Q: I am 29 years old and do not have any circulation problems, although my mother had varicose veins and high blood pressure. I had high blood pressure in my first pregnancy and tend to have high blood pressure with moderate amounts of caffeine. When I walk for atleast 20 minutes at a brisk pace I get a terrible hot and itchy sensation inside my thighs. I don't get this when I do the elliptical machine or stationary bike. It's so bad that I have to stop and rub my thighs furiously and massage them. I can't even walk because it is so bothersome. It feels as if there is some kind of internal circulation problem in my thighs. This has happened when I was pregnant and when I am not. Its with me no matter what and does seem to be only induced by strong and steady walking. Is this a serious circulation issue or poor quality of veins in my legs?

A:The likelihood of any vascular problem in you is quite minimal considering your age and being relatively healthy apart form hypertension, which is not an unusual occurrence during pregnancy. You have described that you had pre-eclampsia during your last pregnancy. I hope with the delivery you would have become normotensive (normal BP). It is not unusual for people to experience similar symptoms in the calf muscles, as when one tries to rush and not give time to muscles to accommodate the increased blood flow that is augmented in response to demand created for walking briskly or running. This is mainly due to the fact that muscles are contained in the tough fascia (deep fascia), which does not expand quickly as the blood vessels in the muscles do, so one finds that calf becomes hot, itchy and painful. These symptoms are worse in the winter months as the leg blood vessels are in contracted state for heat preservation. The remedy for this is that one should not rush to start with and should either walk slowly in the beginning or do limbering at one spot rather like the warm-up exercises done by athletes. Even though I have not encountered a patient who has such symptoms in the thighs but I feel it is possible considering that the fascia around the thigh is also quite tough. As far as possibility of a vascular disease is concerned; one can only be sure by doing a Duplex scan (Vascular Doppler) for veins and arteries to be certain. I suspect that will turn out to be normal.