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calf pain


Sent to Health Experts October 02, 2006 10:41 a.m.
I am a fairly active 34 year old female who has yearly physicals and is in general good health. I have noticed that for the past month there is pain emanating in my inside right calf. It is worse when I am on my feet (which is often because I teach) or if I wear higher heeled shoes. The pain is dull and it comes and goes. Upon inspection I do see a vein where the pain originates from. However it is not bulging or abnormal looking. Could this be as simple as a varicose vein?

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Female , Age: 34

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Answer
October 02, 2006 10:51 a.m. (9 minutes and 53 seconds later) 		REPLIED Check Mark

Hello

This could be Chronic venous insufficiency .When you walk and your leg muscles squeeze, the venous pump works well. But when you sit or stand, especially for a long time, the blood in your leg veins can pool and increase blood pressure. Deep veins and perforating veins are usually able to withstand short periods of increased pressures. However, sitting or standing for a long time can stretch vein walls because they are flexible. Over time, in susceptible individuals, this can weaken the walls of the veins and damage the vein valves, causing CVI.Chronic venous insufficiency can also be associated with varicose veins.

From your history this seems to be mild ,early case of CVI.

Click here to read further



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PictureDr Amit Munjal  -- Physician -- 99% Positive Feedback on 4228 Health Accepts
B.A.M.S{Ayurveda Physician}Worked in various clinical departments like Medicine,ER,Gynae
Reply to Dr AMIT MUNJAL
Sent October 02, 2006 11:09 a.m. (18 minutes and 37 seconds later)
Is this something that I should address with my doctor or can I treat it by myself ?
Customer (name blocked for privacy)
Answer
October 02, 2006 11:14 a.m. (4 minutes and 40 seconds later) 		REPLIED Check Mark

Hello

Well you should consult a physician to undergo clinical examination and investigations to rule out DVT as a cause of CVI .



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PictureDr Amit Munjal  -- Physician -- 99% Positive Feedback on 4228 Health Accepts
B.A.M.S{Ayurveda Physician}Worked in various clinical departments like Medicine,ER,Gynae
Reply to Dr AMIT MUNJAL
Sent October 02, 2006 11:16 a.m. (2 minutes and 21 seconds later)
What is DVT?
Customer (name blocked for privacy)
Answer
October 02, 2006 11:19 a.m. (2 minutes and 22 seconds later) 		REPLIED Check Mark
DVT is deep venous thrombosis.(blood clot in vein). Causes of CVI include deep vein thrombosis (DVT) and phlebitis, both of which cause elevated pressure in your veins by obstructing the free flow of blood through the veins.

DVT occurs when a blood clot (properly called a thrombus) blocks blood from flowing out of a deep or perforating vein. The blood trying to pass through the blocked veins can increase vein blood pressure, which, in turn, overloads your valves. Vein valves that do not work properly are called incompetent because they stretch and no longer work efficiently, and incompetent valves contribute to CVI.

Source- http://www.vascularweb.org/_CONTRIBUTION_PAGES/Patient_Information/NorthPoint/Chronic_Venous_Insufficiency.html



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PictureDr Amit Munjal  -- Physician -- 99% Positive Feedback on 4228 Health Accepts
B.A.M.S{Ayurveda Physician}Worked in various clinical departments like Medicine,ER,Gynae
Reply to Dr AMIT MUNJAL
Sent October 02, 2006 11:22 a.m. (2 minutes and 40 seconds later)
Ok, now I am a bit concerned. Is this something that I need to address immediately? I have an appointment with my doctor in 3 weeks for an unrelated follow up visit. Are there any other symptoms I should be aware of in regards to DVT? And if it is something like CVI, how is it treated?
Customer (name blocked for privacy)
Answer
October 02, 2006 11:27 a.m. (4 minutes and 59 seconds later) 		ACCEPTED Check Mark

Hello

Well the history is not suggestive of DVT which is more potentially serious cause so no need to panic.I just recommended Physician visit as a precautionary measure.CVI is not considered a serious health risk.For mild cases of CVI, your physician may recommend compression stockings. Compression stockings are elastic stockings that squeeze your veins and stop excess blood from flowing backward.



Edited by dr_amitmunjal on October 2 2006 at 11:27am

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PictureDr Amit Munjal  -- Physician -- 99% Positive Feedback on 4228 Health Accepts
B.A.M.S{Ayurveda Physician}Worked in various clinical departments like Medicine,ER,Gynae
Reply
Sent October 02, 2006 11:31 a.m. (4 minutes and 47 seconds later)
Relist: I prefer a second opinion.
Customer (name blocked for privacy)
Answer
October 02, 2006 9:45 p.m. (10 hours and 13 minutes later) 		ACCEPTED Check Mark
I would agree with Dr. Munjal - you likely have chronic venous insufficiency. Blood is pumped under pressure (from the contraction of the heart) to the legs. The mechanism of blood return depends on the pumping action of the contractions of the leg muscles and a series of one way valves.
http://www.nlm.nih.gov/medlineplus/ency/article/000203.htm
With prolonged standing, this mechanism tends to break down. There is nothing to return the blood from the leg veins towards the heart. This causes additional stress on the delicate one-way valves in the legs. As they start to leak, this causes a taller column of blood to bear down on the next valve etc. The overall effet in congestion in the tissues, swelling and discomfort.

The treatment usually is conservative, compression stockings, however is a FEW patients, this can get bad enough to warrant surgery. I DO NOT believe that your symptoms are anywhere near that.

I would suggest using support stockings, and see your doctor (not as an emergency). Getting off your feet even for short periods and WALKING, rather than standing is better. (You can walk some more in the classroom?)

The high heeled shoes change the biomechanics of walking, and I suspect that they are reducing the amount of pumping action from the calf muscles. I would wear GOOD walking shoes, try the support support stockings, and that may help.


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