Leg Pain: Should You Be Worried?

Leg cramps are inconvenient, to be sure, but most of us ignore them. After all, it’s difficult to get worked up over a condition described as a “charley horse,” for which your mother may advise you to eat more bananas. When leg discomfort stops you in your tracks on a daily basis, though, it’s time to pay attention.

“Like back pain, leg discomfort affects millions of people,” said Duke cardiologist Manesh Patel, MD. “Most people believe that all leg pain is caused by musculoskeletal or nerve problems, however some types of leg pain can be the first symptom of heart disease.”

Leg discomfort that occurs during exercise is referred to as claudication. “Most people report the discomfort as a cramp that occurs when walking and goes away with rest,” Dr. Patel added.

It might be a symptom of peripheral arterial disease, or PAD, if you have leg pain every time you exercise or move, and it goes away quickly after you stop.

When Good Arteries Go Bad

PAD develops when fatty deposits build up in major blood vessels that provide blood to the limbs and other vital parts of the body, partly or totally blocking them.

Atherosclerosis, or the hardening and constriction of blood arteries, occurs throughout the body, but in individuals with PAD, it can manifest as leg discomfort, according to Dr. Patel. “The more you utilize your muscles, the more blood flow you need,” he added, “but that flow becomes constricted owing to the buildup,” causing cramping.

“Unfortunately,” Dr. Patel added, “people with this disease tend to reduce their physical activity to prevent the pain,” rather than seeking medical counsel. This is a risky approach since patients with PAD, especially smokers and diabetics, are at risk of dying from a heart attack or stroke, and severe instances can result in limb loss.

Clearing the Pathways

Obesity, high blood pressure, high cholesterol levels, smoking, and diabetes are all risk factors for PAD, just as they are for heart disease. And, like with heart disease, there are a number of things that may be done to limit the course of PAD, particularly if it is detected early.

Dr. Patel stated, “We can successfully cure PAD.” “We can assist ease your symptoms and lessen the chance of problems, but you need a diagnosis.”

That means addressing persistent leg discomfort carefully, especially if you have PAD or heart disease risk factors. “If you have calf, buttock, or leg discomfort when walking and need to stop and relax, think about what you would do if you had chest trouble.’ Even if you believed it was simply heartburn or reflux, you’d definitely get it looked out. This may be your version of heartburn.”

So, what’s next? Following a PAD diagnosis,

What matters most about having peripheral artery disease (PAD) is what it tells about your risk of developing additional, life-threatening diseases.

According to Cynthia Shortell, MD, Duke’s director of vascular surgery, being diagnosed with PAD indicates you have atherosclerosis, also known as hardened arteries. She said, “And you should certainly seek therapy and evaluation for it,” as it is a big risk factor for heart disease and stroke.

However, she claims that PAD is not a disease that need severe therapy in all cases. Treatment (or lack thereof) is frequently determined by how much your symptoms interfere with your life.

Dr. Shortell says three treatments are most commonly advised for patients with mild to severe symptoms:

Smoking cessation: One of the numerous advantages of quitting smoking is improved blood flow in the limbs.

A simple fitness program may be as easy as going for a daily walk. Exercise is an excellent method to create new vessels and enhance circulation — as long as the program is followed.

Medications: These can be beneficial for some individuals, but they come with significant negative effects that should be discussed with your doctor.

Surgical treatments can free up clogged veins in patients who have severe symptoms, such as chronic, agonizing leg pain or wounds that won’t heal. These operations are comparable to those used to unblock blood arteries in patients with severe cardiac disease: a balloon or stent is inserted into a blocked vein, or a bypass is performed utilizing a vein from the patient’s thigh.

According to Dr. Shortell, opting to undergo one of these surgical treatments is similar to deciding to have knee replacement surgery for most claudication patients. She explained, “It’s a quality-of-life decision.”

Because the results are long-lasting but not permanent, doctors typically advise deferring major surgical therapy as long as feasible in younger patients or those who have health conditions that may require bypass surgery in the future.

Dr. Shortell explained, “We typically save bypass for really serious situations, such as those where the patient may lose his limb if nothing is done.” However, she points out that only about 5% of patients will lose a limb as a result of PAD. PAD can become a limb- and life-threatening illness for a variety of reasons, including diabetes, renal disease, and smoking.

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