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Venous Disease in the Podiatric Patient

Venous flow is important in maintaining your foot, ankle, and lower leg health. Venous insufficiency can lead to ulcerations, swelling, feelings of heaviness, and pain. Also, there is a chance for a blood clot or deep vein thrombosis (DVT). During each visit, your foot and ankle doctor evaluates for venous problems by asking questions related to pain, walking, and swelling as well as evaluating the overall appearance of your feet and ankles, edema, coloration changes, or for signs of a blood clot. Below is a list and explanation of what your foot and ankle doctor is looking for:

  1. Generalized foot, ankle, and lower leg pain when walking.
  2. Feelings of heaviness or achiness in the feet, ankles, or lower legs.
  3. Swelling of the feet, ankles, or lower legs without recent injury. Swelling occurs as the veins are either stretched or the valves are no longer working. This allows blood to flow backward and pool within the legs, ankles, and feet.
  4. Varicose veins – twisted, enlarged veins. These are caused by weak vein walls and valves which allow blood to flow backward. When the blood flows backward it collects within the lower veins causing them to swell and enlarge in the legs, feet, and ankles.
  5. Brown/dark discoloration of the foot, ankle, or lower leg. This is what is called hemosiderin deposition. Hemosiderin helps to carry iron within the blood system. When your veins are no longer working properly, the blood can flow backward and leak into the tissue. This deposits the hemosiderin and turns the skin brown/dark color.
  6. Blood clot: Typically, blood clots are provoked by inactivity, immobilization, thrombotic or blood clotting disease, or a history of surgery, however sometimes they can be unprovoked. Blood clots typically cause the calf to be red, hot, swollen, and painful to touch.
  7. Ulcerations: Increased swelling causes increased pressure in the lower leg which in turn causes a lack of nutrients and oxygen getting into the tissues which leads to cell death, damaging of tissue, and wounds forming of the ankle, foot, and lower leg.

If you have any combination of these, your foot and ankle doctor may order testing for further evaluation. Testing is done by ultrasound where the veins are scanned and evaluated for the backward flow of blood or non-collapsing veins (blood clots). Following the testing, your podiatrist will discuss your results as well as the next treatment steps. Treatment may include several different approaches, including compression, medication changes, and possibly a referral to a vascular specialist.

Contact Foot & Ankle Center of Iowa to schedule an evaluation of your feet and ankles today!

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