If you break a leg or sprain an ankle during a basketball game, health care providers have a good idea what happened and how to treat it.

But if you have daily aches, pains and swelling in your legs, it will require some investigation.

Causes

Aman Khurana, MD, a vascular medicine physician who sees patients at OSF HealthCare, outlines common causes of leg pain. 

• Arterial disease
  
  “The arterial cause of leg pain is when people walk, and they get leg, calf, hip or thigh pain. That can be from less arterial flow down in the legs,” Dr. Khurana says. “When we walk, the muscles are demanding more blood. But because of blockages, blood doesn’t come.” 
   
• Venous disease
  
  “Venous pain brings heaviness, tiredness and fatigue. Varicose veins and leg discoloration are signs of venous disease,” Dr. Khurana explains. “That pain seems to get better when you lay flat or with your legs up.” 
   
• Arthritis, or inflammation of a joint
   
• Nerve issues
  
  “We have large nerves that go down from the back,” Dr. Khurana explains. When those nerves are irritated, it can cause a condition called sciatica. “Then there’s small vessel nerve pain that causes tingling and numbness in the feet.”

Wounds, such as those associated with diabetes, and lymphedema, a condition where fluid builds up causing swelling, can also contribute to these problems.

Diagnosis and treatment

Dr. Khurana recommends seeing a provider at the first sign of leg pain. He says it’s hard for people to pinpoint the problem, and waiting can make it worse.

A provider, he says, could check the blood pressure in your arms and legs to gauge blood flow and run a test to check for vein leakage.

“Veins have valves. When blood goes up, the valve should close. Some valves don’t close right. Blood goes up, and it keeps coming down. That’s how you have the heaviness, tiredness and swelling in the legs,” associated with venous disease, Dr. Khurana says. You could be given compression stockings for this problem.

Other treatments include medication, a device (such as a lymphedema pump that massages the legs and aids blood flow to the heart) or an ablation procedure to stop the blood flow in the problematic vein.

Prevention

How do I keep my legs moving? Dr. Khurana repeats advice many doctors have given. Daily healthy habits that prevent cardiovascular disease will help prevent leg issues.

• Keep your blood pressure, cholesterol and chronic conditions like diabetes in check.
   
• Don’t smoke. 
   
• Exercise and eat a healthy diet to avoid obesity. When your weight impacts your ability to get around, Dr. Khurana says, it’s definitely time to see a provider.
   
• Know your family history of health issues, and bring these up to your provider at your regular checkups.

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• Changed demeanor, like mood swings
   
• Frequently stepping away, like asking to go to the restroom a lot at school

“They want to go smoke because they’re addicted already. They need that time. They have to go hide,” says Thompson, a breast health navigator. “Same thing at home. They constantly go to their room or bathroom.”

• New odors coming from your child or their belongings. Williams, a radiation therapist, notes that the smell could be good, like minty.
   
• Listen for kids using new phrases. Vapes are also called hookahs, pens, tank systems and mods.

Adults should also know the changing look of vapes. Boyd says they could be in plain sight in your child’s room, and you could miss them. Vapes can look like computer flash drives, ink pens, key fobs, candy canisters and even handheld video games.

Talking to kids

First and foremost, Boyd suggests taking a loving tone when talking to kids about the dangers of vaping. Don’t start by accusing them of wrongdoing.

“Gather information. Encourage them to open up. Make it a safe place,” Boyd says. “If they don’t feel comfortable talking to mom or dad, maybe try somebody at church, an older sibling, a school counselor or a teacher. Find those accountability people.”

If your child has a hard time opening up, talk to their pediatrician so they can broach the subject at the next appointment. During the appointment, offer to step out of the room so the child isn’t nervous to talk about their habits.

Thompson adds to keep kids active. If you’re playing backyard baseball with them, you know they’re not vaping.

“We want you to be healthy and live a long life,” she adds, suggesting words to use with your child. Not to mention the money you’ll save.

What about smoking?

How does smoking a traditional cigarette or cigar play into all this?

Boyd says some people see vaping as a way to quit smoking. She says that’s a bad idea. Talk to your health care provider instead about medication and other options.

At OSF Moeller Cancer Center, Boyd, Thompson and Williams offer a smoking cessation program. Providers can refer patients to the program, or they can self-refer by calling (618) 474-6791. OSF then connects the person with resources to quit and provides regular check-ins. Schools, businesses and community groups can also call to see how they can benefit from the program.

“Working on oncology, we see the back end. We see patients who have been 30-year smokers. They have a CT scan, and they find an abnormal mass,” Thompson recalls. “So we try to catch them early. We have younger patients who are seeing their primary care provider. Their provider says they’ve been smoking for five years, and they put the referral in. Well, we just saved them 25 years of smoking if we can get them to stop now.”

