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Forum Name: Neurology Topics

Question: pain behind knee -- sciatica?


 irukashi - Fri Aug 22, 2008 4:39 pm

Hello,

I'm a healthy 21 year-old woman overall, but I suffer from PCOS, insulin resistance and palindromic rheumatism (a form of rheumatoid arthritis that doesn't damages the joints). Recently I've also been diagnosed with pinched nerves at L4/L5/S1, after I complained of moderate to severe calf pain as well as numbiness to my doctor. An MRI was done which confirmed the diagnosis. I started PT and after three months got a lot better and stopped.

But recently I've been having intermittent aches behind my knees and a vague cramping pain in my calf. The calf pain is similar to I've had before, so I'm not worried, but the pain behind the knee is a first.

I went to see my doc, who a priori ruled out a blood clot, as my leg is not swollen, red or warm; the pain is not severe or constant and moves around a bit (behind the knee, sometimes above it into the thigh, sometimes around it...); and I've no risk factors (I don't smoke, take the pill, my cholesterol is normal). I also sometimes get slight pain in my buttocks.

Could this pain behind my knee be caused by sciatica? Or is it something else entirely? Should I get a second opinion about DVT?
 John Kenyon, CNA - Tue Aug 26, 2008 9:50 pm

User avatar Hello -

While your description of the pain does sound most like sciatica, you are not unreasonable in wanting to be certain DVT is ruled out. It is so much simpler, once this is done, to deal with the remaining, less-threatening problems, and it is not impossible for a healthy young person to develop DVT, although it is, of course, less likely. It is easy and relatively inexpensive to perform a doppler ultrasound to rule out the presence of a clot and/or deep vein reflux, and once this is done you can truly relax. Often the possibility of DVT is ruled out arbitrarily with young people, and I don't think this is in the best interest of anyone. A second opinion is absolutely warranted, and if that provider also refuses to perform the simple test which can make this distinction early on, then I'd strongly advise you to find someone who will. It only takes a few minutes and once you know the status of that, everything else will be a lot easier to deal with.

Again, it very likely is sciatica, but it is the potential for a weird coincidence that makes it incumbent upon providers to rule out the more serious issues first.

I hope this is helpful. Good luck to you.

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