and trigger point pain
Reply #13 by chris jones
Posted: December 15, 2007 at 10:30
i have been told to'get up,,get goin,, get moving'...stop feeling sorry for myslef etc etc.apparently the diaphragm acts like a syphon and will lift blood pools and then this inturn increases the flows etc.so,,the bike has had its tyres pumped up and away we go today.hopefully i may see some improvement etc and i fully believe i will see excess swelling and some pain,,but i can live with that...will keep you posted on any feedback etc,,chris,x
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Re: DVT and trigger point pain
Reply #14 by Merle
Posted: September 4, 2010 at 19:27
I don't know if my leg pain is from vein problems or not. But a year ago, I had some pain/tightness at the right side of my right knee. From then on, the more I walk, the more my right leg hurts seemingly down the muscle on the right side of my leg and into my right ankle. It is only when weight bearing and if I persevere with walking or standing for long periods of time, my leg aches even when I am sitting or at night when I am trying to sleep. My leg is usually fine in the morning, but gets bad any time I am on it for 20 minutes or more. It's doesn't seem to be anything to do with my knee because I can more it back and forth without pain. Any comments? I am due to get an MRI next May.....
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Re: DVT and trigger point pain
Reply #15 by Bob
Posted: September 5, 2010 at 16:14
You mentioned vein problems - makes me wonder what kind of vein problems you
have, how long you have had them, and if the vein problems are in your right leg?
You might have someone check your pattern of walking, i.e., your gait. Could your
pattern of walking be putting extra weight on the outside of your right leg so that the
outside leg muscles need to carry an additional load? A physical therapist's
evaluation could be helpful in sorting this out. Hopefully, your MRI will be
informative.
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Re: DVT and trigger point pain
Reply #16 by elaine
Posted: September 5, 2010 at 18:04
dvt pain at the back of my knee
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Re: DVT and trigger point pain
Reply #17 by elaine
Posted: September 5, 2010 at 18:28
dvt pain at the back of my knee
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