Swelling and Leg Pain

You can find our first article on leg pain and swelling here. Leg swelling generally occurs because of an abnormal accumulation of fluid in the tissues of the lower extremity. In our practice, the term we use for leg swelling from excessive fluid is peripheral edema. Peripheral edema occurs when fluid builds up in the tissues of the lower leg. It can be caused by a venous circulation illness, the lymphatic system, or a problem with the heart, liver or kidneys.

Over the years I’ve noticed that swelling of the leg isn’t always a sign of a heart or circulation problem. Being overweight, inactive, or sitting or standing for lengthy periods may cause fluid accumulation and swelling.

Symptoms that can be associated with leg swelling include:

leg pain,

numbness,

redness,

itching,

rash,

shortness of breath, 

ulceration of the skin

Main causes of Leg pain and Swelling

Water Retention

Excess fluids accumulate inside your body as a result of water retention. Fluid retention, or edema, is the medical term for this phenomenon. Water accumulation can occur in the circulatory system or within tissues and cavities. It may cause swelling in the hands, feet, ankles, and legs.

Peripheral edema is the medical term for leg, foot, and ankle swelling. It’s also known as peripheral edema because it describes the accumulation of liquid in these areas of the body. Unless it’s due to injury, fluid build-up isn’t usually unpleasant. 

Factors related to fluid buildup include:

Acute kidney failure

Cardiomyopathy 

Chemotherapy

Chronic kidney disease

Cirrhosis 

Deep vein thrombosis 

Heart failure

Hormone therapy

Lymphedema 

Nephrotic syndrome 

Obesity

Pain relievers, such as ibuprofen 

Pericarditis 

Pregnancy

Prescription medications, including some used for diabetes and high blood pressure

Pulmonary hypertension

Sitting for a long time, such as during airline flights

Standing for a long time

Thrombophlebitis 

Venous insufficiency

Poor Circulation

Leg swelling can be caused by poor circulation, damage to the leg veins, pregnancy complications, blood pressure medications or other drugs that treat cardiovascular issues and high cholesterol levels. It may also result from congestive heart failure (CHF), kidney disease or liver cirrhosis. 

Leg swelling related to inflammation

Leg swelling can also be caused by inflammation in leg joints or tissues — either a normal response to injury or disease or due to rheumatoid arthritis or another inflammatory disorder. You’ll usually feel pain with inflammatory disorders.

Conditions that can contribute to inflammation in the leg include:

Sprained ankle

Achilles tendon rupture

ACL injury 

Knee bursitis 

Osteoarthritis

Rheumatoid arthritis 

Baker’s cyst

Broken ankle

Broken foot

Broken leg

Burns

Cellulitis: skin infection

What kind of doctor should I see for leg pain?

A Vascular Surgeon: Except for the brain and heart, vascular surgeons manage veins and arteries in every region of the body. Vascular surgeons, for example, treat blocked carotid arteries in the neck. They deal with problems with the aorta (a big major artery) as it leaves the heart and enters the abdomen.

Do other types of specialists do the same thing? Not necessarily. Rheumatologist & Orthopedic Specialists are physicians who specialize in the treatment of musculoskeletal problems. They usually deal with problems involving your bones, joints, muscles, ligaments, tendons, and nerves. 

A vascular surgeon provides a full range of treatment as a complete vascular care specialist, including prescription drugs, physical therapy, endovascular procedures, and open operations. Other specialists may be trained in only one or two areas of vascular therapy.

So your best option for leg pain and swelling treatment is to see a Vascular Surgeon such as Dr. Schmetterer who can treat any venous disease and issues with minimally invasive methods. Also, not all leg pain treatment requires surgery.

© 2018 - Lawrence Schmetterer MD FACS Thoracic & Vascular Surgery