“Don’t see it as a failure,” if you can’t quit right away or if you relapse and smoke a few, Boyd adds. “Try again. We’re not all made the same. Quitting looks different for everyone”

Interview clips - Karen Boyd

Interview clips - Heather Thompson

B-roll

Scientists are constantly learning more about cancer – what causes it, how it impacts our body and how to treat or cure it. One study has looked at a possible link between frequent drinking of hot beverages and an increased risk of esophageal cancer.

So should coffee drinkers worry? Not drastically, but you should always be mindful of what you put in your body, says Edie Krueger, MD, [pronounced EE-dee // KREE-ger] a radiation oncologist at OSF HealthCare.

“The science behind it is that there’s thermal injury to the lining of the esophagus, or the tube that connects the mouth to the stomach. The thermal injury causes the cells to become aberrant [not normal, in other words] and grow on their own without any checkpoints. That’s basically what cancer is,” Dr. Krueger says.

So what should people do? Dr. Krueger says if you’re a morning coffee or tea person, that’s fine. But if you drink scalding hot beverages multiple times a day, consider changing habits. Let the drink cool off before taking a swig. The study mentions 65 degrees Celsius (149 degrees Fahrenheit) as a danger zone. That’s about the temperature when you get coffee right out of the pot, Dr. Krueger says. Also, swap the afternoon hot coffee or tea with another drink.

“Things in moderation are fine,” Dr. Krueger says.

Why it’s important

Esophageal cancer is not the most common in America (around 20,000 cases per year, Dr. Krueger says). But she says it’s a “tough cancer to treat,” underscoring the need to know about it and get treatment sooner rather than later.

She says there are two types of esophageal cancer. The most prevalent in America is adenocarcinoma. The other type, squamous cell carcinoma, is the one with a possible link to hot drinks.

“The symptoms, in general, are things like reflux or trouble swallowing - especially trouble swallowing things like bread or tough foods like steak or chicken. Just really hard to get food down,” Dr. Krueger explains.

“Usually, esophageal cancer is treated with what we call trimodality therapy. That’s surgery, chemotherapy and radiation,” she adds.

Avoiding alcohol, smoking and obesity are ways to help prevent esophageal cancer.

Learn more

Read more about cancer care on the OSF HealthCare website. Cancer care at OSF includes the OSF Cancer Institute in Peoria, Illinois.

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• Lordosis: This refers to the normal, c-shaped curvature of the lower back.
   
• Kyphosis: This is the normal curvature of the upper back.
  
  In each case, the term itself doesn’t indicate a deformity. But the curvature can become abnormal, prompting a spine physician to take a look and possibly recommend lifestyle changes.

Bonafide spine disorders include:

• Scoliosis: This curvature of the spine brings back pain “from muscles having to compensate to hold the spine and body in the right position,” Dr. Syed says. Sometimes, nerves get pinched, leading to chest, abdomen or leg pain. Severe cases could bring paralysis. Or, a lung could get pinched, leading to impaired breathing. This is called thoracic insufficiency syndrome.
  
  Genetics, nutrition, muscle imbalance and lifestyle can all contribute to getting scoliosis. Your spine can also naturally worsen with age.
  
  “The discs start to thin. The spine starts to tilt. That puts more strain on the joints. They tend to overgrow, twist and change in size. That creates a domino effect. You get this spine that’s really twisted,” Dr. Syed explains.
  
  Dr. Syed adds that most scoliosis cases can be addressed without surgery. The person can change their lifestyle, notably getting on an exercise plan that strengthens the muscles that support the spine. In severe cases, a surgeon would put screws, rods or plates into your spine or make cuts in the bones.
  
  “It pulls the spine into the correct space, frees up the nerves from the pressure on them and gets the spine to heal in that position,” Dr. Syed says.

• Ankylosing spondylitis (AS): Dr. Syed says this is an inflammatory condition in various joints due to the body’s immune system not working properly.
  
  “Normally, your spine is made up of a bunch of repeating segments. They move relative to each other. That’s how you bend and twist,” Dr. Syed says. “In AS, the joints start to become solid bone because of inflammation. That leads to very stiff, brittle painful bones. People are predisposed to fractures with minor falls. Those people we typically see, unfortunately, in trauma settings. They have brittle, stiff spine that doesn’t have any bend or give. They have a fall, and the spine breaks.”
  
  Dr. Syed says a rheumatologist could put an AS patient on an immune-modifying medicine to prevent inflammation.

