Calf muscle pain after cesarean section

Many babies reach their due date before all birth indicators are fully developed in their mother's belly. At this time, if the woman wants the baby to be born, but the baby does not meet the requirements for natural delivery, the woman has to have a caesarean section. Many women feel uncomfortable in many parts of their body after a caesarean section. So what is the cause of calf muscle soreness after a caesarean section?

It is probably deep vein thrombosis in the lower extremities, but it is not serious. Because a caesarean section requires lying in bed for six or seven days, especially on the first day, the legs cannot move. You should massage your legs frequently to promote blood circulation, otherwise blood clots are likely to form. My wife also had a caesarean section in December. I massaged her for at least half an hour on the first day, and she is recovering well now.

A clinical symptom

The most common clinical manifestation of this disease is sudden swelling of one limb. Patients with deep vein thrombosis in the affected lower limbs feel local pain. In mild cases, they only feel heaviness locally. Symptoms worsen when standing. Physical examination has the following characteristics: ① Swelling of the affected limb. The degree of swelling must be accurately measured with a tape measure every day and compared with the healthy lower limb to be reliable. Simply relying on naked eye observation is unreliable. This sign is of high value for diagnosing deep vein thrombosis. Severe swelling of the calf often leads to increased tissue tension; ② Tenderness. There is often tenderness at the site of venous thrombosis. Therefore, the lower limbs should be checked in the popliteal fossa, adductor canal of the calf muscle and the femoral vein below the groin; ③ Homans sign. Sharp bending of the foot to the dorsal side can cause deep pain in the calf muscle. In the case of deep vein thrombosis in the calf, the Homans sign is often positive. This is caused by the stimulation of the calf blood veins when the gastrocnemius and soleus muscles are passively stretched; ④ Superficial varicose veins. Deep vein obstruction can cause increased superficial venous pressure. Superficial varicose veins may occur 1 to 2 weeks after onset.

At the same time, various clinical manifestations may occur depending on the location of venous thrombosis, which are described as follows:

1. Calf deep vein thrombosis Although the calf deep vein is the most vulnerable site for thrombosis after surgery, it is often missed. Common symptoms include calf pain and tenderness, mild or no obvious swelling of the calf, and positive Homans sign. Superficial venous pressure is usually normal.

2. Femoral vein thrombosis Most femoral vein thrombosis is secondary to calf deep vein thrombosis, but a few femoral vein thrombosis can also exist alone. The physical signs are tenderness in the adductor canal, popliteal fossa and deep calf. Mild edema often occurs in the affected calf and ankle. The venous pressure of the affected limb is 2 to 3 times higher than that of the healthy side. Homans sign is positive or negative.

3. Iliofemoral vein thrombosis Most iliofemoral vein thrombosis is secondary to deep vein thrombosis in the lower leg, but sometimes it originates from the iliofemoral vein or iliac vein. It is more common in postpartum women, patients with pelvic fractures, pelvic surgery, and advanced cancer patients. The lesions occur 2 to 3 times more frequently in the deep veins of the left lower limb than on the right side. This may be due to the longer course of the left common iliac vein and the compression of part of the left common iliac vein cavity by the right common iliac artery. Occasionally, it may also be due to the congenital reticular malformation at the junction of the left common iliac vein and the inferior vena cava.

The disease develops suddenly. The whole affected limb will experience pain, tenderness and obvious swelling within a few hours. The upper thigh and the ipsilateral lower abdominal wall have superficial varicose veins. There is obvious tenderness along the femoral triangle and the adductor canal of the thigh. Cords can be felt in the femoral vein and tenderness. In severe cases, the skin of the affected limb becomes bluish purple, which is called "phlegmasia cerulea dolens". It indicates extensive thrombosis of the deep and superficial veins of the affected limb accompanied by arterial spasm. Sometimes it can lead to venous gangrene of the limb. The systemic symptoms are generally not obvious. The temperature rises no more than 39℃. There may be mild tachycardia and symptoms such as fatigue and discomfort. "Phlegmasia cerulea dolens" is relatively rare.