Have you ever experienced pain in your calf muscle when walking or a burning sensation in your feet at night when lying in bed? Ever experienced throbbing or aching in the legs when standing that is associated with prominent varicose veins, spider veins, or swelling of the ankle? There may be a vascular reason for your symptoms, and an evaluation by a vascular surgeon could be essential.
Many people in our community have never heard of a vascular surgeon and if they have are unclear on what our role is in the medical community. Often people do not realize the importance of vascular surgeons until referred to one by their primary care physician.
As vascular surgeons, one of the most common reasons for referrals to us is to identify whether or not there is a vascular cause for symptoms patients are feeling in their legs that may be negatively affecting their lifestyle. In general, there are two main vascular explanations for bothersome leg symptoms.
The first possible explanation is an arterial issue. Arteries carry oxygenated blood to the legs and feet, driven by the heart. As we get older, we tend develop atherosclerotic disease, which is the buildup of plaque in the lining of the arteries. My grandmother used to refer to this as “hardening of the arteries.” As a vascular surgeon evaluating someone for an arterial cause of leg pain, we first obtain a full history and physical, looking specifically at risk factors such as diabetes, high blood pressure, a history of tobacco use, coexisting heart disease, high cholesterol, or a family history. We then proceed with our most valuable tool, noninvasive ultrasound studies. These images help to determine whether or not the patient's arteries are narrowed or blocked and whether or not his or her body has compensated for the blockage by forming new blood vessels around these areas; a sort of natural bypass.
The second possible explanation we consider as a cause of leg pain that could be inhibiting one’s lifestyle is venous disease. Venous reflux disease is very common, four times more common than arterial disease. We see this condition in a wide variety of patients who come to us for answers including older adults and people who are on their feet for long periods like teachers, nurses, factory workers, food service personnel, and even avid runners. Venous reflux disease occurs because we do not have a pumping heart for the venous side of the circulation. Human beings would not suffer the effects of venous conditions if we had small hearts in our ankles pumping venous blood up the leg against the effect of gravity.
Inside our veins are one-way check valves that prevent the venous blood from pooling in the leg due to gravity. These valves are located about every inch in our leg veins and are supposed to close when we stand up to prevent gravity from causing our venous blood to pool in the legs. These check valves have the consistency of a jellyfish, and over time, they weaken and start to leak. When they start to leak, the venous blood pools in the leg and causes painful and unsightly varicose veins, ankle swelling, skin changes, and even ulcerations or wounds on the skin of the ankles. We specialize in both diagnosing and effectively treating this condition as well.
The diagnosis for this condition includes a history and physical and a detailed venous ultrasound where we specifically look for any leaky valves. This is a more extensive venous ultrasound compared to an ultrasound performed in the hospital setting, where the medical staff are simply seeking to identify the presence or absence of a life-threatening blood clot called a deep vein thrombosis or DVT. Ruling out a blood clot as a cause of swelling is extremely important, but often there is no blood clot, and people go home wondering what is causing the swelling. At The Vascular Experts, we have the expertise to both accurately diagnose and effectively treat the cause of the problem.
As a practicing board-certified vascular surgeon in our local community for the last 13 years, I have found that leg symptoms that have a vascular source can have a profound effect not just on a person’s lifestyle but on his or her mental health as well. Just to clarify, we are not leg pain doctors but rather we are board-certified vascular surgeons who evaluate for a vascular cause of leg pain, treat that cause, and get you moving again, enjoying your life.
The Vascular Experts is the largest independent group of board-certified vascular surgeons in the country with offices across Connecticut and affiliated practices in New York, Massachusetts, and Rhode Island. To learn more about conditions we treat or to schedule an appointment with Dr. Bauer, visit TheVascularExperts.com or call (844) 482-7285.
