Brief Answer:
Venous insufficiency is a possible cause

Detailed Answer:
Hello and welcome to 'Ask a Doctor' service,

I carefully read your query and understand your concern.

Swelling on one of the legs that are better when you lay down but is bad again when you start your day and daily activities may be related to venous insufficiency in the leg (closely related to varicose veins). They may also cause pain and pressure sensation in the leg as well.

Treatment for venous insufficiency consists of improving the blood flow by trying to avoid long times standing or sitting, trying to walk regularly, keep your feet raised when sitting, use of compression stockings and in some cases even surgery. Losing weight may be needed if your BMI is over 25 and if you do a job that requires you to sit for long periods you may need to purpose to stand and walk for 2-3 minutes every 20-30 minutes.

On the other hand, because venous thrombosis can also cause swelling and tenderness that generally is on one leg, it is best to first have a doppler ultrasound of the legs. This will confirm the presence of varicose veins and venous insufficiency and will rule out deep vein thrombosis.

To conclude:

- venous insufficiency due to varicose veins is a possible cause of unilateral leg swelling and pain (especially if there is no redness)

- if redness is present then infection should be ruled out and also deep vein thrombosis is another important diagnosis to rule out if there is one side swelling and pain

- a doppler ultrasound is needed to confirm the diagnosis of venous insufficiency and also rule out deep vein thrombosis.

- advises on how to manage venous insufficiency given above but regular check-up with your doctor is needed

I hope this answers your query.
I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj,
General and Family Physician

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