As vascular surgeons, many of the consultations and questions we receive revolve around one issue: foot pain! As people age there can be many sources of foot and leg pain and I want to shine some light onto a few of the most common causes that I see. They include peripheral vascular disease, chronic venous insufficiency, diabetic foot disease, and sciatica.
Peripheral Vascular Disease:
In all people there are two main kinds of blood vessels, arteries, and veins. Arteries bring blood from the heart to the feet. Veins bring blood back from the feet to the heart. In individuals who have a history of
- High blood pressure,
- High cholesterol,
The arteries that lead to the feet can develop blockages, otherwise known as Peripheral Vascular Disease. When too many blockages develop, the feet do not receive the amount of blood they need to stay alive, and they become very painful. When this happens, patients tend to hang their feet in dependent positions off the side of the bed at night to allow gravity to help the blood travel through the blockages to the feet. The pain tends to concentrate on the forefoot and toes where the blood vessels are the smallest.
Chronic Venous Insufficiency
With vein disease, patients tend to have swelling in the legs below the knee including the ankle and feet. Normally, there are structures in the veins called valves that allow blood to go to the heart but not to go back down towards the feet. In patients with vein disease, these valves leak and cause blood to pool in in the legs below the knees. After patients are standing or sitting upright for extended periods of time, the pressure in the veins of the legs builds resulting in an aching pain as well as also causing varicose veins, dark discoloration of the skin, and, in the worst cases, ulcers on the leg.
Diabetic foot disease
Diabetic foot disease is one of the most common problems I see as a vascular surgeon. These patients describe numbness much more often than pain. This numbness is a result of the inflammatory damage that high sugar levels in the blood can inflict on the nerves of the foot. Sometimes, even when these patients develop ulcers, they do not feel any pain because the nerve damage is so severe. As such, patients with diabetic foot ulcers, though they can experience pain, often experience numbness as well.
Lastly, sciatica can also be a cause of leg and foot pain. The nerves that detect sensation from the legs and foot originate from the spinal cord in the back of the pelvis and abdomen. As such, when these nerves are pinched they tend to cause the patient to feel a pain radiating from the lower back or buttock down the leg and sometimes even to the foot. This radiating pain can be easily distinguished from the pain of peripheral vascular disease and venous insufficiency which is concentrated in the legs and feet.
If you or anyone you know suffers from leg pain at night and if any of these stories seem to fit the pain or discomfort that you may be having in your legs, please call one of our South Bay Vascular Offices in either Campbell or Gilroy CA at 408 376 3626 today to schedule an appointment! We Can Help!