One of the main concerns/fears that people have today is having a Thrombosis. In fact, this is not new today, but the SARS-COV 2 pandemic has brought this subject to incredible evidence. Now, let's understand how the doctor suspects that a thrombosis is actually happening.
Whenever an abnormal clot forms, we can guarantee that 03 other changes happen:
a) a congestion of blood behind the point of thrombosis;
b) a relative reduction in blood flow ahead of the problem site;
c) an inflammation of all structures close to the clot.
Thus, thrombosis can generate Pain for these three reasons. “Both the stasis due to the overload of venous blood and ischemia due to arterial obstruction can cause inflammatory reaction and be, therefore, painful for the affected leg or arm.” Obviously, only a physical medical examination, complemented with Doppler ultrasound, can confirm or rule out the condition with absolute certainty, but it is essential to clarify some points:
1. Despite being the most serious and urgent cause of leg pain, thrombosis is not the most common cause;
2. The pain of thrombosis is not usually intense from the beginning, usually it starting slightly to moderately, such as weight, numbness or feeling tired;
3. Pains of severe intensity from the beginning are usually caused by Muscles, so the hooks and / or cramps that happen more at night, as frightening and uncomfortable as they are, are not usually related to thrombi;
4. Another most common cause of leg pain is spinal problems such as herniated discs, parrot beaks, arthrosis and others. The “Sciatic Nerve” is a large nerve located a little posterior and a little lateral in the thigh. Any pinching along its path can manifest itself as a sharp pain in the thigh, without swelling or any change in skin color;
5. Chronic diseases like Diabetes and Alcoholism can affect the nerves in the legs and arms. Usually these changes are more in the sense of decreased sensitivity, with numbness and tingling but, in some cases, there may be pain and be mistaken for thrombosis;
6. Pulmonary embolism is caused by venous thrombosis;
7. ARTERIAL thrombosis can cause leg amputation;
8. The complications described in 6 and 7 are rare and totally treatable, especially if recognized early;
9. When a person has venous thrombosis, the temperature of the diseased leg becomes warmer and the color is darker red;
10. In Arterial Thrombosis, the affected leg becomes colder and paler than normal.
Thrombosis is one of the diseases that kill the most in the current world, either directly or as an associated condition, so it is very important to talk more about it. COVID-19 has an especially high rate of thrombosis in cases of severe symptoms and this has left doctors and patients alarmed. Even in moderate cases, we have seen an increase in the D-Dimer test (blood test used to detect the formation of clots/thrombus early. Although, the increase in D-Dimer may also increase in other inflammatory situations). However, the panic caused by the pandemic should not be a reason for excessive antithrombotic treatment, as there is a risk of spontaneous bleeding as severe or even more than the thrombosis itself.
Severe pain in the legs is probably the result of changes in muscles or nerves. The stronger the pain, the less likely it is to be a Thrombosis. Changes in temperature and in skin color, increased volume (swelling) and hardening of the musculature are initial signs more present at the beginning of the formation of the thrombus than the pain itself.
The information presented in this text can avoid unnecessary suffering and fear, but if you have any questions or shows any symptoms of thrombosis described above, see a doctor.
For more information, visit the website of Dr. Ronald Fidelis.