Leg Pain and Swelling

Leg swelling (edema) generally occurs because of an abnormal accumulation of fluid in tissues of the lower extremities. Common causes of leg swelling include salt retention, cellulitis, congestive heart failure, venous insufficiency, pregnancy, and medication side effects. Less common causes of leg swelling include blood clots in the leg (deep vein thrombosis), parasite infection, lymphedema, liver disease and cirrhosis, kidney disease and nephrotic syndrome, broken ankle, broken leg, and diseases that cause thickness of the layers of skin, such as scleroderma and eosinophilic fasciitis. In these diseases, the leg swelling is typically characterized by non-pitting edema. When leg swelling occurs for unknown reasons, it is referred to as idiopathic edema.

Symptoms that can be associated with leg swelling include leg pain, numbness, redness, itching, rash, shortness of breath, and ulceration of the skin.

Generally, leg pain is a result of tissue inflammation that is caused by injury or disease, which can cause inflammation to any of the tissues of the leg and lead to leg pain. Since the leg contains a number of different structures and tissue types, a wide variety of conditions and injuries can cause leg pain.


Venous Disease / Venous Insufficiency

Veins carry oxygen-poor blood back to the heart after it has delivered essential nutrients to our body’s tissues. They have one-way valves every few inches that help keep blood flowing in the right direction. If these valves leak or become blocked, some blood may flow backwards and pool in the vein. Blood pressure rises and the vein weakens under the additional strain so that its elastic walls balloon outward. Any of the body’s veins may be affected by venous disease, including the superficial veins just beneath the skin, the deep veins near the bones, and the perforating veins that carry blood between the two.

Also called venous insufficiency, venous disease can result in a number of cosmetic disfigurements and health problems, from spider veins and varicose veins to blood clots and skin ulcers. Common symptoms include swelling and discomfort as well as skin discoloration, skin thickening, spider veins at the ankles, and leg ulcers.

Blood tests, ultrasound, CT, MRI and venograms (X-ray exam with contrast dye) may be used to examine the veins for signs of disease. Conservative treatment typically involves a combination of leg elevation and compression stockings to improve blood flow. Blood thinners may be given to treat or prevent blood clots, although these drugs may themselves damage the valves and raise blood pressure. Surgical options include varicose vein removal for superficial veins; sub fascial endoscopic perforator surgery (SEPS) for perforating veins; and valve repair, valve transplant from the arm veins, and vein bypasses for deep veins.
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