When is Peripheral Arterial Disease (PAD) the cause?
Anthony J. Avino, M.D., F.A.C.S.
There are many causes of leg pain ranging from arthritis to bulging discs in your lower spine to blockages in the arteries of your legs (peripheral arterial disease or P.A.D.). Other causes include neuropathy, fibromyalgia, venous insufficiency or swelling and an assortment of muscular-skeletal conditions (ailments affecting muscles, joints, bones, tendons etc.). While all of these conditions can cause significant discomfort, a diagnosis of peripheral arterial disease has the greatest implications for your health. A good understanding of when leg pain is caused by P.A.D. is very important not only because this will affect treatment options but also because P.A.D is associated with significantly increased risks of heart attack, stroke and death.
WHAT IS PERIPHERAL ARTERIAL DISEASE?
P.A.D. is a very common condition that affects an estimated eight million Americans. P.A.D. occurs most often in the arteries of the legs but can also affect the arteries that carry blood to the brain, the arms, the kidneys and other vital organs. When blockages affect the arteries to the heart, this is called coronary artery disease. The buildup of plaque in arteries causes the arteries to harden and narrow and this significantly reduces blood flow. This serious condition is called atherosclerosis and often referred to as “hardening of the arteries” or “poor circulation.
WHAT ARE THE SYMPTOMS OF P.A.D. AS OPPOSED TO THE MANY OTHER CAUSES OF LEG PAIN?
This distinction is very important since most leg pain is not caused by circulation problems. Night cramps and leg pain while you are sitting, lying or standing is rarely caused by P.A.D. Pain in your joints, feet or back while walking is most frequently related to one of many muscular-skeletal disorders.
Symptoms of P.A.D. are usually very specific. The most common signs include calf or thigh or buttock muscle pain that occurs while walking (not night cramps) and is relieved with only a couple minutes of rest. This is called claudication and occurs when blockages prevent the additional flow of blood and oxygen needed by the muscles for the extra work of walking.
Your physician can review your history and risk factors and examine the pulses in your feet and legs. If your pulses are normal, you do not have P.A.D. If your pulses are weak or absent, you may well have P.A.D. and require further diagnostic studies.