One of our patients, whom we’ll call Joan, confided last week that she is finding it increasingly uncomfortable to walk anywhere. She finally decided to seek medical help when she and her daughter went to the mall to shop for more comfortable shoes.
They hadn’t even arrived at the shoe store when she had to sit down to rest. Her legs have been feeling heavy, she told us, with soreness after she goes to the mailbox and back (just a few minutes’ walk up the driveway). Now she was wondering whether this could be something serious.
We examined Joan and ordered an imaging test (ultrasound, for starters). Joan is a smoker, and she has high blood pressure. She’s also diabetic. She has a handful of risk factors for something doctors call Peripheral Arterial Disease, or PAD.
PAD refers to blocked arteries, often occurring in the legs. When blood can’t move properly through the arteries, the nerves, muscles and other tissues don’t get sufficient oxygen and nourishment. Joan is actually fortunate that she could feel the pain. Some diabetic patients who have nerve damage aren’t aware they have PAD until ulcers form.
It’s important to seek treatment for Peripheral Arterial Disease (PAD) because if left untreated, it can lead to amputation of a foot or leg. Fortunately, Joan had sought help before the situation was serious.
Sore Legs, Potential Long-term Damage
Many people ignore PAD because the damage comes on gradually.
People who gain a few pounds as they grow older, who walk less, who are smokers and diabetic have the greatest risk of developing Peripheral Arterial Disease (PAD). Those who are diagnosed with PAD in turn have a higher risk of arterial disease in the brain and heart, as well as stroke or heart attack.
There are actually two types of PAD. Functional PAD means there is no inherent defect in the blood vessels; the symptoms tend to be spasms that come and go. Organic PAD, on the other hand, is caused by a fatty build-up in the walls of the arteries, which blocks normal blood flow.
In the beginning, PAD patients may notice occasional pain or fatigue in the legs and/or buttocks. Gradually, the pain returns more often and is more intense.
PAD tends to affect the iliac artery at the base of the spine, the femoral artery in the groin area, the popliteal artery in the knee and the tibial arteries in the shin and calf.
How Can Peripheral Arterial Disease Be Treated?
One of the first recommendations we made to Joan was to quit smoking. In addition, we encouraged her to get more exercise. If walking is difficult, she could try the water aerobics class at the YMCA pool or the stationary bicycle at the gym.
Diet, always an issue for a diabetic, needed some scrutiny as well. We suggested she meet with a dietitian who could help get her blood sugar under control.
While there are medications to improve circulation, to help prevent clotting, to control blood pressure, cholesterol and glucose levels, lifestyle is critical for patients with PAD.
If none of these interventions relieved the situation, we would recommend surgery to open the arteries and increase blood flow.
Poor circulation is a critical issue with Peripheral Arterial Disease (PAD) patients. Blood flow is important for healing, and even minor blisters or sores can lead to complications.
Self-help Guide for Patients with PAD
There are simple steps you can take to manage PAD:
- Wash your feet daily and dry them well
- Don’t go barefoot; always wear shoots and socks
- Choose shoes that don’t cause blisters
- Keep the skin soft and don’t let it become too dry
- Check your feet every day for rash, corns, calluses, blisters, swelling, ingrown toenails or infections.
- See your foot and ankle surgeon regularly if you think you might have PAD.