I am having pain in my legs. What could be wrong with me ?
To answer this question we have to concentrate on the type and source of pain.
Arterial or vascular pain
This is due to inadequate supply of oxygenated blood to the tissues, due to narrowing of vessels to the limb. It can be due to many factors, including, smoking, genetics, diabetes, hypertension and excessive lipids in the blood.
If arteries in the abdomen are narrowed, pain is experienced in the buttocks. Narrowing of the vessel in the thighs and legs can cause pain in the thighs, legs and feet. Particularly after walking; feeling like a charley horse in the limb. It is worse when walking uphill and is relieved by rest.
Pain due to venous insufficiency
Or poorly functioning valves in the veins. This could be due to stagnation or deoxygenated (low oxygen) blood in the tissues of the lower extremity. This is characterized by vague night cramps in the thigh and calf muscles or burning and stinging in the skin or superficial tissues due to varicose or spider veins.
Clots in the deep veins are associated with swelling and calf tenderness on movement of the foot, which requires urgent medical attention.
Presence of a clot in the superficial veins (phlebothrombosis) causes localized tenderness in the segment of the vein, as well as inflammation of the skin.
Patients with venous insufficiency may have ankle swelling, skin pigmentation or eczema, loss of hair, hardening of skin and ulceration of lower legs and ankles.
Pain due to musculoskeletal system (joints, bones and tendons)
This is a degenerative disease due to wear and tear of these structures and is commonly associated with the aging process or trauma. Although other diseases like rheumatoid arthritis, autoimmune or collagen disorders could be responsible.
Pain of neurogenic origin, spine, nerves and sometimes, the brain
The most common causes are due to degenerative disease of the spine which can cause pressure on the spinal column or nerve roots, causing radiating pain to the limb along with disturbing the relevant verve supply.
Another common cause of pain particularly in the legs and feet is due to neuropathy. That is damage to the nerve sheathes, which can cause the sensation of pins and needles in the feet. This condition can be caused by diabetes, drugs and other factors.
Included are chronic pain syndrome, myositis and phantom pain which are not well understood.
To diagnose and treat these problems requires a detailed history and in-depth physical examination, relevant tests including ultrasound doppler studies, blood tests, x-rays, CT and MRI scans, and finally the appropriate treatments.
Dr. Hormoze a. Goudarzi is celebrating 32 years of surgical service to the community.
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