Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand and writes about medical facts.
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Dear Martin,
I have problem with my right lower leg, starts at the knee to the foot 90% when I rest, so sleep. During the day I am very active and then I feel the pain less. Now I have read on the internet that it is due to poor blood circulation. The blood from the heart is pumped down but on the way back there is a blockage. I hope not. This is an expensive affair and unaffordable as a pensioner.
Now they also say you shouldn't smoke (I'm a non-smoker) and your blood pressure might be too high. Also my blood pressure is excellent and I measure this every morning between 115/65/76 and sometimes 131/72/81.
It is also said more movement, sports. I run my 7,5 km every morning so I think this is good too. My question is could it also be rheumatism, since I keep the leg warm with 2 pairs of long socks, massage it a bit at night and the pain will subside.
My second question is can you see the blood circulation with an MRI scan?
I look forward to your response and thank you in advance for reading my complaints. (I will be 79 in 3 months)
Best regards,
J.
******
Dear J,
With an Angio MRI (Magnetic resonance angiography) you can see the blood circulation. However, whether much can be done in your case, I doubt.
Heat can indeed help a bit and so can massaging. A well-fitting support stocking is also an option.
Is your lower leg swollen at night? Do you see welts on your socks?
When you walk, you activate the muscle pump, which pushes the blood upwards. In young legs there are valves that prevent the backflow. You can also activate that pump by standing on your toes and then going up and down on your feet. See picture.
If you put your legs a little higher than the heart at night, you will probably have less trouble. Pillow under the foot of the mattress or blocks under the bed.
Try that first. At the moment it seems better to ignore hospitals etc., unless there is no other option.
Rheumatism doesn't seem very likely to me.
Yours faithfully,
Dr. Maarten