Vascular & Endovascular Interventions of New York

(718) 372-8346

FREEDOM OF MOVEMENT: CIRCULATION, CIRCULATION, CIRCULATION
Circulation disease specialist Dr. Lev Khitin answers our readers' questions.
"Dear Doctor, I always read your publications and always get great pleasure. Now I decided to ask myself. I have chronic back problems. At the same time, the pain in the lower back appears when I am in an upright position, it is relieved when I sit down or lean on my elbows, and almost go away when I lie down. These pains radiate to the outer surface of the thighs and shins, and also to the toes and feet, which, in addition to everything, often become numb, numb and sometimes cold. Recently, however, the sensations described above have become legs began to appear without and regardless of pain in the lower back.
I wondered: could they possibly be unrelated?
I would like to know your opinion." (Zinaida K., Brooklyn)

Dear Zinaida, you are absolutely right in your observations and conclusions. The problems of the lower back and legs that you described are most likely provoked by the same factor: vertical position. In this case, firstly, the distribution of body weight changes and the load on the spine increases , especially at its base: the lumbosacral region. This is where the back pain comes from. Secondly, a similar mechanism is responsible for pain in the upper outer surface of the legs. The source of pain in this area, however, is no longer the lumbar nerves, but the hip joint, affected , usually arthrosis - degeneration of intra-articular cartilage. Thirdly, the calf muscles, being the most distant muscle group from the heart, can suffer from a lack of oxygen in atherosclerosis of the arteries, or obliterating endarteritis. Hence the pain in the lower leg. Fourthly, the shins are the "lowest" and therefore the most sensitive compartment of soft tissues, subject to high hydrostatic pressure of the blood column during venous congestion in the lower extremities. This causes aching pain and heaviness in the ankles. They (veins legs), fifthly, are often responsible for the feelings of "numbness" and "burning" in the shins.
And finally, unpleasant sensations in the feet, as a rule, owe their appearance, sixthly, to various so-called "circulatory neuropathies." In this condition, nerve endings, suffering from abnormal blood supply, gradually die off, causing false sensations of non-existent stimuli: heat or cold, numbness or "bloating".
All of the above, of course, is just one of many possible scenarios explaining the set of your problems, Zinaida. A specialized and detailed examination would allow us to differentiate the clinical picture, substantiate a specific diagnosis and develop an appropriate treatment plan.
"I heard that in addition to the already known problems of clogged blood vessels, a new disease has been added - their expansion. Is this true, and how dangerous is it?" (Lydia Sh., Queens)
The so-called "varicose veins" is an ancient disease, just like the narrowing of the arteries, known to mankind since the time of Hippocrates. Its real name is "venous insufficiency". This disease is quite common, but at the same time, little known, or rather, poorly understood, even in medical circles. Most people know about varicose veins, which, oddly enough, are just one, and quite rare, symptom of venous insufficiency. Much more common symptoms include leg pain, feelings of heaviness and fatigue, swelling , cramps, problems maintaining balance, aching and twisting sensations, feelings of "burning", "cotton wool", "numbness" or coldness in the legs. As this condition develops, complications are added, including thrombophlebitis, trophic ulcers, infections and even bleeding.
The mechanism of this disease is quite simple. In the human body, as is known, there are two types of vessels: arteries and veins. Arteries carry blood from the heart to the peripheral organs. Veins return the used blood "from the periphery", in simple terms, back to the heart. Problems arteries are usually associated with their narrowing. Therefore, treatment usually consists of their expansion. Diseases of the veins, unlike arteries, are rarely associated with their blockage.
As a rule, the problem lies, on the contrary, in their expansion. And this leads to peripheral stagnation of blood and its incomplete return to the heart. The approach to treatment is therefore selective, depending on the degree, location and length of the dilated segment, as well as on many other factors.
Lower limb circulation problems are widespread and varied, yet relatively poorly understood and therefore one of the most frequently mismanaged diseases. At the same time, lower limb circulation diseases are statistically the leading factor limiting the ability to walk independently, and means freedom of movement in space and, consequently, freedom of communication.
The rights of free movement and unimpeded communication are, in turn, inalienable and the most basic human rights. These rights directly express the quality of the years lived and allow us to distinguish the quality of life from its simple quantity.
Thank you very much for the invitation and attention.
Lev Khitin, MD, FACS

Vascular & Endovascular Interventions of New York
IF YOU SUFFER FROM PAIN, CRAMPS OR WEAKNESS IN YOUR LEGS, IF YOU
IT IS DIFFICULT TO STAND OR WALK IF YOU HAVE
FEET ARE TIRED, BURNING, NUMB OR COLD,
contact:
WE WILL HELP YOU!
Lev Khitin, MD, FAC S
A physician of the highest category in the fields of cardiovascular, thoracic and general surgery. Member of the American Academy of Surgery, Corresponding Member of the American Association of Cardiac Surgeons, Chairman of the Scientific Council of the American Academy of Vascular Medicine, founder and permanent president of the New York Institute for the Treatment of Vein Diseases.
Manhattan, 30 Park Ave, NY, NY 10016
Brooklyn, 406 15th Street
(718) 372-8346