How to handle pregnancy-related leg pain at 14 weeks?

Question

Hello doctor,

There is a complaint of severe pain in both legs of my wife, who is 14 weeks pregnant. She is unable to sleep due to the pain. All ANC checks and blood tests are fine. This is the second pregnancy. She has complaints of a lot of pain in her legs on both sides, more on the right leg.

She says she is unable to sleep due to pain. We complained to her obstetrician, and she at that time said that such pain was not expected. However, following two to three days, the pain persists and makes her life difficult. We have now temporarily traveled away from her doctor, so I need some help. She has some tenderness in her lower back, though not significant.

These are similar but less severe complaints before pregnancy. Kindly suggest treatment. Of note, she has taken Paracetamol once, but with minimal relief.

Please guide.

Answer 1

Hello,

Welcome to icliniq.com.

To tell you the truth, I need more information or to examine the patient to come to an accurate diagnosis. Differential diagnosis includes vascular problems for which we can consider a venous or arterial Doppler.

The probable diagnosis is a pregnancy-related lumbar strain, which is less likely. We need to check for her peripheral pulses, and we also need to do some basic blood tests to check for any inflammatory markers.

She needs CBC (complete blood count), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), uric acid, calcium, RA (rheumatoid arthritis) factor, RBS (random blood sugar), RFT (renal function tests), vitamin D3, vitamin B12, and MRI (magnetic resonance imaging) of the lumbar spine (if required).

Firstly, we need to check if the leg pain is associated with any tingling or numbness. If her mild back pain with both sides' leg pain is associated with tingling and numbness, it could be a lumbar disc problem/herniation. For this, we need to consider a lumbar spine MRI (magnetic resonance imaging).
Secondly, if it is mainly leg pain, we can treat it conservatively with medications and physical therapy. So once the pain settles, she can learn pregnancy-related lumbar stretches and gentle back-strengthening exercises from a good physiotherapist.

She can continue tablets of Paracetamol 1000 mg twice a day, once in the morning and once in the evening after food times, for one week until the pain subsides. Consult your specialist doctor, discuss with him or her, and with their consent, take the medicine.

She needs to avoid lifting heavy weights, bending forward, jerky travel, and strenuous work. She needs a firm bed mattress. Follow-up depends on improvement. If she does not improve, she needs to consult a pain management specialist or an orthopedic doctor.

I hope this helps.