Painful legs (burning sensation behind both knees)

[Oldmasons]

Hi all

Well, I’m hoping someone can provide a view on what is happening to me now!

For the last couple of months I have had severe pain in the legs which has now started to become a burn behind my knees. It doesn’t improve or worsen on exercise and is particularly painful laying in bed. I used to be able to shake it off after 10 mins of walking around, but not now. Painkillers only take the edge of it.

I’m due my annual review with the cardiology team in 4 weeks. I know you shouldn’t….but…. Dr Google suggests Peripheral Arterial Disease. As some of you know I have heart disease (pacemaker, valve replacement, double bypass and endocarditis), could this be related and, if so, will it wait until the my planned review?

Thanks a lot

[Happyrosie]

I remember my father, a heavy smoker, had this. Another name is angina cruris. It’s quite uncommon now as the majority of cases are caused by heavy smoking. Thirty years ago a nurse would see this often and be able to diagnose but probably not familiar with it now. Though I have a friend with it who has never smoked. But, it gets worse with walking not better.

If you do have it there’s not much that can be done that you, as a heart patient, are not doing already (diet and lifestyle) so it would certainly wait, IF this is what this is. But I am not a medic,

[Oldmasons in reply to Happyrosie]

Thank you so much, very interesting comments. I have never smoked, but the rest seems very appropriate.

[Blearyeyed]

To be honest , there are lots of reasons that this could be happening behind the knees , and a lot more common than PAD.Have you seen your GP about it?

I think it would be worth getting them examined before you see the Cardiologist and also request having your blood tests done by your GP now and x-rays too , to rule out some of the causes for knee pain and inflammation but also so that you can take the blood results to show the Cardio to help them give their opinion and assess what to do next with new results.

Request your GP to do your full blood count , liver function and kidney function tests ( these will help rule out medication or salt imbalance reasons for the knee complaint), Vitamin D , Vitamin B 12 , Magnesium and Folates ( these can rule out any low nutrient levels or Deficiencies that can cause nerve and muscle pain and inflammation as well as neuropathy and can be treated very simply) , Ferritin/ Iron ( as Anaemia can also cause non specific joint pain and arthralgia). If you haven't had them request a Diabetes HbA1c test and Total Cholesterol, as these can also affect joints , inflammation and neuropathy.

Request a copy or get a copy of the results online when they come in.

Often the GP will tell you the result is normal when it is still very low or only just above deficiency and you could find that it would be sensible to start changing your diet or taking a short term supplement now to help increase your levels and improve the symptoms.

You can request these blood tests every six months according to NICE guidelines ( every year for Vitamin D) if you are on medications , as many medications including PPIs , Statins and NSAIDS like aspirin can change you blood nutrient and liver levels. If you have ongoing symptoms they can be requested three monthly. It is also good to have a baseline of these figures to work with to improve your self care.

The x-rays will hopefully rule out more mechanical things like water retention , cartilage, joint or bone problems that require their own treatment. Some medications and general age and change in mobility can increase the chance if things like osteoporosis or Oestoarthritis, natural joint degradation or things like fluid on the knee , bursitis and types of rheumatic pain. These obviously require their own treatment and might require a trip to a joint specialist or Rheumatology rather than the waiting to be seen by the Cardio whom would still have to refer you to them for checks anyway.

Both cold weather , and any change in weight ( gain or rapid loss) can increase knee joint pressure related problems and affect bone symptoms.

The GP should also be able to advise you if you need supports , steroid injections or can prescribe water pills and an appropriate pain killer to take alongside your usual medications which is better than the over the counter alternatives. You may also find a topical cream will improve the symptoms like Flexiseq or Pernaton , which can both be used with cardiac medications.

Let us know how you get on , take care , Bee

[Oldmasons in reply to Blearyeyed]

Thanks for taking the trouble to reply - with exceptionally useful advice!

[Qualipop]

Do you have any swelling behind your knees? Bakers cysts can cause a burning pain when the fluid from your knees leaks out and creates a cyst behind your knees. Eventually the fluid disperses and can cause pain in your calf. The cysts caaaaaaaan be drained but normally clear themselves.

[Oldmasons in reply to Qualipop]

No nothing there at all