Home » Feature, Health & Wellness

Why Do My Legs Ache?

Author: Jane M. Lingelbach, MD 19 June 2010 No Comment


Why do I have varicose veins?

Why do my legs swell?

Why do I have unsightly spider veins on my legs?

Why do my legs ache?

The answer to all of these questions may be the same: gravity. Gravity brings us down, literally. The force of gravity holds us down to earth; the force of gravity causes rain to fall to the ground. If you drop a marble from a bridge, three seconds later, it is falling towards the earth at over 30 mph. This same force is constantly pulling down on the blood in your veins.

Imagine five barrels of water sitting in a line. If you dunk your head into any one of the barrels, you feel a little pressure from the water on your ears. Now imagine plunging deeper into that barrel. With your head at the bottom, your ears will feel more pressure from the water. You feel more pressure at the bottom because of all the fluid above pressing down.

Next, imagine stacking all five barrels on top of one another. The pressure at the bottom of the lowest barrel is still essentially the same as the pressure at the bottom of the highest barrel. That’s because each container of water is separated from the others. At the bottom of the lowest barrel, you feel only the pressure of the fluid bearing down within that one container. But if we punch down though the stack of barrels, we now have a single tall column of water. The water at the bottom of the lowest barrel now feels the pressure from all of the fluid in all the barrels above. The pressure at that point is five times higher than when the barrels were intact and separated.

In much the same way, the column of fluid which is the blood in your leg veins is separated by a series of valves interspersed along the vein. These valves, when working correctly, prevent the pressure of the column of blood from communicating down through the vein to the feet and ankles. In the circulatory condition called venous insufficiency, these valves fail. As venous insufficiency develops, the increased pressure of the blood pushes down through the veins below which begin to bulge and ache.

Venous insufficiency can present with varicose veins, spider veins, swelling and aching discomfort. Patients with venous insufficiency may complain of aching, fatigue, itching or restless legs. Symptoms worsen with increased time on your feet, and are typically worst at the end of the day. Relief is obtained with leg elevation, support stockings, or sometimes even pain medication. Because symptom onset is gradual, this disease may take decades to become apparent. Over time, venous insufficiency will lead to tissue damage, including dermatitis and ulceration. As blood is not flowing properly in the involved veins, the varicosities may clot, causing phlebitis, or they may rupture and bleed. Additional risks of untreated venous insufficiency include deep venous thrombosis and pulmonary embolism, a potentially fatal event. All too often, patients and physicians alike defer seeking care.

 “Spider veins” or telangiectasias can be an early sign of venous insufficiency that appear when tiny skin veins, previously invisible, become engorged and enlarge. Maryland Vein Professionals evaluates many patients who present to us for treatment of spider veins which they have had previously “treated,” only to see reappearance after many months. Some patients who have undergone only superficial, cosmetic treatments of spider veins exchange the veins for dark blotches in their skin. The underlying problem, venous insufficiency, was never treated. A careful ultrasound evaluation performed and interpreted by a vein care specialist can identify this underlying problem, showing a pattern of venous insufficiency in the leg veins.

In the great majority of people, the problem of venous insufficiency can be easily treated. An outpatient treatment called the ClosureÒ Procedure uses radiofrequency energy to close the malfunctioning or “leaky” veins which are the source of the problem. This eliminates the major cause of the symptoms of venous insufficiency. During the ClosureÒ  Procedure, a tiny catheter placed into the leaky source vein through a small puncture into the skin delivers a form of light energy to the vein wall. This energy causes collagen in the vein to change shape, closing the blood flow channel in the vein. This elegant procedure is completed in minutes with minimal or no discomfort, less than two hours time in the office is typically required, and people return to work or normal activity the same day.

ClosureÒ  is covered by most all insurances and is performed in the office setting. Clinical studies have shown outstanding safety, efficacy, and patient satisfaction. Patients are delighted with symptom relief and cosmetic improvement, and 98% say they would recommend Closure for a friend.

Please visit our Website, www.MDVeinProfessionals.com  for more information, including over 100 patient testimonials and before and after images. Call us at 410-964-VEIN (8346) or 877-7MD-VEIN for a complimentary screening evaluation.

Additional posts by Jane M. Lingelbach, MD