Leg Pain 

What is causing my chronic leg pain?

Imagine the amount of work that a person’s legs do over the course of their lives. Your legs bear all the weight of your body every single day, functioning to move you from one place to the next and absorbing significant stress and impact when you’re running and jumping. Chronic leg pain can be very distressing and can significantly impact a person’s quality of life on a a day-to-day basis.

There are many causes of chronic leg pain, most of which are related to “wear and tear” involving damage to joints, muscles, tendons and ligaments. Nerve compression and nerve injury related to prior trauma and chronic conditions such as diabetes can also cause leg pain.

An important, and often overlooked, cause of leg pain is poor circulation. This can be the result of narrowing or blockage in the arteries bringing blood down to the legs or abnormalities in the veins preventing blood from returning from the legs back to the heart.

suffering from leg pain

What is arterial claudication?

Claudication is a term used to describe pain related to compromised vascular circulation. Arterial claudication results from narrowing or blockage in the arteries of the legs. These blockages typically develop slowly over time and are the result of progressive buildup of cholesterol and calcium (plaque) on the inner lining of the vessels, a condition know as peripheral arterial disease (PAD). 

How do I know if my leg pain is due to peripheral arterial disease (PAD)?

If you have one or more of the risk factors and sign/symptoms, your leg pain may be due to PAD.

Risk factors for PAD:

  • Diabetes
  • High blood pressure (Hypertension)
  • High cholesterol
  • Tobacco use
  • Renal failure requiring dialysis

Signs and symptoms of PAD:

  • Decreased hair and nail growth
  • Cramping or “burning” pain in the muscles of the calf or thigh with walking that improves with rest
  • Leg numbness or weakness
  • Cool or cold leg compared to the other side
  • Non-healing leg or foot wounds

Several non-invasive studies can be performed for diagnosis including arterial US and CT angiography.

How is peripheral arterial disease treated?

If diagnosed early, PAD and its symptoms can often-times be managed with a combination of lifestyle modification, medication, and exercise.  In cases of severe arterial blockage, intervention may be warranted to remove plaque and re-establish blood flow to the limbs.  Most procedures can be performed in the safety and convenience of our state-of-the art outpatient facility using minimally invasive techniques that involve only a tiny “nick” in the skin.    

Read more about PAD treatment.  

How do I know if my leg pain is due to vein problems?

Abnormalities in the veins of the legs can also be a cause of chronic leg pain.  This may be due to narrowing, compression or blockage of the deep veins of the legs and pelvis related to prior trauma, surgery, acute or chronic DVT, or anatomic abnormalities such as May Thurner’s Syndrome.  Leaking valves in the superficial veins of the legs (so-called venous incompetence or venous insufficiency) leads to the formation of painful varicose veins, blood pooling, and leg swelling.  

Symptoms of Peripheral Vein Disease:

  • Leg swelling which worsens with prolonged standing and towards the end of the day
  • Varicose veins and spider veins
  • Skin discoloration usually in the lower calf and ankle (hemosiderin staining)
  • Scaling of the skin in the lower calf and ankle (venous stasis dermatitis)
  • Skin thickening in the lower calf and ankle (lipodermatosclerosis)
  • Calf cramping at night
  • Restless leg symptoms
  • Superficial, “wet” ulcers and blisters often on the front of the lower leg or inside of the ankle

How are peripheral vein abnormalities diagnosed?

Diagnosis begins with a clinic visit and physical exam. Ultrasound is often sufficient to confirm the presence of clot in the veins (DVT) or venous insufficiency (leaky valves) and can performed in the convenience of our in-house vascular imaging lab on the same day of your consultation. If there is significant suspicion for deep vein disease, we may proceed to a diagnostic venogram in our state-of-the-art angiography suite.

How is peripheral venous disease treated?

Management of peripheral venous disease depends on the nature of abnormality and the veins that are involved (deep or superficial). Broadly speaking, this involves opening blocked or compressed deep veins and closing abnormal (“leaky”) superficial veins.

Treating Venous insufficiency and Varicose Veins

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Treating Deep Venous Thrombosis (DVT)

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Treating May-Thurner’s Syndrome

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The experts at APEX are skilled and experienced in diagnosing and effectively treating all vascular causes of chronic leg pain.  Evaluation begins with a clinic visit and physical exam.  If there is suspicion for peripheral arterial or peripheral venous disease, a painless, non-invasive ultrasound is usually sufficient for confirmation and can be performed the same day in our in-house imaging lab.

From there, we’ll discuss treatment options which may involve medication or compression stockings versus a safe, minimally invasive procedure in the comfort of our state-of-the-art outpatient facility.

Taking care of injury

Wound care

Chronic, non-healing leg wounds (wounds that have been present for > 30 days) are a distressing and relatively common problem affecting more than 6 million Americans every year.  Not only are leg wounds unsightly and painful, they can also be dangerous leading to infection and sometimes, limb amputation.

Chronic leg wounds are often attributed simply to “poor healing”, particularly in patients with diabetes.  Between 80-90% of non-healing leg wounds, however, are actually due to underlying problems with blood flow.  This may be in the form of blockages in the arteries which prevent oxygen rich blood from getting to the legs or abnormalities in the veins that keep blood from getting out of the legs thereby causing leg swelling.  The good news is, these vascular conditions are often treatable and when properly addressed by an experienced vascular specialist, can lead to rapid wound healing and decreased risk of recurrence.

Dr. Ahmed received his vascular training at Harvard Medical School’s world-famous Massachusetts General Hospital and has been practicing in Colorado for the last 7 years.  He is credentialed at numerous hospitals on the Front Range and works closely with multiple wound care centers. Using cutting edge, minimally invasive techniques, Dr. Ahmed has helped hundreds of Front Range patients heal wounds that often times had been present for months or even years.

The experts at APEX are highly experienced and skilled in identifying and treating the entire spectrum of vascular abnormalities that may be contributing to your leg wounds.  We are the first and only full-service outpatient vascular facility in Northern Colorado capable of treating not only venous disease but also peripheral arterial and mixed vascular disease.

At APEX, we work closely with your podiatrist, dermatologist, or primary care provider to identify the underlying causes of your poor wound healing and treat any vascular abnormalities to help you heal rapidly and get back to your life.

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