- Conditions & Treatments

Leg Pain

Leg Pain Vascular Causes

Vascular (circulatory) causes of leg pain include any condition that interferes with circulation of the blood and lymph. Many people ignore leg or arm swelling and pain as a normal change due to aging.  Below are several vascular conditions that can result in pain in the legs.

Peripheral artery disease (PAD)

PAD is due to impaired blood flow to the legs which is commonly caused by hardening of the arteries, or atherosclerosis. PAD increases the risk of heart disease, heart attack and stroke.

Reduced blood flow to the legs can injure the surrounding tissues and nerves. When there is not enough oxygen flowing to the leg muscles there will be pain, ache, fatigue, burning and discomfort in the muscles of the feet, calves and thighs. The most common symptom of PAD is painful muscle cramping (claudication) that occurs when walking, climbing or exercising. When the pain stops with rest this is called Intermittent Claudication.

In severe PAD, you may experience new symptoms, including  impotence, leg pain and cramping at night, pain and tingling in the feet or toes, pain that gets worse when you raise the legs and improves when legs return to normal position. Calf muscles can shrink. You may lose hair on your legs. There may be painful sores that are difficult to heal. Your toes may turn blue, and your toenails can thicken.

PAD can be confused with diabetic neuropathy. The board-certified vascular surgeons at South Valley Vascular in Visalia, Porterville and Hanford, California are experts at diagnosing the cause of your leg pain.

Varicose Veins

The underlying cause of varicose veins is venous insufficiency. In healthy veins, the valves control blood flow and return blood to the heart. When the valves in these veins are damaged or destroyed, blood pools in the veins. This process creates the familiar dark blue, tortuous veins that you recognize as varicose veins.

Valve dysfunction can be hereditary, the result of a deep vein thrombus or blood clot, and sometimes vein valves can fail without a reason.  There may be no symptoms. Venous insufficiency feels like heaviness in the legs, with some pain and swelling. Skin darkening and leg ulcers can develop.

Deep Vein Thrombus (DVT)

Deep vein thrombus is development of a blood clot, due to poor blood flow in the legs. Inactivity, injury and blood vessel damage are common causes. DVT is a serious condition because the clot can break loose and travel to your lungs (a pulmonary embolism), which can damage your lungs and lower oxygen levels which can damage other organs.

Cancer and genetic diseases can cause the blood to clot too easily. And, some medications like hormone therapy can cause clots to form.

DVT can occur suddenly without warning.  There may be swelling, pain, redness and heat at the location of the blood clot. Blood tests and ultrasound are diagnostic tests for DVT.


The lymphatic system is a network of lymph nodes and vessels that collect and carry lymph fluid back to the heart. It is  part of the immune system that filters out harmful substances and sends out white blood cells to fight infection. The lymph vessels contain one-way valves that work with the muscles to remove the lymph fluid.

Lymphedema occurs when there is a blockage in the lymph system that prevents the lymph fluid from draining which results in swelling in the arms and/or legs.  It’s typically the result of surgery, trauma, infection or radiation.

Symptoms of lymphedema are swelling and heaviness, tightness and itching in the affected area. Increased fluid accumulation creates an inflammatory reaction that causes scar tissue, which makes it even more difficult for excess fluid to be removed.  This process can delay delivery of oxygen and impair wound healing. Lymphedema is commonly a chronic condition that can be controlled. If left untreated, it can lead to irreversible changes and poor quality of life.

Quick, accurate diagnosis is essential to identify appropriate treatment. If you have a long history of painless swelling in the legs following removal or damage to lymph nodes, a vascular surgeon can diagnosis lymphedema from a patient history, symptoms and physical examination.  Additional testing is generally not necessary, but can be used to evaluate  changes in the condition.

The vascular experts at South Valley Vascular in Visalia, Porterville and Hanford, California specialize in the diagnosis, treatment and management of diseases and conditions of the blood vessels. Our vascular surgeons will determine a treatment plan that  provide the best benefits for your specific needs.

Leg Pain Non-Vascular Causes

Non-vascular leg pain is the term used to describe leg pain that suggests vascular disease but upon examination is shown not to be the cause. Commonly, the underlying medical cause for leg pain is nerve-related, musculoskeletal or vascular. Here we are focused on nerve-related and musculoskeletal leg pain.

Nerve-related causes of leg pain include diabetic neuropathy, spinal stenosis and trapped nerves, and sciatica. Nerve-related pain is due to damage (injury or disease) to or dysfunction of the nerves. It is a complex, chronic problem. Nerve pain feels like being pricked with needles or electric shocks, and shooting pain.

1- Neuropathy is pain caused by peripheral nerve inflammation that is not associated with spinal cord issues. Neuropathies can be caused by direct nerve irritation or damage, or medical illness. The pain is described as burning, tingling, shooting, pins and needles pain, and numbness.

Diabetic leg pain, is due to diabetic nerve damage and is called diabetic neuropathy or peripheral neuropathy. Diabetic neuropathy is pain in the feet that burns and tingles. It typically begins as foot pain and migrates up the leg.

2- Lower back problems can cause leg pain due to the location of the nerves, especially the sciatic nerve.  Sciatica is a lower back problem. The sciatic nerve runs from the buttocks down the back of the legs. When compressed, damaged or irritated it causes pain, weakness, numbness or tingling. The pain may be a dull ache or a severe shooting pain.

Lumbar spinal stenosis affects more than 200,000 U.S. adults. Stenosis is the narrowing of the spinal cord canal which compresses spinal nerve roots and causes substantial pain in the buttocks and legs, with or without back pain. It is related to sciatica. It is aggravated by standing, walking and lumbar extension, and is relieved by forward flexion and sitting or lying.

A herniated or slipped disc in your lower spine puts pressure on your nerve roots. It is due to aging and strenuous activity. It can cause back pain, leg pain (including sciatica), numbness and tingling, weakness and even loss of bladder or bowel control. The pain usually occurs on one side of your body.

Intermittent claudication that is neuropathic (nerve-related) or vascular is called pseudo claudication. Claudication is typically pain associated with walking, and most often is vascular in origin. However, leg pain with walking is not always caused by vascular problems. It may be related to lumbar spinal stenosis, and mimics vascular intermittent claudication. With intermittent claudication due to peripheral artery disease the pain is typically a dull ache in the calves or thighs.

Degenerative joint disease (Osteoarthritis) is joint disease due to inflammation that also affects the surrounding tissue. The cartilage at the ends of your bones, wears away. The bones begin to rub together causing a lack of mobility, joint stiffness, joint pain and swelling.  It is common among the elderly, usually develops slowly and affects the knees, hips and spine.

Cellulitis is a bacterial infection that attacks the middle layer of skin and the tissues below. The skin of the lower legs is infected, causing pain, tenderness, and redness. The affected area appears  tight, shiny and swollen. This infection must be treated immediately to avoid serious consequences.

Muscular disease can also be a source of leg pain. In patients with vascular disease, muscular disease may be secondary to medication (statins), and may cause leg pain with walking.

Neuropathic pain is chronic, difficult to diagnose, and can negatively affect your quality of life.

Too often patients have leg pain that is attributed to an orthopedic or neurologic problem. Patients spend time and money to get the correct diagnosis. If you have leg pain that interferes with your life, the best approach is to consult a vascular surgeon to rule out vascular causes. Experienced clinicians know how to evaluate vascular causes of leg pain, so you get a correct diagnosis early and receive the treatment you need.  The board-certified vascular experts at South Valley Vascular Associates in Visalia, Porterville and Hanford, California are experienced and have state-of-the-art technology to get you up and walking pain-free.