Many people at some point in time have had uncomfortable feelings in their legs. Pain can arise from muscle, bone, and joints as a result of different medical problems. This write-up focuses on pain that occurs in the legs because of decrease blood supply (peripheral arterial disease - PAD).

When you exercise the muscles of the leg (as is the case when walking), there is increased demand on your blood supply to keep up with the exercise. When the arteries (vessels that carry blood with oxygen) are clogged by fat deposits, they are unable to meet up with the required increase in blood supply to such muscles. Discomfort ensues which varies in intensity from mild discomfort to severe pain that may necessitate the need to stop and rest the leg. The pain that occurs with walking is called intermittent claudication. The pain should be taken seriously because what is happening to the arteries in the leg may be an indication of widespread fatty clogging of arteries to vital organs like the heart, brain, and kidney.

Who is at risk for PAD?

Habits: Smoking

Chronic Disease: Diabetes (high blood sugar); hypertension (high blood pressure); high cholesterol

Weight: Obesity

Age: PAD incidence increases with age

Family History:  Heart disease or stroke

What are the symptoms of PAD?

Pain: PAD may start with discomfort and pain in the calf muscles while walking or climbing steps. As the blockage gets worse, the pain becomes more severe, and may even occur at rest.

Temperature: Affected leg may feel colder

Color: Discoloration of the leg. Hair loss can make the leg shinier

Decreased Feeling: Sensation may decrease, making it easy to have sores in the involved foot

Pulses: It is more difficult to feel pulses of the leg in PAD

Sex-Related: Men may have sexual problems

How is PAD detected?

It is necessary to have a high index of suspicion to test for it. A simple test called ankle brachial index (ABI) is used to diagnose PAD. The test involves comparing blood pressure measurement in the arm and leg. The test can be done at the doctor’s office.

What treatment is available for PAD?

Treatment ranges from properly controlling any underlying disease such as diabetes and high blood pressure to:

Life style changes: Losing weight, stop smoking, and exercising gradually as tolerated

Cholesterol-lowering medications: Called statins are used in most cases, except in a case when the person has a reason for which it cannot be used

Blood thinners: Aspirin or in some cases Plavix

Pain reliever: Achieved by using medication that improves the blood flow to the artery (cilostazol) or its less effective alternative, pentoxyfylline

Surgical intervention: A tube may be placed in the narrow artery (angioplasty) or another blood vessel is used in place of the blocked artery (bypass surgery).

Take Home Message

PAD can be diagnosed easily by a simple test.

Smoking cessation is very vital to slowing done the progression of the disease.

PAD should be taken seriously as it may be a pointer to widespread fatty deposits in blood vessels to major organs which can lead to a heart attack, stroke, or kidney damage.

Dr. Oluwatoyosi Dairo can be contacted at Amazing Medical Services on 110-16 Sutphin Blvd, Jamaica New York, NY 11435 or by phone at 718-526-7600.

Disclaimer: This article is for educational purposes only and not meant to replace the advice of your doctor.

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