Differential diagnosis of Deep vein thrombosis from mechanical dysfunction of the lower leg.

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Your leg is swollen from the calf down and you don't know why. Visiting your doctor can result in their taking your pulses, doing an examination and perhaps, using a doppler which can detect clots.

While this is the standard of practice, most people do not have clots. Older folks with many other health problems are often just given water pills with the idea that as long as you take them, the swelling should go down.

Other tried and true medical ideas are support hose to improve the flow of fluid out of the tissues of the leg back to the heart, yet the swelling persists otherwise and over time, pain may develop in the knee or ankle or back or all of those areas.

The most often overlooked reason for swelling is impact. In the medical world, they look for medical problems but are not trained to look at body mechanics. Poor body mechanics results in problems of impact on a joint or joint series. Ignore them for years and it results in not only swelling but chronic pain in the foot, ankle, hip and back and can result in marked joint damage as the problem becomes more chronic over time.

Years later, the problems will be seen as osteoarthritis on an x ray.

Imagine if I began to hit you in your shoulder for hours at a time. Your shoulder would become sore and eventually the tissues may swell. Then imagine I injected the shoulder with something to reduce the swelling and then began hitting you for hours again. While this sounds rediculous, it is also rediculous to treat conditions of impact this way and look only for a medical reason with only a limited examination to the leg that is swollen.

If you look at the person, you may then see they have flat feet, with one that is worse, unlevel hips, knees that roll in or out and they may also have neck and back pain but because they go to different doctors for these problems, and your doctor never ask about it, they do not have a complete picture of it.

Chiropractors are taught to evaluate and treat holistically, meaning they will consider all the possibilities and perform a thorough evaluation of your problem. If they suspect the problem is due to a clot, which they are trained to evaluate, they will refer you to the appropriate medical provider. The good news is the problem is usually easy to treat if you take the proper history and improve the problem from the ground up using methods such as soft tissue techniques to improve movement in the ankle, knee and back, and then manipulation to restore motion in those joints. Foot orthotics are often recommended to resolve imbalances from the ground up.

This approach is preferable as it saves time, cost, reduces chronicity and helps people lead better lives rather than only trying to evaluate a clot and then treat the swelling. Improved ability to walk, improved joint movement and improved function frequently reduces or resolves swelling in a few short visits without medication as it will naturally reduce impact by improving function. Improved function also reduces the likelihood for future problems as well.

While the idea of seeing a chiropractor first for leg swelling is not something most people have been taught to do, chiropractors practice primary care for the musculoskeletal system, something that is needed in our healthcare system. Swelling in the lower leg often requires a primary care approach that looks at you, rather than assuming you have a clot while you schedule for a test to confirm it. Many of these tests are negative however a simple exam and a thorough approach to care often solves the problem and helps you feel and function better.

Keep it simple, think chiropractic first.