Leg Pain and Swelling
While leg pain can be normal after intense exertions or a long day on your feet, it should not persist or be unbearable. Since one in five people will have at least some degree of leg vein problems, a very common source of leg pain and swelling is venous insufficiency or “leaky veins”. This means that the valves that are in our veins are staying open too long which allows backwards venous pressure to build up. It is this pressure that forces fluid from the bloodstream into the surrounding tissue and thereby causes swelling and pain. Excessive fluid also irritates your muscles causing more pain, itchiness, cramping, burning, heaviness or fatigue.
A Varicose vein is by definition an enlarged and dilated vein. Just because you do not see a bulging vein along your skin surface, does not mean you do not have varicose veins. The dilated veins can be below the skin surface. As they continue to enlarge, they can cause serious issues such as leg pain, swelling, itchy skin, discoloration, achy legs, cramps and ulcers.
Varicose veins are typically caused by venous reflux, a broken/weak valve in your veins controlling the flow of blood back to your heart. When the valve is weak/broken, the blood cannot make it all the way to the heart and it goes back down towards the foot. The valve failure has many etiologies including genetics, obesity, standing or sitting for long periods of time, and multiple pregnancies.
Spider veins are small thin veins that are usually on the surface on your legs. They tend to form in clusters and are red, purple or blue. Spider veins commonly occur simultaneously with other vein disease but can also be independent. Spider veins typically do not cause pain but can be cosmetically displeasing. They seem to get worse during or after pregnancy. There are no real medical issues related to spider veins alone, but spider veins could also be a sign of an underlying issue.
Itching and Burning
Itchiness and burning can naturally be caused by many things. When it comes to vein disease, itchiness and burning are caused by venous insufficiency. Venous insufficiency is when the valves in the veins are not closing correctly and allowing backwards venous flow. This backwards flow creates increased venous pressure in the legs and forces fluid from the bloodstream into the surrounding tissues in the legs. This fluid causes symptoms of itching and burning. An ultrasound done in the office will show which veins are responsible for the symptoms by showing which ones are dilated and have valves not closing appropriately.
Ulcers are due to the eventual break though of the skin due to venous reflux. The continued pressure on the skin from the backflowing blood creates an ulcer which is the final stage of venous reflux disease. Ulcers can be quite painful and happen after developing symptoms of spider veins, varicose veins, leg swelling, and dermatitis.
Leg discoloration is a change in pigmentation of your skin to a darker color usually around the feet or ankles. This discoloration is a sign of blood depositing in your lower legs causing inflammation of the surrounding skin. This can lead to thinning of the skin with eventual ulceration.
Deep Vein Thrombosis (DVT)
This is a blood clot in the deeper or larger veins in the legs which is a dangerous condition. These blood clots can move into the lung circulation and cause death. You can notice DVT if you have swelling, cramps, unexplained severe pain in the foot/ankle, warmer spots of skin, and skin discoloration. DVT can be diagnosed with a detailed lower extremity ultrasound.
DVT causes can include a genetic pre-disposition (i.e., hereditary causes), prolonged immobility when traveling long distances without walking (e.g., air travel or long car rides), or underlying disease such as cancer or certain infections.
Treatments: different in every case and based on our findings, so a customized treatment plan will be developed and followed through.
Restless Leg Syndrome
Restless leg syndrome is a condition when you experience uncomfortable sensations and movements in your legs. Sometimes the only way for you to reduce the pain in your legs is by massaging or shifting them. Restless leg syndrome is related to vein disease since vein disease can cause inflammation that irritates your muscles and soft tissues.
Common symptoms are crawling/creeping sensations, aching, throbbing, tingling, etc. Typically these symptoms worsen at night when you are relaxing or sleeping.
This condition is a swelling of the legs as a result of a malfunction to the lymphatic system. There are very small vessels (lymphatics) that normally capture and transfer the small amount of “leaked” fluid between arterioles and venules in the legs back into the venous circulation. A malfunction can be from hereditary reasons (anatomically defective) or acquired by secondary reasons (surgical damage or removal of lymph nodes, or chronic venous edema). Early treatment of venous insufficiency may prevent or improve secondary lymphedema.
Treatments: We specialize in the treatment of lymphedema, which can be very difficult to treat and each case will be evaluated on an individual basis.