Listen to Your Legs

At some point, nearly every adult woman will have some leg complaints: varicose or spider veins; swelling or aching; muscle cramps; hip, knee or ankle pain. While these symptoms are common, they are not "normal" and they deserve medical attention. For example, nearly one-third of Americans over the age of 45 have some form of peripheral vein disease. While the early symptoms may seem benign, major problems may develop if they are ignored. Clues to serious problems may come from listening to your legs: if you have any of the following symptoms, you may be suffering from circulation problems. These symptoms are particularly problematic for anyone with risk factors for venous compromise: pregnant women; people who smoke; people who have high blood pressure; people who are overweight; people who have diabetes; people who have a sedentary lifestyle; people with a family history of vein disease; women who take birth control pills or estrogen therapy; or people who have already been told that they have circulatory problems. Your legs take you everywhere else: if they are complaining of these symptoms, let them take you to your doctor.

1. Tired, heavy-feeling legs. We have all had tired, heavy-feeling legs after a day at an amusement park.  However, if your legs consistently feel tired and heavy in the evening, this may indicate that your return blood flow from the legs to the heart is impaired.   While gravity is the cause, weakened veins are the culprit. The result is oxygen-depletion in your legs, giving you that heavy, tired feeling.
   


2. Leg pain from prolonged sitting or standing. In addition to getting you going, your leg muscles massage your veins and get your blood going!  During prolonged periods of sitting or standing, your blood may collect in your legs and ankles. The leg veins stretch easily and may become enlarged by the pressure of the pooled blood. This can cause a dull, aching pain.  While this isn't normal or acceptable, it's not an emergency.  On the other hand, if you experience pain that is sharp or continuous, contact your doctor or go to an emergency room immediately. You may have a very serious condition called deep vein thrombosis (DVT), a blood clot in the central vein in your leg.   This is the condition responsible for "Economy Class Syndrome" in which passengers cramped in coach class on lengthy airplane flights have developed DVT's.
   


3. Swollen ankles at night. Thick, swollen ankles are signs that blood is pooled in the leg veins. Over time, damaged vein walls can become even more stretched out and permeable, allowing fluid and protein to filter from the veins into surrounding leg tissue, which worsens the swelling. When you lie down, gravity's pressure is equalized across your leg, which is why swelling usually resolves overnight.  This is more common in pregnancy, but just because it's common, doesn't mean it's normal.
   


4. Swollen knees. Swelling in the knee area is never normal.  Swelling in the joint may indicate a knee problem or may also indicate a form of arthritis.
   


5. Varicose or spider veins. These are also more common during or after pregnancy.  While common, they are usually viewed as a cosmetic problem.  Yet they may also be symptoms of vein disease.  During pregnancy, the amount of blood in the body greatly increases, stretching your veins beyond their normal capacity. Even though varicose veins, swelling and pain often resolve after childbirth, the damage done to veins during pregnancy is permanent and may cause problems later.
   


6. Tingling, numbness, burning or cramping in legs and feet. Since vein disease can cause serious circulation problems, your lower legs and feet may not be getting the oxygen they need. In essence, they may be "falling asleep" more often than usual, or you may be suffering from muscle cramps. Numbness or tingling in the legs may also indicate spinal or nerve problems which require further evaluation.
   


7. Skin Discoloration. When the deep veins are unable to carry the blood back toward the heart efficiently, this is called chronic venous insufficiency. Over time, leakage of blood into the area surrounding the veins can cause tissue to die, darkening the skin.
   


8. Open sores or ulcers on the lower leg. When chronic venous insufficiency reaches its most serious point, ulcers may appear on the lower leg. These are the result of blood leaking into the leg tissue and damaging the skin. These open sores are often very difficult to heal, especially in people with diabetes.
   


9. Family History of vein problems. There are many different causes of vein disease, but the main one is genetics. This condition often runs in families.  Those with a family history of venous disease should take particular preventive precautions and treat any problems which arise earlier in order to avoid potentially serious complications.
   


10. Pain or swelling over a bone. Pain or swelling over a bone is a fracture until proven otherwise.  While fractures in the various bones of the hips and legs usually result from some sort of trauma (most commonly falls), it is important to look for osteoporosis in a woman with a fracture that is disproportionate to the extent of trauma, especially if she has risk factors for osteporosis.  Osteoporosis can be diagnosed with a non-invasive bone density test. 
    

Created: 9/12/2005  -  Donnica Moore, M.D.