By Mark H. Reddig
William Lupo knew he had a problem. And it seemed to have started after he installed a new driver’s seat.
The 58-year-old OOIDA member from Oxford, IA, noticed that his legs would turn red. He would run a fever at times. Later, he started to feel nauseated, and his legs began to hurt – a lot – mainly in the calves. That was followed by swelling, and even blisters that eventually turned into ulcers.
“It’ll hurt just to even look at it,” he said.
Lupo went to his doctor, who diagnosed “trucker’s leg.” The term can describe several conditions, but is most frequently associated with peripheral arterial disease, or PAD.
What to watch for
A third or more of those with trucker’s leg will experience symptoms that can include:
- Muscle pain or cramps that come on with exercise but stop when you rest;
- Cold legs or feet;
- Sores on the leg that won't heal;
- Weakness or numbness in the leg;
- The color of your leg changes;
- Hair loss on your feet and legs; and
- Changes in your nails.
What is PAD
Peripheral arterial disease refers to any blockage or reduction in flow in blood vessels outside of the heart. A similar condition in the veins is called peripheral veinous disease. Some doctors also refer to the whole group as peripheral vascular disease.
But the terms are most often used when talking about blood flow in the legs and disease in the arteries of the legs, according to information from the Mayo Clinic. The disease affects about 10 million people in the United States, half of whom have no symptoms.
For truckers like Lupo, extended periods sitting can reduce blood flow and cause the symptoms. But for many others, Mayo Clinic doctors say, it is clogged arteries – atherosclerosis or arteriosclerosis – that bring on the illness.
Registered Nurse Sharon Mitchell, vice president of American Business Medical Services at the Jessup Truck Stop near Baltimore, said the term trucker’s leg can also refer to a particular symptom, dependent edema.
According to Dr. Ron Kennedy, writing for The Doctor’s Medical Library, dependent edema is a condition where fluid in the body collects at the lowest point. For a trucker on the road, that’s the legs and feet.
How truckers get trucker’s leg
When Lupo bought a new seat for his truck a couple of years ago, it had a shorter track than the original equipment.
“My knees are bent more because I’m closer to the dash,” he said.
“You don’t get as much track travel; I don’t get to the back of the cab like we used to. This thing was in the back of my mind, but it never really jumped up till the second time I was in the hospital.”
As a result of his sitting position, the circulation in Lupo’s legs was reduced. That led to PAD, which led to other problems like pain, infections in his legs and other symptoms.
“While this was happening, I spent a week in the hospital and a month at home recovering,” he said. “You have to keep your leg up, and all that stuff. And while you’re in the hospital, you get hit 24 hours a day with high-potency antibiotics.”
Mitchell, also known as “Nurse Red” on the Truck.Net forum, agreed that the long periods of being seated could cause trucker’s leg.
“There’s the bend in the groin area – especially if they’re overweight – that’s going to impede circulation in the femoral artery,” she said. “Then their knee is bent, and there’s another narrowing in arterial and vascular circulation,” which can cause some of the same symptoms.
However, she said it’s not the only factor involved. Being overweight, poor eating habits, poor circulation and heredity can play a part as well.
In part, the problem is gravity, she said, which helps keep the blood and fluids in the lower part of the leg.
It can also be caused in part by phlebitis, an inflammation of the veins, or an old injury that caused scar tissue in the leg or knee.
Not all truckers will develop the condition, Mitchell said.
“There are people who spend a great deal of their time in a seated position that don’t develop this disease,” she said.
“You’re going to find, if you dig pretty deeply into people’s medical history and that sort of thing, that there are other contributing factors that evolve into this problem.”
The Mayo Clinic lists several factors that increase your risk of developing PAD. They include:
- Being over 50;
- Being overweight;
- High blood pressure or a family history of it; and
- High cholesterol or a family history of it.
That profile is similar to the profile of the general population of truckers. The average age of member truckers in a survey by the OOIDA Foundation was 49. Truckers are more likely to smoke than the general population, and are more likely to be overweight.
But trucker’s leg is not strictly a condition of middle age. Lupo said that at both hospitals where he was treated, staff said they were noticing the condition in more and more younger drivers.
What you can do
Lupo’s doctors offered him several pieces of advice on how to deal with the condition if you have symptoms.
“You have to get out of the truck more often, walk around the truck if nothing else,” Lupo said. “Exercise is a thing we don’t get enough of. With the hours of service, it’s even worse.”
Mitchell agreed: “Just general increased activity is going to help people – riding a bike, carrying a pair of roller skates and roller skating around, walking and taking the stairs instead of the elevator. Anything they can do to get their heart pumping and increase their circulation is going to help.”
Lupo suggested sleeping with your legs elevated on a pillow.
Another easy step is to wear support stockings – that’s medical stockings, guys, not pantyhose. The stockings are typically found near the elastic bandages at drug stores.
While some truckers may have their doubts, Lupo said the support stockings “keep your legs from swelling and keep your circulation flowing.”
Mitchell offered this tip for people who choose to use support stockings: Don’t sleep with them on, she said. Rather, put them on in the morning as you wake up, while you are still in bed.
By doing so before you stand, you will help the stockings keep fluid out of your lower legs.
Another step: Alter your driving environment, Lupo said.
“My girlfriend and I … moved the seat back two inches; that made a hell of a difference,” he said. “You get the feeling in your legs, it’s not as tingly … 90 percent of it was getting the seat far enough back.”
Nothing to fool around with
Mayo Clinic doctors are direct about the seriousness of the condition: “Circulatory problems in your legs can also be a clue to the presence of arterial disease to your heart, brain and elsewhere.”
Mitchell said any of the conditions that are related to trucker’s leg should prompt a person to seek immediate medical help.
Mitchell said people who have trucker’s leg could develop wounds very similar to diabetic ulcers that can be slow to heal. There is a possibility that a blood clot can even form. In extreme cases, sufferers can have bone infections or lose a toe or even a foot.