The Lowdown on Vascular Leg Pain


If you are like most of us, you may find yourself with tired, achy, painful legs at some point. Maybe it’s an occasional problem that happens after a lot of strenuous activity, or maybe it’s an issue that bothers you daily. There are so many potential causes of leg pain, it can be hard to know where to start to get answers.
There are two very specific types of leg pain that can be evaluated and treated by a vascular surgeon. Don’t let the name scare you; many types of vascular leg pain can be managed without surgery.
The first type of leg pain vascular surgeons manage is related to veins. When the veins in our legs do not efficiently pump blood back to the heart, it can cause swelling, achiness, heaviness, and pain, which are worse in the evening after you’ve been on your feet all day. You may also notice bulging varicose veins on your legs. The most severe manifestation is nonhealing ulcers, usually around the ankles or lower calves. Venous insufficiency can be diagnosed with a special type of ultrasound. Depending on the type, we will typically have you try compression stockings and elevation before discussing invasive treatments.
The second type of leg pain that vascular surgeons manage is related to the arteries. Arteries carry oxygen and nutrient-rich blood away from the heart to the rest of the body. Problems can arise when the arteries develop blockages. This is most often a result of high blood pressure, high cholesterol, smoking, and family history. The blockages can cause pain that occurs after walking and gets better with short periods of rest. Once the blockages become more severe, they can cause pain in the feet, even without exercise, and eventually wounds that have difficulty healing. This is called peripheral vascular disease and can also be diagnosed with a special ultrasound or sometimes a CAT scan. The blockages are the same blockages that can form in your heart, causing a heart attack. It makes sense, then, that the initial treatments are the same. A program of daily walking can help tremendously! Quitting smoking is critical and there are many techniques out there to help with this. We generally recommend an aspirin every day, as long as it is okay with your primary care provider. There are also certain medications that can help. If your peripheral vascular disease is severe or limiting your lifestyle greatly, there are many things we can do to help. Oftentimes, a minimally invasive angioplasty or stent is enough, with open surgery being reserved for more extensive blockages.
If you are concerned that your leg pain is being caused by vascular disease, bring it up with your primary care provider. They can examine you, order simple testing, and provide a referral to a vascular surgeon for further treatment if necessary.
Dr. Chesley Lewis is a board-certified vascular surgeon, specializing in open and endovascular treatment of peripheral arterial disease (PAD), aortic and peripheral aneurysms (AAA), varicose vein treatment, dialysis access, and more. To make an appointment with the SolutionHealth Vascular Center at The Elliot, call 603-627-1102.

This article was originally published in the Summer 2021 edition of Your Wellness Solution