Why Does Polycythemia Vera Cause Leg Pain?

Polycythemia vera (PV) is a type of blood cancer where the bone marrow produces too many blood cells. The extra red blood cells and platelets thicken the blood and make it more likely to clot.

A clot can occur in many parts of the body and cause damage. One type of clot is deep vein thrombosis (DVT), which usually occurs in the leg. DVT may lead to a potentially deadly pulmonary embolism (PE). The risk of DVT is higher in people with PV.

There are different types and causes of leg pain. Not all leg pain is linked to PV, and cramping doesn’t necessarily mean you have DVT. Read on to find out more about the types of leg pain and when you should contact your doctor.

Why does polycythemia vera cause leg pain?

PV causes blood to be thicker than normal due to high levels of red blood cells and platelets. If you have PV and leg pain, a clot may be the cause.

A high red blood cell count makes blood thicker so it flows less efficiently. Platelets are designed to stick together to slow bleeding when you have an injury. Too many platelets can cause clots to form inside the veins.

Higher levels of both red blood cells and platelets increase the risk of a blood clot occurring and causing a blockage. A clot in a leg vein can cause symptoms including leg pain.

What is deep vein thrombosis (DVT)?

Deep vein thrombosis (DVT) is when a blood clot happens in a large, deep vein. It occurs most often in the pelvic area, lower leg, or thigh. It can also form in an arm.

PV causes blood to flow more slowly and clot more easily, which increases the risk of a DVT. It’s important to be aware of the symptoms of DVT if you have PV. These include:

  • swelling in one limb
  • pain or cramping not caused by injury
  • skin that’s red or warm to the touch

A major risk of DVT is that the clot can break free and travel toward your lungs. If a clot gets stuck in an artery in your lungs, it blocks blood from reaching your lungs. This is called a pulmonary embolism (PE) and is a life threatening medical emergency.

Signs and symptoms of a PE include:

  • sudden difficulty breathing and shortness of breath
  • chest pain, especially when coughing or trying to take a deep breath
  • coughing up red or pinkish fluids
  • rapid or irregular heart rate
  • feeling lightheaded or dizzy

You can have a PE without any signs of DVT, like leg pain. You should get medical help right away if you have any symptoms of PE, with or without leg pain.

Leg cramps

Leg cramps don’t always indicate a more serious medical condition like DVT and aren’t necessarily linked to PV. They’re typically not serious and go away on their own within a few minutes.

Cramps are a sudden painful and involuntary tightening of your muscles, usually in the lower leg.

Causes can include dehydration, muscle overuse, muscle strain, or staying in the same position for long periods of time. Cramps may have no obvious trigger.

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Cramps can last a few seconds to a few minutes. You may feel a dull ache in your leg after the cramping stops.

Signs and symptoms of leg cramps include:

  • sharp or aching pain in your leg that’s sudden and intense and lasts a few seconds to a few minutes
  • a lump where the muscle has tightened
  • being unable to move your leg until the muscle loosens up

Treating leg pain

Treatment of leg pain depends on the underlying cause.

It’s important to treat DVT to reduce the risk of a PE. If you have PV, you’re likely already on blood thinners. Your medications may be adjusted if your doctor diagnoses DVT.

Your doctor may also recommend compression stockings. These help to keep blood flowing in your legs and reduce DVT and PE risk.

To treat leg cramps, try massaging or stretching the muscles until they relax.

Preventing leg pain

Several strategies can help prevent DVT and leg cramps.

The following tips can help prevent DVT if you have PV:

  • Follow your PV treatment plan to manage symptoms and keep blood from getting too thick.
  • Take all medications recommended by your doctor exactly as directed.
  • Talk to your doctor if you have any trouble with side effects or remembering to take prescribed medications.
  • Maintain regular contact with your healthcare team to discuss symptoms and blood work.
  • Try to avoid sitting for long periods of time.
  • Take breaks to move around at least every 2 to 3 hours and stretch often.
  • Exercise regularly to increase blood flow and reduce the risk of a clot.
  • Use compression stockings to support good circulation.

Ways to prevent leg cramps:

  • Dehydration can cause leg cramps. Do your best to drink fluids throughout the day.
  • Point your toes up and down a few times every day to stretch calf muscles.
  • Wear supportive and comfortable shoes.
  • Don’t tuck bedsheets in too tightly. This can keep your legs and feet stuck in the same position overnight and increase the risk of leg cramps.

When to see a doctor

DVT is a serious complication of PV that can lead to a life threatening pulmonary embolism. Seek emergency medical attention immediately if you have any of the symptoms of DVT or PE.

The takeaway

PV is a type of blood cancer that causes high levels of red blood cells and platelets. Untreated PV increases the risk of blot clots, including deep vein thrombosis. A DVT can cause a pulmonary embolism, which can be deadly without prompt medical treatment.

Not all leg pain is DVT. Leg cramps are common and usually go away quickly on their own. But redness and swelling along with leg pain can be signs of DVT. It’s important to get medical attention right away if you suspect DVT or PE.

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