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Don’t Ignore Leg Pain


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Pain in the leg while walking or resting could be due to a vascular problem and should not be ignore, warns Doctors, Vascular Surgeon.

 Doctors say that most of us ignore the pain or take some pain killers to get momentary relief. “But such recurrence of leg pain to be ignored as it could be due to an underlying vascular problem. The vascular disease is caused due to blockage of artery to the leg. It is caused by deposition of fat within the arterial wall. This reduces blood supply to the leg and causes pain and other problems,” he says.

 Doctors say that about 25 to 30 patients are diagnosed as suffering from vascular disease in a month. He says that a lot of patients diagnosed with vascular disease come to him late. By this time, gangrene has set in. This results in necrosis of the tissue.

The symptoms of vascular disease are pain on walking, which is relieved by rest, pain on walking, which is relieved by rest, pain preventing a person from sleeping at night, pain in legs, hips and buttock, pain when lying down or when legs are elevated, change in complexion of legs and feet, brittle toe nails, blue or purl toes, hairless toes, legs and calves, wounds between toes or on the ankles.

“If the pain gives a person a sleepless night, he could be in danger of losing his leg. This condition should be brought to the notice of a vascular surgeon immediately,” he says. A number of tests can ascertain if the pain is vascular. The color Doppler or ultrasound of the leg arteries is necessary to indicate and finding out if collators will be able to take the increased blow flow after surgery.

While DVT is common after prolonged immobilization like long journeys and after injuries to the leg following accident or surgery, women are more prone to it during pregnancy.

Millions have big dilated, visible veins in their legs known as varicose veins. You do not care if they are unsightly as they are invisible below our clothes. Your legs ankle swelling and ache towards the end of the day but this pain and swelling goes away at night when you elevate your legs. At times you have pain on touching these prominent veins. But you can cope with all these minor symptoms and have done so for years. What is the fuss about?

 

Yes! At present you have minor problems but as time passes there is bound to be discolouration just above the ankle that slowly will lead to distressing weeping ulcer which is not only very uncomfortable but needs daily dressing. It alters your life style. Should some injury take place over the dilated veins, they bleed like a tap and scare the patient, who lands up in the casualty. Why have you to wait for these complications to occur? You have to get it sorted out one day, so why wait for the scary events to happen?

 

You must see your doctor or the Vascular Surgeon when you have time. Your Vascular Surgeon will examine you and conduct a bed side ultrasound to know if the cause is due to weakness of the valves in your veins or is it the weakness of the vein wall that is responsible for these ugly looking veins. Having established the basic cause he will advise you the treatment.

 

This is the price man pays for his erect posture. When we stand, the ankles take all our weight. In a normal person, on standing, the weight of blood is transmitted to the ankle but the valves break the column of blood into small compartments and reduce the pressure at the ankle. However when the valves are spoilt the weight of the entire blood column is transmitted to the ankle (which is increased more than 10 fold). This is responsible for all the distressing complications like profuse bleeding, discolouration and ulcers. Thus the basic treatment of varicose veins is to reduce this abnormally high pressure at the ankle. There are three forms of treatment universally accepted.

 

1.     Just wear stockings.

2.     Injection treatment into the veins – sclerotherapy.

3.     Operative treatment

 

Of course stockings look the best option for the patient as it avoids surgery. Sure it reduces the pressure at the ankle, which is the main purpose, but they have to be worn life long, despite the seasonal variation, even during the hot Indian summer. They also are found to delay the inevitable ulcers but not prevent them. You are only buying time.

 

Injection therapy (sclerotherapy) is very commonly conducted in the OPDs. This does not need admission and involves multiple needle pricks over the dilated vein using a sclerosing agent. This brings on a chemical reaction within the vein at the site of the injection leading to a blockage. This has its limitations as it may not succeed in cases with strong reflux, which is commonly the case. It is used in case of spider veins, recurrent veins after previous surgery, isolated veins not connected to the main systems. It may be used in aged and non-surgical candidates.

 

Surgery is commonly advised, in cases with venous reflux, as it is effective. There may be a perforator that has to be identified by a Doppler pre-operatively. A tiny incision is made at the site and the involved vein removed. Should the main veins be involved then tying of the main vein with all its branches is done. The vein is stripped till the knee. Then below knee dilated veins are ligated by multiple stab incisions.  The whole process is cosmetic with tiny cuts hardly visible.

 

Surgery is conducted by making legs numb by an injection in the back. Hospital admission is for 48 hours and no bed rest is needed after surgery. The patient can go back to work on the third of fourth day with discomfort which is easily borne by most. This is the most commonly followed method all over the world as it is effective.

 

Thus to conclude varicose veins are a common problem all over the world and are neglected as complications take years to present. Most people wait for this stage when it starts to become distressing. Why? Make life comfortable for yourself by getting it treated early when the results of surgery are better and you are permanently cured. People are concerned about recurrence. How can a vein removed from the body by stripping recur? It may occur at another site, which anyway would have occurred in time.

 

 

Dermal Varicose veins

 

 

Tiny 4-5mm cuts to take out the veins.  Four months later no cuts visible

Dilated varicose veins.                      After surgery – High tie and stripping

 

Ulcer due to varicose veins. Much reduced after 5 weeks treatment.

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Rajnish kumar Article's Source: http://articles.org/don%e2%80%99t-ignore-leg-pain-2/
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  • Posted On January 24, 2012
  • Published articles 4

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