In my practice, the most common reasons for a patient referral are leg pain and swelling. So many people have problems with their legs, but often these difficulties seem to take a back seat to high blood pressure, heart disease, diabetes, and other serious health issues.
Many times patients hesitate to mention these problems to their primary care physician, or their symptoms just don’t seem to get as much attention as other problems. Leg pain and swelling are important signs of potentially serious medical problems and can be sorted out with a referral to a vascular surgeon.
Causes of Leg Pain
Patients may experience leg discomfort or swelling for a variety of reasons. Each patient is evaluated based upon what they are feeling and the findings on physical examination. Problems that may cause leg pain include, first and foremost, peripheral artery disease (PAD) caused by narrowing or blockage of arteries carrying blood to the legs. Patients with PAD often experience cramping of the thighs or calves after walking a distance (intermittent claudication). With more advanced disease, patients may experience burning pain of the lower legs and feet, sometimes with the development of leg ulcers which is called critical limb ischemia (CLI). These are serious signs and require urgent attention.
Other common causes of leg pain include peripheral neuropathy frequently caused by diabetes mellitus. Patients typically describe both a burning sensation and numbness or a feeling of pins and needles. It is not uncommon to confuse the symptoms of diabetic neuropathy with critical limb ischemia. A thorough vascular exam is crucial.
Lower extremity pain may also be caused by venous insufficiency, blood clots of the veins (deep venous thrombosis), or nerve compression at the spine (spinal stenosis), or a bulging intervertebral disk. Many patients suffer from pain related to arthritis of the hip or knee joints. All of these possible causes and more are considered at the time of evaluation after which the appropriate testing is completed. Most problems can be treated with substantial or complete resolution of pain depending on the cause.
Causes of Leg Swelling
Leg swelling is a common problem with a variety of possible causes. Commonly, patients suffer from venous insufficiency or venous backflow across incompetent valves within the legs’ veins. This can occur within the deep leg veins or the superficial veins and may also cause symptoms such as heaviness, aching, throbbing, burning, itching, or restlessness of the legs. Ultrasound testing reveals the cause of the swelling and treatment is very effective in solving this problem for most patients. Patients may also suffer from severe leg swelling caused by compression of the large veins (iliac veins) in the pelvis which can be identified and treated with dramatic improvement in symptoms. Other causes of leg swelling include deep venous thrombosis, congestive heart failure, kidney disease, or lymphedema. All of these problems can be treated once the underlying cause of swelling is identified.
Many patients suffer from a combination of conditions causing leg pain and swelling. It is important to seek proper consultation in order to work through these causes and improve your health and well-being.
If you have either of these problems, please schedule an appointment for an evaluation. Typically, patients can be seen within the week at one of our two locations: in the outpatient clinic at Salem Regional Medical Center or the Austintown Medical Building. A physician referral is not required to make an appointment and allow me to get you back on your feet.[/column]