Q: I don’t recall ever reading one of your articles about venous congestion in the legs. If you have any information, could you please write about it? I’ve appreciated your many articles during the years and have learned a lot about various subjects. Thanks.
A: Venous congestion is a dilation of veins and capillaries that results from impaired drainage. Affected tissues will be bluish in color because of red cell stasis and the accumulation of deoxygenated hemoglobin. Venous disease is quite common, with approximately 15% of the adult population affected. Mild conditions are generally not a problem; however, as the disease worsens, it can become major. Normally, arteries carry oxygen-rich blood from the heart through the body. Veins then return that blood to the heart for re-oxygenation. The veins in our bodies have one-way valves that keeps blood flowing to the heart. Healthy muscles contract and blood surges forward. When those muscles relax, the valves close, preventing blood from flowing backwards When veins become weakened or damaged for a variety of reasons or if the valves are injured, the system no longer works as it should and blood begins to flow backward as muscles relax.
The legs have three types of veins – superficial, communicating and deep. The superficial veins are located just under the skin and carry up to 15% of the blood in the legs. These superficial veins drain into communicating veins that drain into deep veins. Those deep veins are inside the muscles and carry 85% of blood back to the heart. This results in greater pressure in the veins that causes additional stretching and swelling. It’s the abnormal veins that create the disorder known as venous disease, examples of which are spider veins, varicose veins, phlebitis, chronic venous insufficiency, and more. Risk factors for venous disease include the use of some medications, obesity, prolonged periods of standing or sitting, a family history, prior history of blood clots in the veins, trauma, and more.
When the condition is long-standing, it can advance to chronic venous insufficiency that is the result of chronic pooling and congestion caused by those leaky veins, from chronic venous obstruction, or from phlebitis. Treatment is directed toward relieving the edema and pain involved. When venous disease becomes severe, venous stasis ulcers, phlebitis, superficial thrombophlebitis, deep vein thrombosis, and other conditions can occur and even minimal trauma can be difficult to treat.
Two of the most common causes of leg pain and venous congestion are obesity and because of prolonged sitting or standing which can cause a buildup of fluid in leg veins. The pain can resemble a burning sensation or severe cramping that often presents in the calf area. If you find you fall into one of these categories, get up and move around periodically, consider a weight reduction program, wear compression hose, keep your legs elevated above your heart for 15 to 20 minutes whenever possible, and eat nutritional meals. Plan to visit your primary care physician who can order testing, provide options to lower any problems, and get you back on the road to recovery. There could be something serious going on that isn’t being addressed, so make an appointment soon. You’ll be glad you did.
Readers who would like related information can order Dr. Gott’s Health Report “Managing Chronic Pain” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order payable to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
