Lower leg pain and swelling often are associated with venous insufficiency and varicose veins. Symptoms can be quite painful: Lower leg pain can be a constant dull, throbbing and aching sensation.
Varicose veins are large blue bulging — and frequently painful —blood vessels that lie under the skin, near the surface of the leg. The term "varicose" refers to instances when valves inside the vein, which keep blood flowing back toward the heart, become worn out and dysfunctional.
It is important to note that lower leg swelling can be caused by heart failure, as well. Not all patients who have lower leg swelling have venous insufficiency. How can the two diseases be differentiated? Leg swelling related to heart failure is often accompanied by shortness of breath and does not have entail discoloration of the skin. Swelling related to venous insufficiency is not accompanied by shortness of breath, but does entail skin discoloration.
One Cause of Chronic Swollen Lower Legs:
The Great Saphenous Vein
Of all of the veins in our superficial venous system, the great saphenous vein is most prone to vein disease. Because it must propel blood upward for a long distance, the great saphenous vein depends on the function of its valves, which prevent the backflow of blood down the vein.
When a valve in the saphenous vein fails, blood is allowed to "leak" toward the ankles; blood is not sent back to the heart. As a result, blood pools in the lower legs, in the smaller veins closer to the skin. Veins become swollen — resulting in varicose veins, leg swelling and considerable pain.
Leg swelling related to varicose veins is characterized by a reddish or purple discoloration. Sometimes, the swelling becomes so great that a patient must wear differently sized shoes.
Treatment for Venous Insufficiency
Many patients seek venous insufficiency treatment at John C. Lincoln after suffering swelling and pain in a leg for several months.
To determine whether a patient is suffering from venous insufficiency, a John C. Lincoln physician will perform a physical examination and take the patient’s medical history during the initial medical evaluation.
While this is taking place, the patient will be standing, or sitting on the examination table, with the affected leg dangling over the edge. If a patient has venous insufficiency, leg swelling will become apparent within minutes.
To determine the patient's level of discomfort and swelling, the physician will ask whether it hurts when pressure is applied to the lower leg or ankle. When the leg demonstrates swelling accompanied by pain, the patient is most likely a candidate for varicose vein removal.
A Related Complication: Venous Stasis Ulcers
Symptoms of venous insufficiency can worsen over time if left untreated. If as swollen veins exert pressure on the surface of the skin, skin can begin to break down due to the relentless tension, resulting in venous stasis ulcers.
Venous stasis ulcers can be a severe consequence of not seeking medical treatment for venous insufficiency. These skin ulcers result when intense vein swelling breaks down the skin. Venous stasis ulcers actually can become infected. If the ulcer reaches the bone, amputation may be necessary.
If venous stasis ulcers are evident during the patient's initial medical evaluation, a John C. Lincoln specialist will refer the patient to a staff podiatrist who has expertise in wound care.