Leg pain can arise from many medical problems. Sometimes it is difficult to differentiate leg pain resulting from venous insufficiency from leg pain that comes from other conditions. The most common description of leg pain that is attributed to venous insufficiency is that it makes legs feel heavy, fatigued, and tired. Such vague symptoms make it hard to pinpoint exactly what is causing them and everyone interprets discomfort differently so descriptions vary greatly.
Venous insufficiency that results in varicose veins tend to make the legs feel heavy due to the increased fluid volume in the legs. The veins leak and deposit fluid in the tissues as well as over-dilated, congested veins increase the amount of blood that is pooling in the lower extremities. Fluid weight can significantly contribute to leg fatigue from having to exert more energy in normal movements. While venous insufficiency causes increased fluid volume in the legs, other conditions such as kidney disease, congestive heart failure, lymphedema, musculoskeletal injuries, hormonal influences and medication side effects can cause it too.
Leg fatigue and tiredness can also result from the lack of oxygen and nutrients. When blood is not efficiently returned to the heart and lungs for exchange of waste and nutrients, it becomes stagnant and deoxygenated. This stagnant blood is not being effectively circulated to replenish supply to the surrounding tissues with the necessary nutrients and oxygen to remain healthy. While the visual changes in the skin such as dryness, discoloration and scaling can be an indicator of venous insufficiency, muscle symptoms are not as easily identifiable. Fatigue is defined differently by each individual. What you feel is fatigue may differ greatly from what others feel. Fatigue can also come from anemia, fibromyalgia, neuro-muscular conditions, over use of muscles, viruses and general illness. There is no single test to figure out what is causing muscular fatigue.
Muscle cramping is another common symptom our patients present with. While muscle cramping is not one of the most common symptom attributed to venous insufficiency, it is not uncommon for the cramping to subside after treating the disease. Cramping due to venous insufficiency generally occurs after prolonged muscle use. Cramping can also be an indication of peripheral arterial disease but the cramping from this disease is usually abrupt and after just a short period of exertion. For example, if you walk a half a block and you get severe cramps in your legs, this is most likely from arterial disease. If you can walk a half of a mile before getting cramps, it is more likely to be venous related. Electrolyte imbalances, nerve injury and muscular diseases can also contribute to leg cramping.
Neurological disorders generally cause a burning pain before numbness occurs. Peripheral neuropathy, diabetic neuropathy, back problems, severe arterial disease and localized nerve injury can result in burning discomfort. Also, restless leg syndrome which is neurological in origin, is often reported as a common leg problem. Nerves and veins live side by side in the body. When the veins are inflamed and damaged, it can result in increased nerve symptoms. Sometimes when we treat the veins, the nerve symptoms improve but there is no way to tell before treatment if it will work or not. Often treating the veins is as much a test as a treatment. If we treat the veins and the symptoms improve or resolve, then we know the veins played an important part of causing the symptoms. If the symptoms do not change, then we know the symptoms weren’t coming from the veins.
Every person may describe their leg discomfort in different terms. It is always important to discuss your symptoms with your family medical provider to have a complete evaluation. If you suspect veins may contribute to your symptoms, please call for an evaluation. We would be happy to answer any questions you may have!