Leg Pain : What to do ?

Dr KK Pandey *

Quite often you would have heard your friends, neighbours and relatives complaining of pain in legs and feet. Pain as they would say used to start as soon as a person started walking and it did disappear suddenly the moment he stopped walking then to reappear once again at the start of walking.

Sometimes old people complain of pain in their feet. There are some people whose leg pain disappears the moment they start walking,but it increases in intensity once they take rest.If you are a diabetic or a smoker or addicted to tobacco-products like Zarda Paan Masaala, Khaini, Chaini, Zaafraani Patti and also at the same time suffering from pain in leg or foot, beware you might lose your leg sooner or later.

Most often people have a myth that there is no connection between diabetes and leg as they think diabetes is supposed to affect only heart and kidney. In the same way smokers think that smoking affects lung only and causes cancer. But people are not aware that among smokers and chronic users of tobacco products, the danger of gangrene always looms large at their feet. It is doubly dangerous for a diabetic to smoke.

Diabetes and smoking if combined together will definitely destroy the feet eventually. Therefore these two factors must be controlled to keep your legs and feet healthy and active.

After all why there is pain in leg and feet?

In our country the most important cause of pain in leg and feet is the disease of blood pipes (arteries) of leg. These arteries constantly supply pure oxygen-rich blood to legs so that these legs and feet can function smoothly and at any given time can increase quantum of blood supply to legs manifold, if need for more oxygen arises during vigorous and long walk or running.

When these blood pipes (arteries) due to any reason are not able to supply blood adequately to leg muscles, pain will start in leg during walking or during any vigorous leg activity or excercise as these will increase the sudden demand of pure oxygenated blood , but a diseased and narrowed artery will then not be in a position to fulfil the demand of adequate blood supply.

Diabetes and Smoking are the biggest reason of leg Pain

There are various reasons of artery (blood pipe) not working properly for example diabetic disease leads to decrease in flow of pure blood as in diabetes there is slow but progressive deposition of cholesterol and calcium in the wall of the artery.The other reason of disease of artery is smoking and tobacco chewing.

Tobacco has a chemical compound called nicotine which causes narrowing of small arteries of leg resulting into considerable decrease in blood flow. If a person who is diabetic and smoker both starts pain in the leg,one must immediately consult a vascular surgeon and get your arteries investigated.

Disease of vein is too important cause of leg pain

The second most common cause of leg pain is the disease of vein. When pure blood supplied by arteries to the leg,get depleted of oxygen after supply and thus becomes impure, the impure blood has to go to lung for replenishment of oxygen through special blood pipes called Veins.

In other words, veins constitute the drainage system of leg and feet. When due to any reason, veins are unable lift the impure blood upwards towards lung., the impure blood begin to collect in the leg and feet. When a person with diseased veins of leg start walking, the increased amount of impure blood gets collected in the leg.

With the result aperson thus feels pain and fatigue in the leg. One of the most important diseases of veins is the disease of C.V.I.(Chronic venous insufficiency). In this particular disease the impure blood does rise upwards towards lung, but due to weakness of valves inside the vein, the most of the blood that has gone upwards comes down again in the lower part of leg, this is the exact reason why more accumulation of impure blood in the leg.

Varicose Veins of leg also cause leg pain

The other important reason of leg pain is the disease of varicose veins of leg. Varicose veins now-a-days in modern times is damaging the legs.As new avenues of comfortable and sedentary life style are emerging, so is being manifested varicose veins in various forms.These varicose veins in the early stage look like a blue-coloured spider like net which are present initially on the back of thigh and knee joint.

If these varicose veins are not handled properly in initial stage,this will result into an unpleasant sight and dark black spots or patches or non healing ulcers will develop. If a person develops pain and heaviness in leg after sitting for a long time and blue colored veins become visible on leg and foot, never waste time in consulting a vascular surgeon.

Deposit of blood clots in veins too can cause leg pain

The third reason of leg pain is the clogging of blood clots inside the veins of leg. This leads to blockage of most of the leg veins.This impedes the process of upward flow of impure blood.In our country,due to negligence and improper treatment these blood clots make their permanent home inside the vein.

This causes constant pain in the leg and along with pain there appears a swelling in feet also. Therefore any person suffering from leg pain should consult a vascular or acardiovascular surgeon.

Vitamin “D” deficiency also causes leg pain

Due to sedentary and indoor life style,people are getting almost no exposure to sunlight everyday. Whatever sunlight one has is not enough. If a person’s body is not exposed to sunlight daily at least for 2-3 hours, he will develop deficiency of vitamin D in blood.

Absence of adequate amount of vitamin D in blood will lead to severe leg cramps, pain and leg swelling,because in such situations leg muscles do not work properly and there is always a possibility of bone fracture of leg even with minor injury. Maintaining an average level of vitamin D in blood is very essential for overall health of body including leg.

Other reasons of leg pain

Sometimes in old age ,legs develop ”muscle cramps”especially during night time and sometimes severe pain. Sometimes due to osteoarthritis or inflammation of covering membranes of knee joint such as synovitis cause leg pain during walking. Sometimes leg pain is caused by sciatica.

Where to go in leg pain ?

If you have a complaint of leg pain, consult a vascular surgeon and get examined and investigated for leg arteries and veins. Specialized investigations like Doppler study, MR venogram, CT peripheral angiography are required for detailed evaluation.

Therefore go to a hospital where the facility for such investigations are available and a full-time vascular surgeon is available because on the basis of clinical assessment and the result of such specialized investigation, further treatment plan is decided. It is advisable to consult promptly a vascular surgeon as soon as pain in leg starts, otherwise condition may become worse later on.

If diseased arteries and decreased blood flow are responsible for leg pain, a variety of treatment modalities are applied like reconstruction of artery, arterial bypass and angioplasty and stenting. If the disease of vein is responsible for leg pain, venous valve reconstruction ,laser or radio frequency ablation treatment or venous bypass surgery are done.

In most of the diseases of veins, other nonsurgical treatment like graduated compression stockings,pneumatic compression devices and some special leg excercises are very helpful. When these measures fail, surgery becomes the natural choice.

In case of arthritis of joint,some special excercises,physiotherapy and some special excercises, physiotherapy and some medication and life style modification definitely helps.

* Dr KK Pandey wrote this article for The Sangai Express
The writer is Senior Vascular & CardioThoracic Surgeon, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi and can reached at drpandeyin(AT)yahoo(DOT)com
This article was webcasted on 26th August, 2019.

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