Chapter 71 - Leg swelling and pain: Leg swelling and pain while sitting or standing, associated with abdomino-pelvic venous compression diseases

Abstract

Leg swelling, pain, heaviness, numbness, tingling, “restless legs” sensation at night, nocturnal cramping, and discoloration of the ankle and shin should prompt consideration of neuro and vascular pathologies. In this case study, the patient is diagnosed with May-Thurner syndrome (MTS). With MTS, pain and swelling are worse when standing or sitting, especially in pregnancy, and are minimally relieved with the use of compression stockings and leg elevation. Findings in this case study include painful, large varicose veins, predominantly in the left leg, with chronic pelvic cramp-like discomfort. Increased venous pressure may result in venous congestion, which may manifest as: cardiovascular, spinal, or neurological symptoms; pain in the lower back, hip and sacroiliac joint pain; and pelvic congestion, with the consequence of painful intercourse. The reader is referred to the chapters discussing low back and leg pain, abdominal pain and vascular entrapment syndromes, and pelvic floor prolapse.