Foot Or Leg Cramps?

It could be your VEINS!

Bernadette realized relief from her foot cramps almost immediately after her vein procedure.

Philadelphia native Bernadette Bremme spent most of her married life as a homemaker and mother. But when her children became adults and moved out of the house, she searched for a job outside the home and she found one at her local YMCA.

“I had a full spectrum of responsibilities,” Bernadette shares. “I opened up at 5:30 in the morning, turned on the lights, adjusted the thermostat and got the building ready for people. Then I worked the front desk and welcomed the little kids as they came in with their parents. In the afternoon, I worked with the 3- and 4-year-olds. I loved my job.”

Bernadette was not as fond of the frigid Pennsylvania winters. Her disdain for chilly temperatures prompted a move to the warmer climate of the Sunshine State.

“I hated winter,” she bemoans. “One year, I finally said, This is the last winter I’m putting up with zero-degree weather. By the time that year was over, we were living part time in Florida. We went back and forth as snowbirds for two years but really loved Florida, so in 2004, we sold our house in Philadelphia and moved south permanently.”

Bernadette, 75, has now resided full time in Florida for 17 years. For longer than that, though, she has battled painful issues with her legs and feet. Those issues began when she was 40 years old, but a couple of years ago, the pain in her legs and feet intensified.

“Two years ago, my feet were really bad,” Bernadette details. “I got severe cramps in my feet, especially when driving. I’d be halfway to my destination and have to pull the car off the road and rub my feet before I could continue driving.

“The foot cramps woke me up in the middle of the night. The pain was so severe I could hardly walk; I had to almost crawl to the kitchen. It was a crippling pain. It felt like someone was twisting my feet until all the muscles were tight. When they cramped, my feet crunched up together and looked half their normal size.”

Believing a mineral deficiency was causing the cramps, Bernadette took potassium and magnesium supplements. These remedies provided some relief, but over time the cramps became increasingly severe, which worried her. Bernadette began to feel hopeful after reading an article by Dr. Joseph Magnant about venous disease in Florida Health Care News.

“I didn’t know anything could be done for my condition until I read Dr. Magnant’s article in the newspaper,“ she recounts. “I learned there’s a minimally invasive procedure that might help.”

Joseph Magnant, MD, is a board-certified vascular surgeon at Vein Specialists in Fort Myers and Bonita Springs.

Dr. Magnant is dedicated to the modern and comprehensive evaluation of leg vein disorders and uses the most advanced minimally invasive techniques to treat them.

“Leg cramps are a common symptom of venous insufficiency, when the one-way check valves in leg veins leak, interrupting blood flow back to the heart,” Dr. Magnant describes. “Bernadette had a rather unusual presentation because her cramps were in her feet. We do not often see foot cramps as the primary complaint, but they are an often-unrecognized, underappreciated symptom of venous disease.

“We evaluated Bernadette’s legs using ultrasound and noted significant leaking of her great saphenous vein and several smaller accessory veins. A successful trial of compression stockings predicted that she would respond positively to a vein ablation procedure. We chose radiofrequency ablation, which uses heat from radiofrequency energy to seal leaking veins.”

Nighttime Triad

Dr. Magnant explains that the underlying mechanism behind leg and foot cramps is fluid accumulation in the leg’s tissues. This fluid accumulation is secondary to venous insufficiency.

“When the check valves in leg veins don’t function properly, blood pools in the veins of the lower legs, particularly those around the ankles and feet,” Dr. Magnant educates. “This causes the pressure in those veins to be much higher than normal.

“The increased pressure causes blood, protein and water to leak out through the vein walls into the surrounding tissues, namely the muscles, skin and fat. As the veins continue to leak over time, more fluid accumulates in those tissues.”

Excess fluid is reclaimed by the lymphatic system and returned to venous circulation through the jugular vein. This generally occurs at night while people sleep and their legs are elevated or equal to the level of their heart.

“When fluid moves out of the tissues, specifically the muscles, and into the lymphatic system, it results in a water and electrolyte imbalance,” Dr. Magnant informs. “That imbalance is what causes the cramps, which are essentially muscle cramps.”

Typically, leg cramps are more intense at night and are accompanied by charley horses. These symptoms are part of a trio of symptoms called the “nighttime triad.” The others are restless legs syndrome and frequent nighttime urination, which are also related to excess fluid accumulation in the legs due to leaky veins.

“The lymphatic system is located in the dermal layer just underneath the skin,” Dr. Magnant details. “As fluid is reclaimed, its movement through the lymphatic vessels produces a sensation of restlessness and a feeling that something is crawling under the skin. That’s restless legs syndrome.”

“Since Dr. Magnant performed the procedure two years ago, I haven’t had any problems.”
– Bernadette

The kidneys are tasked with maintaining the appropriate concentration of water and solutes in the blood. If there is too much water, the kidneys create urine and store it in the bladder. A full bladder prompts individuals to urinate. Because excess fluid is reclaimed at night, this process leads to frequent nighttime urination.

“The most common physical signs of venous insufficiency are varicose veins and swelling, along with other symptoms such as leg fatigue, achiness and heaviness that’s worse at the end of the day,” Dr. Magnant observes. There is another rare vein related symptom of neuropathy, which is often associated with a condition called tarsal tunnel syndrome, similar to carpal tunnel syndrome but involving the feet.

“Primary care physicians and many specialists recognize varicose veins as a sign of venous insufficiency but often don’t relate other signs and symptoms to venous disease. We are dedicated to educating physicians about venous disease and its other signs and symptoms so patients can be properly treated and achieve good outcomes, as Bernadette did.”

Lasting Relief

Dr. Magnant’s assessment of Bernadette was on target. She achieved what she describes as an excellent and longstanding outcome from her radiofrequency ablation.

“My results are fantastic,” Bernadette raves. “Since Dr. Magnant performed the procedure two years ago, I haven’t had any problems. I’ve never had a cramp, and the pain is completely gone in both legs.”

Bernadette realized almost immediately that Dr. Magnant’s procedure was effective. She noticed substantial relief from her foot cramps after the initial radiofrequency ablation on her right leg.

“Before, when I stood up after lying down for a while my feet and legs would cramp,” she reports. “But when I stood up after the procedure, my right foot didn’t bother me. I walked to my car and drove home. And I made it all the way without a cramp.

“Dr. Magnant is amazing. He is the sweetest, most wonderful doctor I’ve ever met. He sang songs while he performed my procedure. It calmed me down. The next thing I knew, the procedure was over.

“Everybody at Vein Specialists is nice. They are really friendly and sweet. That makes a difference to me.”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. mkb
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    • Vein Specialists

      Vein Specialists is 100 percent dedicated to identifying and treating vein disorders. Led by Dr. Joseph G. Magnant, they understand that the venous system varies between patients and consists of both deep and superficial venous systems and a net... Read More

    • Joseph G. Magnant, MD, FACS, RPVI

      Joseph G. Magnant, MD, FACS, RPVI, is a Fellow of the American College of Surgeons and is board certified by the American Board of Surgery in vascular surgery. He earned his medical degree from Medical College of Virginia. He completed a g... Read More