Prevention

Keeping a healthy spine comes down to “fundamental good behavior,” Dr. Syed says.

• Avoid activities that could injure the spine. That could be everyday things like heavy lifting or career choices like a contact sport.
   
• Maintain a healthy weight through a healthy diet and active lifestyle.
  
  “You don’t want to be too skinny or too big,” Dr. Syed suggests. “That puts either too much strain [when you’re overweight] or not enough muscle to support the spine [when you’re underweight].
  
  “It’s like Goldilocks,” Dr. Syed adds, referring to the “not too hot, not too cold” fairytale. “You want to work out but not too intensely that you’re crossing over into injury.”
  
  Walks or light jogs could be the things for you, he says.
   
• Avoid smoking.

Learn more

The OSF HealthCare website has information on orthopedic health. The OSF Illinois Neurological Institute also provides comprehensive care.

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When watching a basketball game on television, you may hear coaches and announcers say the star player is missing time with a hernia.

A sports hernia is different than a hernia suffered in everyday life, says Raman Kumar, MD, a colorectal surgeon and general surgeon at OSF HealthCare. But each should be taken seriously.

Hernia

Dr. Kumar says a hernia is when an internal organ or piece of fat goes through a hole in the abdominal wall. The most common type – around 80%  – is an inguinal hernia, when a part of the intestine pushes through the abdominal wall in the lower belly (also called the groin). Anyone can get a hernia, even newborns. But Dr. Kumar says they are seen more in older men. Symptoms include a bulge or swelling in the abdominal area and pain when moving.

“A lot of chronic heavy lifting,” can cause hernias, Dr. Kumar says. “Other things weaken the abdominal wall such as diabetes and smoking. Being obese causes a lot of weight hanging down on the abdominal wall. If you’ve had surgery in the past, that’s also a risk factor.”

So be mindful when lifting objects, Dr. Kumar advises. Lift with your knees, not your back, and don’t try to lift heavy items. Get a cart or a partner to help. Eat healthy and exercise to avoid obesity and diabetes. Avoid alcohol and cigarettes.

Dr. Kumar says an exterior wrap known as a hernia belt or abdominal binder can be a short-term solution. But surgery is often the endgame.

“If you have a hole or defect, it needs to be closed,” Dr. Kumar says. “The reason we fix hernias is because we don’t want a loop of intestine or bowel to get into the hernia, twist off and die.”

That would make a person very sick and possibly threaten their life, Dr. Kumar says.

Sports hernia

Dr. Kumar says a sports hernia is a muscle tear in the groin area. They’re seen in athletes due to all the twisting, turning and bending that comes with competition.

“Stretch before you do any type of activity. Work and develop your core muscles, including your abdominal and hip muscles.” Dr. Kumar says. “If the muscles are strong, they are less likely to tear.”

Athletes who complain of groin pain should immediately leave the competition and get checked out by a trainer or doctor. Resting and icing the groin will help, but a combination of medication, physical therapy or surgery will likely be needed to fully heal.

Be proactive

If you have symptoms of a hernia or sports hernia, see a health care provider right away.

“Nine times out of 10, we can determine you have a hernia just based on a physical exam,” Dr. Kumar says.

But for more complicated cases, your doctor may order an ultrasound or CT scan. Then, the provider will develop a treatment plan.

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Previous coverage

Hernias: More common than you think

Breast cancer is one of the most common cancers in the United States, says Heather Thompson. And she would know. Thompson is a breast health navigator at OSF HealthCare, helping patients navigate appointments, insurance and more. And Thompson is, herself, a breast cancer survivor.

But what many in the cancer space might not realize, Thompson says, is that breast cancer can affect men. It’s rare, with 1% of men statistically getting it, Thompson says. But it’s worth knowing how to spot, prevent and treat it.

“There can be severe cases. A lot of times, men don’t notice things or worry about things like women might,” Thompson says. “The cancer is there longer and has a chance to metastasize [spread] and get into their lymph nodes. A lot of times, men will get gynecomastia. That can cause swelling in the breast tissue and a mass.” Those gynecomastia masses can limit a man’s ability to feel a cancerous lump, delaying care.

Breast cancer basics

Genetics (i.e. a family history of cancer), alcohol use and smoking all put you at a higher risk for breast cancer.

So do men need to do monthly self-checks and get mammograms like women are told to? Not always, Thompson says. You should talk with your primary care provider about a plan, especially if you have a family history of breast cancer. That plan could involve genetic testing or blood work to check estrogen levels (since estrogen feeds cancer cells). But day to day, Thompson says to just keep an eye on your breasts. Look for inverted nipples, lumps, redness or achiness.

