Leg Swelling

 Did you know that 1 in 4 patients in chronic pain management for leg pain has undiagnosed venous insufficiency? Leg pain and swelling are sometimes associated with venous insufficiency and varicose veins. In some patients, symptoms can be quite painful, while in others, the pain is very mild or even associated with another ailment.  Lower leg pain can be throbbing, a constant dull ache, burning or stinging sensation, or an aching sensation that is hard to describe and varies in its occurrence.  Varicose veins are large blue bulging veins that and frequently painful. The vessel can lie under the skin, near the surface and protrude or be on the surface under a layer of fat and not be noticeable. The term "varicose" refers to instances when valves inside the vein fail or are not existent. The valves are made to keep the blood flowing back toward the heart. The valves are one-way valves and, when worn out and dysfunctional, allow flow to resume toward the feet and ankles. Think of the valves as a ladder. When one ladder or valve becomes dysfunctional, the weight or pressure us applied to the valve below. This causes that valve or, in this case, ladder rung to become weak and give out as well. The result is a domino effect and increased pressure and failure of subsequent valves.

Not all leg swelling is caused by venous disease, and leg swelling can be caused by heart failure, kidney failure, and lymphedema often though the venous disease is involved and maybe missed by your cardiologist, kidney specialist or doctor. The only way to know is to have an ultrasound performed.  The ultrasound can differentiate different diseases. Leg swelling related to heart failure has a pulsatile nature on the venous duplex exam and is often accompanied by shortness of breath.  

The great saphenous vein is most prone to vein disease due to increased pressure that occurs with the increased length and diameter of a vein. The great saphenous vein originates at the feet and dumps into the common femoral vein in the groin. 

When a valve in the saphenous vein leaks anytime, increased pressure is applied flow will flow around or through the valve toward the ankles. This is why when you stand up, your veins distend or bulge out. The blood that is traveling down toward the feet does not get back to the lungs. As a result, the increased pressure spreads to the smaller veins closer to the skin. Venous disease is all about pressure and finding the pressure sources. Proper ultrasound techniques can be performed and play a huge role in successful diagnosis and treatment. Vein Specialists has a fully accredited vascular laboratory and only uses only the best vascular technologist to perform your exam.