Night cramps, tingling, numbness, and restless legs are not caused by diseased veins

  • Posted on: Apr 29 2017

So many people have heard that leg vein clots can break off, travel to the lungs and result in a fatality, that almost any symptom below the groin can produce real anxiety. At least once or twice a week, I evaluate a complaint that simply does not arise from diseased circulation. Some of these include night cramps, restless legs, and tingling or numbness.

Night cramps, not surprisingly occur at night when one is lying in bed. The cramp results from a sudden contraction of a muscle group. The pain is excruciating and can last anywhere from seconds to an hour. In my experience, the most common location is in the back of the calf, but they also occur in the thigh and in the foot. If the cramp is in the back of the calf, the best treatment is to get out of bed and stand up while leaning forward, i.e. opposite the location of the pain. If the cramp is in the front of the calf, you should try to stand on your tiptoes. After a few seconds, the pain will usually go away.

The cause of these cramps is completely unknown, even though the usual suspects are low potassium or magnesium, and tired muscles. One thing is for sure. They are not caused by artery or vein pathology. They occur more often with advanced years (take my word for it!), but the first few times you get one, you may well panic. A “Charley horse” is an American slang term for this condition, and most authorities suggest a colorful origin in the early days of American baseball, possibly associated with a white horse called Charley.

Tingling and numbness somewhere in the legs are a subset of symptoms called paresthesias, which are, literally, strange feelings. Tingling is a sensation of electricity, which in all cases arises from abnormal nerve signals that are definitely not vascular in origin. Numbness can arise from diabetes and a number of other less common conditions but never results from the disease in the veins. Occasionally, numbness can result from blockages in arteries, but these blockages typically occur in older individuals with significant risk factors such as diabetes, high blood pressure, and a long history of smoking. There are other paresthesias such as burning, which may be secondary to varicose and spider veins, but the association is uncommon and is usually easy to rule out.

Another of these unrelated complaints is the restless leg syndrome.  I often hear radio ads that suggest you should see your vein doctor if you have this symptom, but in all the vein literature, there is only one very poor study that tries to make that association.

Unscrupulous doctors may prey on the vulnerable to do unnecessary vein procedures that have no effect whatsoever on these symptoms, and if you succumb to their convincing spiel, you will be “sorely” disappointed with the results of treatment.

There are other common complaints that are almost never associated with vein problems. Chief among them are symptoms that arise along the outside of the thigh and/or calf. There are no major veins that run beneath the skin in these anatomical areas, and I never expect clots, much less any major vein major problem at these locations. The exception, of course, occurs when there are visible varicose and large spider veins in these areas which can cause some local symptoms, but certainly not the kind that causes serious medical concern.

With the exception of night cramps, for which there is no good treatment, all the symptoms I have mentioned above are best evaluated by your internist or a specialist in nerves and muscles such as a neurologist or orthopedic surgeon. I am always happy, however, to rule out diseases of the arteries and veins and discuss the matter with any patient who for one reason or another winds up in my office.

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Posted in: Featured News, Varicose veins

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