“Men really do not require regular screening or imaging for breast tissue. That is not in the American Cancer Society guidelines or any other guidelines,” Thompson says. “However, men should monitor their bodies for anything irregular. Then, get it addressed right away. Don’t wait. You might be in that 1%.” Thompson adds that if any type of cancer spreads, it can be fatal.

Treatment for male breast cancer typically involves a mastectomy, or the removal of breast tissue, Thompson says. This could be after cancer is found. Or it could be preventive if you’re at high risk, like the case of actress Angelina Jolie.

“There’s not much tissue that a man has,” Thompson points out, allaying fears that your chest will look significantly different. She says you won’t have a nipple, and your chest will be flat. But that’s about it. “We will still test those lymph nodes during surgery to make sure the cancer hasn’t spread.

“After that, there’s special testing called oncotype,” she adds. This looks at the likelihood of cancer returning. “If it’s a high score, those people sometimes have to have chemotherapy or radiation.”

Changing minds

Thompson knows men can be apprehensive about seeing a doctor in general. But when breast cancer enters the conversation? She’s heard things like “I’m not a woman. I don’t need to worry about that.”

At OSF Moeller Cancer Center in Alton, Illinois, where Thompson works, she sees one to two men per month come in for imaging. Most, she says, are cases of gynecomastia that can be managed by the person’s primary care provider. But some do hear the words “It’s cancer.”

“I tell them they’re not alone,” Thompson says. “Other men have gone through this. We have a roadmap to treat it.”

Learn more

Read more about cancer care, specifically breast cancer care, on the OSF HealthCare website. Cancer care at OSF includes the OSF Cancer Institute in Peoria, Illinois.

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A brawl is brewing between government regulators and the manufacturer of the best-selling e-cigarettes in the United States. The U.S. Food and Drug Administration (FDA) has agreed to pause its ban on products from vaping company Juul while the government reviews the company's electronic cigarettes. 

The FDA had banned the marketing and sales of all vaping products produced by the company, a decision that was appealed by Juul, yet applauded by health care professionals. 

“Why would we inhale anything in our lungs except good clean air?” remarks Dr. Patrick Whitten, an OSF HealthCare pulmonologist in Peoria, IL. “So it's just yet another step in the right direction to try to get people not to put anything in their lungs this damaging.”

The FDA claims Juul’s application for authorization lacks enough details about the chemical makeup of its vaping formulas, and doesn’t significantly prove that its e-cigarettes help adult smokers quit or reduce their smoking. 

Another concern of government regulators and health care providers alike is the increase in teen and adolescent vaping, and what Juul Labs, which is owned by Altria Group Inc., the maker of Marlboro cigarettes, is doing to prevent it. 

“The cigarette companies realize that it's important for them to get people hooked on these products because cigarettes kill people and if they kill their consumer, they have to replace that consumer or else they don't have a business model,” says Dr. Whitten. “So this despicable business model is to get younger smokers or younger people hooked on their products to continue to use. If they don't replace their consumers that they're killing off, they have no business.”

As the battle between the FDA and Juul continues in the courtroom, Dr. Whitten urges parents to be proactive at home. 

At high doses, nicotine can cause dizziness and vomiting. Users who refill their own cartridges are especially at risk for unsafe levels of the drug. Even more concerning, young children have been poisoned after coming in contact with the nicotine-containing liquid. Teens who use e-cigarettes may become addicted to nicotine, which can harm their developing brain. There’s also concern they may start smoking regular cigarettes. 

According the U.S. Centers for Disease Control and Prevention (CDC), in 2021, about one out of every 35 middle school students and one of every nine high school students reported that they had used electronic cigarettes in the past 30 days.

Dr. Whitten says a parent’s open and honest communication with their kids can help pave the way to a smoke and vape-free future. 

“Education is the key here,” he explains. “We can all learn things from each other, right? So even for our own kids, who we think are not going to be doing things like vaping, information is so important. So why they shouldn’t do things like that. So it's good to have that open dialogue between the parents and the kids.”

When it comes to both vaping and smoking, the top takeaway, according to Dr. Whitten, is to not start. And if you are a smoker to quit. He says it’s never too late – even for life long smokers. 

“It’s never, never too late to quit. When someone quits smoking, even within hours, some of the respiratory cells start to heal themselves a little bit. And you do reduce your risk for lung cancer over time. It's not back to zero, but you do decrease some of that risk if you quit smoking.”

For help quitting smoking, speak with your primary care physician. OSF HealthCare also offers structured programs to help individuals who want to quit. To learn more visit osfhealthcare.org and search “smoking cessation.”

Interview Clips - Dr. Patrick Whitten