Symptoms

Leg Pain Swelling Restless Legs Ulcers

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Leg Pain

Common causes of cramps include:

• Dehydration or low amounts of potassium, sodium, calcium, or magnesium in the blood
  
• Medications such as:
  • Diuretics, which can cause you to lose too much fluid or minerals
    
  • Statins, which lower cholesterol and can cause muscle injury
• Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time

An injury can also cause leg pain from:

• A torn or overstretched muscle (strain)
  
• Hairline crack in the bone (stress fracture)
  
• Inflamed tendon (tendinitis)
  
• Shin splints -- pain in the front of your leg related to overuse or repetitive pounding

Other common causes of leg pain include:

• Atherosclerosis that blocks blood flow in the arteries (this type of pain, called claudication, is generally felt when exercising or walking and relieved by rest)
  
• Blood clot (deep vein thrombosis) from prolonged bed rest
  
• Infection of the bone (osteomyelitis) or skin and soft tissue (cellulitis)
  
• Inflammation of the leg joints by arthritis or gout
  
• Nerve damage -- common in diabetics, smokers, and alcoholics (symptoms include numbness, tingling, or a sensation of pins-and-needles)
  
• Varicose veins

Less common causes include:

Benign tumors or cysts of the femur or tibia (osteoid osteoma)
Drugs such as allopurinol and corticosteroids
Legg-Calve-Perthes disease -- poor blood flow to the hip that may stop or slow the normal growth of the leg
Malignant bone tumors (osteosarcoma, Ewing sarcoma)
Sciatic nerve pain (radiating pain down the leg) caused by a slipped disk in the back.
Slipped capital femoral epiphysis -- usually seen in boys and overweight children between 11 and 15 years old

Home Care

If you have leg pain from cramps or overuse, take these steps first:

• Rest as much as possible.
  
• Elevate your leg.
  
• Apply ice for up to 15 minutes. Do this 4 times per day, more often for the first few days.
  
• Gently stretch and massage cramping muscles.
  
• Take over-the-counter pain medications like acetaminophen or ibuprofen.

For leg pain caused by varicose veins, leg elevation and compression with elastic bandages or support hose can help.

For leg pain caused by nerve disorders or claudication, control diabetes, eliminate alcohol and tobacco, and avoid ill-fitting shoes.

Prevention

To prevent claudication and nerve damage:

• Don't smoke or use tobacco.
  
• Limit how much alcohol you drink.
  
• Keep your blood sugars under good control if you have diabetes.
  
• Reduce other heart disease risk factors, including high cholesterol and high blood pressure.

To prevent overuse injuries, like shin splints, muscle cramps, and other causes of leg pain:

• Warm up before physical activity and cool down afterward. Be sure to stretch.
  
• Drink plenty of fluids throughout the day, especially before, during, and after exercise.

 

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Swelling

Foot, Leg, Ankle Swelling & Throbbing

Painless swelling of the feet and ankles is a common problem, particularly among older people.
Abnormal buildup of fluid in the ankles, feet, and legs is called peripheral edema.

Considerations

Painless swelling may affect both legs and may include the calves or even the thighs. Because of the effect of gravity, swelling is particularly noticeable in the lower part of the body.

Causes

Foot, leg, and ankle swelling is common with the following situations:

• Prolonged standing
  
• Long airplane flights or automobile rides
  
• Menstrual periods (for some women)
  
• Pregnancy -- excessive swelling may be a sign of preeclampsia, a serious condition sometimes called toxemia, which includes high blood pressure and swelling
  
• Being overweight
  
• Increased age
  
• Injury or trauma to your ankle or foot

Swollen legs may be a sign of heart failure, kidney failure, or liver failure. In these conditions, there is too much fluid in the body.

