Q. What could be the reason for pain and darkening of the lower legs?

Answered by
Dr. Isaac Gana
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 27, 2023

Hello doctor,

I am experiencing pain in my lower legs and feet. The affected skin is significantly darker than the rest of my skin and rougher than the normal surface. My Doppler test results are as follows:

Neither lower limb show features for DVT, saphenofemoral, or saphenopopliteal reflux. No deep venous valvular reflux or DVT features are present. The right leg shows medial incompetent perforators - 18 cm, 27.5 cm above the plantar surface, and 4.5 cm, 3 cm from the anterior margin of the leg.

Impression: Medial right leg incompetent perforators.

A new compression stocking prescription has been provided by my family physician (not a vascular medicine specialist). I already wear compression stockings, but my family physician thinks they are not tight enough.

Kindly help.



Welcome to icliniq.com.

Thank you for your query.

I understand your concern and reviewed your reports (attachment removed to protect the patient's identity). You have venous insufficiency. This is a disease of the veins of the legs. Circulation is affected which is why some parts of your legs are darker than others. Based on the picture it is still in its early stages. The best treatment for your condition is a surgery known as valvuloplasty. Unfortunately, this carries a severe risk of developing DVT in the future, so I do not suggest it. In addition to wearing compression socks, exercise is the best. Exercises like cycling, and jogging 5 days a week will help.

I hope this has helped you. Thank you.

Hello doctor,

Thank you for your reply.

The tighter compression stockings have been obtained and are now in use. Are there any less invasive procedures that might be helpful?



Welcome back to icliniq.com.

It is actually a good idea for you to consult a specialist physician. There are a few types of procedures that can be done, depending on location and availability of expertise they are:

  1. Ligation with stripping.
  2. Simple ligation and division.
  3. Sclerotherapy.
  4. Stab avulsion.
  5. Radiofrequency ablation.
  6. Endovenous laser therapy.

Some of the above procedures are minimally invasive while others are invasive. You should discuss with the vein specialist the availability of options for you.

I hope this has helped you. Thank you.

Hello doctor,

Thank you for your guidance.



Welcome back to icliniq.com.

I wish you good health and a quick recovery.

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