Heavy legs: What to do & causes

Quick overview: Frequently asked questions and answers

What can heavy legs mean? The symptom can be an indication of venous weakness, lack of exercise, long periods of standing or sitting, excess weight and fluid retention.

Which home remedies help against heavy legs? Regularly raising your legs, alternating showers, massages from bottom to top and wearing compression stockings can help.

How can diet affect heavy legs? A balanced diet with sufficient magnesium, potassium and iron can support muscle function and thus relieve the feeling of heaviness in the legs.

Table of contents:

What are heavy legs?

Heavy legs are an unpleasant feeling of heaviness, fatigue and sometimes pain in the lower limbs. This symptom often occurs after long periods of standing or sitting, especially at the end of the day or in warm temperatures.

Although healthy people can also be affected, heavy legs are also a sign of various diseases.

Quick help for heavy legs: What to do?

Heavy legs in the evening can be a major burden for those affected, especially if there are other symptoms such as tingling, pain or itching. Often, simple measures can stimulate blood circulation in the venous system and help alleviate the symptoms.

Tips for heavy legs:

• Drink plenty of fluids (water or unsweetened tea)
• Alternating showers
• Put your feet up
• cooling gels or ointments from the pharmacy, for example with ingredients such as horse chestnut or vine leaves
• Pull your feet up and then relax them again (venous pump)
• Walking up stairs
• Feet rocking and rolling
• Products with mountain pine

In addition, if you often have heavy legs, you should make sure you wear the right shoes: high heels or shoes that are too tight can make the problem worse.

Treatment of underlying diseases

Treatment for heavy legs depends on the underlying cause.

If a venous disease is the cause of the leg heaviness, special compression stockings can help to alleviate the symptoms. Compression stockings press on the tissue from the outside and thus support the muscle pump and the venous valves. Compression therapy supports blood circulation to the heart and also reduces the risk of serious consequences such as an open leg (ulcus cruris) or thrombosis.

Compression stockings are not support stockings that you can buy in retail stores. The stockings must be specially fitted and purchased from a medical specialist retailer. The costs are usually covered by the health insurance company with a small private co-payment.

In addition, medication can sometimes help. If severe swelling of the legs and water retention occur, doctors often prescribe diuretics, which have a dehydrating effect.

In addition, varicose veins can be removed. Sometimes this requires surgery on the vein.

Causes: How do heavy legs occur?

The heart pumps blood through the body, but it also has to flow back again to complete the cycle. To do this, the blood has to be transported from the legs to the heart against gravity. This process does not always work smoothly – the result can be heavy legs.

As a rule, the muscles in the legs ensure that the blood is pressed upwards (muscle pump). So-called venous valves in the leg veins prevent backflow. If the venous valves are defective or the muscle pump stops due to a lack of movement, blood backs up. As a result, the legs and feet become heavy.

In addition, if blood is permanently trapped in the veins, the pressure in the blood vessels can be so high that fluid passes from the blood into the tissue and causes swelling. This water retention (edema) is accompanied by heavy and swollen legs.

Diseases as a cause of heavy legs

Heavy legs can be harmless and can be caused by excessive strain or sitting for long periods (such as when travelling by plane). People who often have to stand for long periods, such as in the catering industry, also often suffer from heavy and tired legs in the evening.

In addition, heavy legs can occur as a result of various diseases. The most common cause of heavy legs is venous insufficiency, which is associated with defective venous valves.

Other causes and risk factors:

• pregnancy
• Heart failure
• Thrombosis
• allergic reaction
• Side effects of certain medications
• Kidney disease (renal failure)
• Liver diseases (such as liver cirrhosis)
• Obesity
• weak connective tissue
• high age
• tight clothes
• Heat (especially in summer)
• Magnesium deficiency

In some cases, the heavy legs are not caused by physical factors, but by psychological factors. For example, the legs feel tired as a result of depression or anxiety disorders. Those affected have the feeling that they cannot get up.

Accompanying symptoms: How do heavy legs feel?

Heavy legs are not considered a disease in their own right. Rather, they are a symptom that is often associated with other complaints:

Diagnosis of heavy legs

If heavy legs occur occasionally after standing or sitting for a long time, there is usually no cause for concern and a medical examination is not necessarily necessary. However, if the symptoms occur regularly or if the heavy legs are accompanied by severe pain, medical advice should be sought soon.

The first port of call can be your GP’s office. During a conversation (anamnesis), the exact symptoms and the situations in which they occur are first recorded. Previous illnesses and possible venous and heart problems in the family also play a key role in the diagnosis.

As part of a physical examination, the legs are examined and palpated for visual changes such as visible varicose veins. In addition, various imaging procedures are required to assess the venous system. They provide information about whether there are any venous problems and can also show vascular blockages.

Possible examination procedures:

• Doppler sonography: special ultrasound examination that makes the blood flow in the vessels visible

• Duplexsonographie: Advanced Doppler sonography, which also allows the assessment of vein walls and venous valves

• Phlebographie: special X-ray examination of the veins using contrast medium

• Phlebodynamometry: Method for determining pressure changes in the vein using a venous catheter

• digitale Photoplethysmographie: Visualization of blood filling of skin veins and capillaries using infrared light

Further examinations can be carried out in an angiological or phlebological practice that specializes in diseases of the blood vessels.

How can heavy legs be prevented?

If you want to prevent heavy legs, you should make sure you exercise regularly and maintain a healthy weight. Since a mineral deficiency, especially magnesium, can also lead to problems such as sensory disturbances and muscle cramps in the hands and feet, a balanced diet also protects against venous disorders.

Anyone who is at increased risk of heavy legs, even if they do not have any acute symptoms, should wear compression stockings on long journeys or other occasions where you sit for long periods of time. It also helps to occasionally move your feet or stand up when sitting for long periods of time to stimulate the muscles and prevent blood congestion.