The medical history (history of illness) represents an important component in the diagnosis of leg pain. Family history
- Is there a frequent history of cardiovascular disease, thrombosis in your family?
Social history
- Do you have a job that requires you to stand or sit for long periods of time?
- Have you taken a long-haul flight recently?
Current medical history/systemic history (somatic and psychological complaints).
- Where exactly is the pain localized?
- Is the pain always in the same place?
- When did the pain first occur?
- Did the pain occur suddenly or gradually?
- When does the leg pain occur?
- During the day and/or at night; if at night, do you wake up from the pain?
- Initial pain (start-up and run-in pain)?
- After standing or sitting for a long time?
- Permanently?
- Is the pain burning, throbbing, pounding, stabbing pulsating or dull?
- Does the pain radiate?
- Do you have any functional limitations* * due to the pain? If yes, which ones?
- Are there any neurological limitations* * such as sensory disturbances or reduction in strength?
- Is there a trigger for the pain?
- On a scale of 1 to 10, where 1 is very mild and 10 is very severe, how severe is the pain?
- In addition, is the leg overheated? * *
- Does the pain change after lying down and at night? If so, in what way?
- Do you have any other complaints such as:
- Acute onset thoracic pain* * (chest pain), sometimes felt as annihilation pain.
- Bluish skin color? * *
- Cold and bluish discolored lips and fingers? * *
- Palpitations? * *
- Cold sweat? Are you pale and do you have a drop in blood pressure? * *
- Shortness of breath on exertion or at rest? * *
- Fever? Chills?
- Cold skin?
- Atrophic skin changes (loss of skin elasticity).
- Dry, itchy skin?
- Areal redness of the skin?
- Calf swelling* ?
Vegetative anamnesis including nutritional anamnesis.
- Are you overweight? Please tell us your body weight (in kg) and height (in cm).
- Has your body weight changed unintentionally?
- Do you get enough exercise every day?
- Do you drink enough?
- Do you smoke? If so, how many cigarettes, cigars or pipes per day?
- Do you drink alcohol? If yes, what drink(s) and how many glasses of it per day?
- Do you use drugs? If yes, what drugs and how often per day or per week?
Self-history
- Pre-existing conditions (blood clotting disorders, cardiovascular disease (eg, deep vein thrombosis; peripheral arterial occlusive disease), tumor disease, accident).
- Operations (blood transfusions? ; prolonged bedriddenness?).
- Allergies
- Pregnancies
Medication history (medications that may cause leg swelling).
- ACE inhibitors (angioneurotic edema; incidence (frequency of new cases): approximately 1%; mortality (death rate): 1%) – benazepril, captopril, cilazapril, enalapril, fosinopril, lisinopril, moexipril, peridopril, quinapril, ramipril, spirapril
- Analgesics
- Non-steroidal anti-inflammatory drugs (NSAIDs, non-steroidal (acetylsalicylic acid (ASA), diclofenac, indometacin, ibuprofen, meloxicam, piroxicam) – lead to increased fluid retention in the feet and ankles, among other things.
- Selective COX-2 inhibitors (coxibe) – celecoxib, etoricoxib.
- Antidepressants (amitriptyline* /in patients > 70 years of age).
- Antihypertensives – especially dihydropyridine-type/nifedipine-type calcium antagonists; second- and third-generation such as lercanidipine are better tolerated
- Typical: ankle edema – increases during the day and regresses overnight
- Antipsychotics (neuroleptics).
- Chlorpromazine* , clozapine* , haloperidol* , thioridazine* .
- Diuretics* – especially loop diuretics such as furosemide and torasemide, which can cause leg edema [exsiccosis].
- Glitazones
- Typical: peripheral edema
- Hormones (lead, among other things, to increased fluid retention in the area of the feet and ankles).
- Androgens (testosterone, testosterone antate, testosterone undecaonate).
- Progestogens* (etonogestrel, desogestrel, dienogest, levonorgestrel, medroxyprogesterone acetate, medrogestone, norelgestromin, norethisterone).
- Glucocorticoids* (budenoside, cortisone, fluticasone, prednisolone).
- Estrogens* (ethinyl estradiol, estradiol) – estrogen therapy as hormone replacement therapy (HT): increase in thromboembolic risk by: + 6 events per 10,000 women per year of use.
- Estrogen-progestin combinations* (oral contraceptives: ethinyl estradiol + norethisterone / norgestrel derivative – especially in combination with smoking; hormone replacement therapy, HRT; English : hormone replacement therapy / HRT) in menopause: increase in thromboembolic risk by: + 17 events per 10,000 women per year of use.
- Growth hormone (somatotropic hormone (STH), human growth hormone (hGH), growth hormone (GH), growth hormone (WH), somatropin (INN)).
- Laxatives – when taken for prolonged and uncontrolled periods, they disrupt water and electrolyte balance, as well as protein and mineral concentrations, impairing the removal of fluid from tissues
- Psychotropic drugs – atypical neuroleptics, lithium, MAO inhibitors, tricyclic antidepressants.
- See also drugs that can cause myalgia (muscle pain) and thrombosis.
* Thrombosis / embolism caused by drugs.
* * If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Information without guarantee)
