Although, there are potentially many reasons for leg cramps, by far, the most interesting and common reason is Venous Insufficiency (Venous Reflux).
Venous insufficiency is a progressive medical condition in which the valves that allow the blood to travel from the legs to the heart no longer function. This can cause blood to pool in the legs causing veins to swell. The incorrect blood flow (or reflux) causes the blood to seep into the tissues and cause cramp in the legs. These cramps are often described as spasms or Charley Horses and mostly occur at nights.
Patients with chronic venous insufficiency (CVI) of lower extremities can often present with complaints of leg pain, fatigue or ache, swelling, restless legs, and varicose or spider veins, in addition to the leg cramps . In more advanced cases, skin discoloration (Stasis Dermatitis) and skin hardening (fibrosis and panniculitis) as well as dreadful ulcerations (Venous Ulcers) may develop.
Although Venous Insufficiency is the most missed diagnosis the other cause of leg cramps includes electrolyte imbalance (like potassium and calcium), muscle fatigue for exercise, neuropathy, pregnancy and other rare medical conditions. Ironically, most medical practitioners are not trained in Venous Insufficiency and its treatment so they futily look for these less common causes.
A simple blood test can detect any potential electrolyte imbalance. To detect Venous Insufficiency, a specialized venous ultrasound is necessary which is most often performed only in centers that do the treatment.
Duplex ultrasound evaluation of these patients usually reveals significant reflux in the greater and lesser saphenous veins, and may involve several accessory veins, tributaries and perforator veins. It is generally accepted that endovenous radiofrequency (RF) ablation have become the gold standard in the treatment of superficial lower extremity venous insufficiency.
We will first get a thorough history and examine your legs. The confirmation of the diagnosis requires a specialized ultrasound of your legs that we will do in our Alpha Vein Clinic .
To treat the leg cramps, you really need to treat the underlying cause.
Venous insufficiency is very nicely treatable through a simple in-office and only minimally invasive procedure. It is performed under local anesthesia and is well covered by most insurance companies. Early treatment is crucial to prevent further complications from venous stasis. Since the valves in the legs cannot be repaired, the only alternative is to re-route the blood flow from the diseased veins to healthy veins. Traditionally, this has been done by surgically removing (stripping) the troublesome vein from your leg. The Venefit procedure, however, provides a less invasive alternative to vein stripping by simply closing the diseased vein. Once the diseased vein is closed, it remains harmless in the body.
A common misconception is that the leg cramping is caused by abnormal potassium, sodium or calcium, when in fact, all are normal and treatment to replenish these electrolytes yields no results.