Other conditions that can cause swelling to one or both legs include:

• Blood clot
  
• Leg infection
  
• Venous insufficiency (when the veins in your legs are unable to adequately pump blood back to the heart)
  
• Varicose veins
  
• Burns (including sunburn)
  
• Insect bite or sting
  
• Starvation or malnutrition
  
• Surgery to your leg or foot
  
• Blockage of the lymph nodes in the legs (lymphatic obstruction)

Certain medications may also cause your legs to swell:

• Hormones like estrogen (in birth control pills or hormone replacement therapy) and testosterone
  
• Blood pressure medicines called calcium channel blockers (such as nifedipine, amlodipine, diltiazem, felodipine, and verapamil)
  
• Steroids
  
• Antidepressants, including MAO inhibitors (such as phenelzine and tranylcypromine) and tricyclics (such as nortriptyline, desipramine, and amitriptyline)

Home Care

• Elevate your legs above your heart while lying down.
  
• Exercise your legs. This helps pump fluid from your legs back to your heart.
  
• Wear support stockings (sold at most drug and medical supply stores).
  
• Follow a low-salt diet, which may reduce fluid retention and swelling.

Prevention

Avoid sitting or standing without moving for prolonged periods of time. When flying, stretch your legs often and get up to walk when possible. When driving, stop to stretch and walk every hour or so. Avoid wearing restrictive clothing or garters around your thighs. Exercise regularly. Lose weight if you need to.

 

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Restless Legs Syndrome

Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move them for relief. Individuals affected with the disorder describe the sensations as burning, creeping, tugging, or like insects crawling inside the legs. The sensations range in severity from uncomfortable to irritating to painful.

Is there any treatment?

For those with mild to moderate symptoms, many physicians suggest certain lifestyle changes and activities to reduce or eliminate symptoms. Decreased use of caffeine, alcohol, and tobacco may provide some relief. Physicians may suggest that certain individuals take supplements to correct deficiencies in iron, folate, and magnesium. Taking a hot bath, massaging the legs, or using a heating pad or ice pack can help relieve symptoms in some patients.

Physicians also may suggest a variety of medications to treat RLS, including dopaminergics, benzodiazepines (central nervous system depressants), opioids, and anticonvulsants. In 2005, ropinirole became the only drug approved by the U.S. Food and Drug Administration specifically for the treatment of moderate to severe RLS.

What is the prognosis?

RLS is generally a life-long condition for which there is no cure. Symptoms may gradually worsen with age. Nevertheless, current therapies can control the disorder, minimizing symptoms and increasing periods of restful sleep. In addition, some patients have remissions, periods in which symptoms decrease or disappear for days, weeks, or months, although symptoms usually eventually reappear.

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Venous Ulcers

Venous ulcers are areas of the lower leg where the skin has died and exposed the flesh beneath. Ulcers can range from the size of a penny to completely encircling the leg. They are painful, odorous open wounds which weep fluid and can last for months or even years. Most leg ulcers occur when vein disease is left untreated. They are most common among older people but can also affect individuals as young as 18.

Causes

Venous ulcers are formed when blood flow through the legs has been constricted, which causes blood to back up and pool in the veins of the legs. This in turn causes a pressure increases in the veins. This results in fluid to leak from the blood vessels into the tissue that surrounds the pooling veins and swelling develops. After some time the swelling restricts oxygen movement to the capillaries and tissues and depletes their nutrients. This causes tissue damage and venous ulcers can form.

Prevention & Treatment

One of the main goals of prevention and treatment is to reduce leg swelling and therefore reduce the pressure in the veins. If swelling can be reduced enough, a venous ulcer may never form or may heal without intervention. Your physician may recommend that you wear specially designed compression stockings or socks to help reduce the swelling in your legs. Another very important aspect to prevention and treatment is elevating your legs whenever it is possible. This simple act both reduces swelling and the pressure in the veins.

If there are signs of infection present upon examination your physician may prescribe antibiotics to be taken by mouth.

When a severe venous ulcer is present, your physician may apply a to the affected area. Once the past hardens it then can be bandaged and booted for extra protection, so that the ulcer can heal more quickly.