That Pain in the Leg Could Be Serious

7/8/2022

While pain in your legs while walking is often caused by sore or tired muscles, it can also be a symptom of peripheral arterial disease (PAD), a narrowing of one or more arteries that supply blood to the legs. PAD often goes undiagnosed since leg pain has many possible causes.

“The development of blockages in our arteries is typical as we age,” said Seth T. Purcell, M.D., vascular surgery specialist. “This can be worsened by other health factors such as diet, exercise, smoking, and family history. The cramping sensation that many people experience while they're walking or exercising is due to blockages in the arteries of the leg, and is called intermittent claudication. It's basically our body's way of telling us that the muscle isn't receiving enough blood flow.”

Many people with PAD go undiagnosed because they either have no symptoms at all, or they mistake the symptoms for something else.

“Oftentimes patient's will needlessly suffer from PAD, simply because they think their symptoms are due to normal aging or a different diagnosis,“ said Dr. Purcell. “They begin to limit their daily activities which in turn leads to poorer overall health. Properly diagnosing and treating PAD should be done by a specialist using an evidence based approach in order to help patients live their best possible life.”

People also tend to dismiss leg pain as a normal sign of aging, assuming its arthritis, sciatica, or just stiffness. To start, it’s helpful to consider the source of your pain. PAD leg pain occurs in the muscles, not the joints. If you have diabetes, you might confuse PAD pain with neuropathy – a common diabetic symptom that causes a burning discomfort in the feet or thighs. Other PAD symptoms can include:

• Activity-driven pain. Painful muscle cramping in the hips, thighs or calves that lessens or stops a few minutes after walking, exercising or climbing stairs.
• Chronic leg pain. Can also present as leg pain that does not go away once you stop exercising.
• Non-healing wounds. Foot or toe wounds that heal very slowly, or not at all.
• Cold feet. Notable decrease in temperature of the foot or lower leg, especially as compared to the other leg or the rest of the body.
• Nail and hair growth. Poor or decreased growth of leg hair or toenails on one or both legs.
• Erectile dysfunction. Especially prominent in men with diabetes.

If you suspect you might have PAD, the first step is a physical examination with your vascular or primary care physician. The exam will likely start with an ankle-brachial index (ABI) test that compares the blood pressure in your feet to the blood pressure in your arms to establish how well your blood is flowing in the lower body. The test takes only a few minutes, and ideally the ankle pressure is at least 90 percent of the arm pressure. With severe narrowing, it may be even less than 50 percent. If your ratio is abnormal, you may be encouraged to undergo more testing, including doppler and ultrasound (duplex) imaging, CT scan, magnetic resonance angiography (MRA) or angiography.

Medicines can be used to manage PAD, but the best method of preventing and managing PAD is regular, moderate exercise. Walk until the pain develops, rest for a few minutes, and then resume walking once the pain eases. Keep this up for at least 30 minutes each day. The pain isn’t damaging to the muscles, and over time the distance you can walk without pain will increase.

It’s important not to ignore the possibility of peripheral artery disease as the source of your pain. PAD is more than a discomfort or inconvenience – untreated PAD can lead to a greater risk of heart attack or stroke, and even to the loss of a leg.

Seth T. Purcell is a board-certified vascular surgery specialist and an independent member of the medical staff at Bravera Health Brooksville and Spring Hill. He earned his medical degree at the Loma Linda University School of Medicine in Loma Linda, California. Dr, Purcell then went on to complete his general surgery residency, followed by his vascular and endovascular surgery fellowship at the prestigious Texas A&M Health Science Center located at Baylor Scott & White Health Center in Temple, Texas. As the newest member of Pinellas Vascular, he is looking forward to meeting and caring for those seeking vascular care in Hernando and Pasco counties. Dr. Purcell’s office is located at 10441 Quality Dr. Suite 205 in Spring Hill. For appointments, call (352) 770-8346 or fax (352) 755-0926. Most insurance plans are welcome.

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