Aching, cramping, burning in the legs, calves, toes and feet or the presence of non-healing wounds – these are the symptoms of inadequate blood circulation otherwise known as peripheral artery disease (PAD).
September is PAD Awareness Month. Raising awareness is vital because PAD is a common condition that affects upwards of 10 million Americans and one in every 20 over the age of 50. Often PAD is underdiagnosed and certainly undertreated.
Although PAD affects many Americans, I find that most of my patients know very little about it. In fact, PAD is lesser known than other relatively rare diseases such as Lou Gehrig’s Disease or multiple sclerosis.
PAD is a circulatory problem that occurs when blood vessels in the leg become narrowed or blocked by plaque, commonly due to smoking, high cholesterol, diabetes or high blood pressure.
Along with pain and difficulty with walking, the risks for gangrene or limb amputations may be a reality if left untreated. Blockages can build up over a lifetime, symptoms, however, may not develop until blockages are severe.
Common symptoms can include aching and painful cramping in the calves, thighs, or buttocks that make it difficult to walk. Many of my patients are unable to walk in the grocery store or even to get their mailbox because of the pain in their legs. Leg pain tends to occur regularly when active, but subsides at rest. Other symptoms can include aching or burning in the toes and feet when lying flat, often occurring at night. Non-healing wounds on the feet and ankles are also key indicators and are the result of more advanced disease.
If you have ever been a smoker, or suffer from diabetes, kidney disease, high blood pressure, high cholesterol, or have a family history of peripheral vascular disease, you are at a real risk of developing PAD.
It is important that you partner with your healthcare provider to manage these risk factors. It may also be wise to talk to your healthcare provider about whether you could benefit from vascular screening. This is commonly performed by a vascular specialist utilizing painless ultrasound technology. Most insurances will cover ultrasound evaluation with a referral.
Because PAD is generally least understood, many who suffer from it believe their pain and walking limitations are simply due to age or being out of shape. Knowing whether you are at risk, recognizing the symptoms, and communicating your symptoms to your healthcare provider in a timely manner are vital to preventing future complications.
As is the case with most disease, the best treatment for PAD is prevention. Managing diabetes, high cholesterol, and high blood pressure are key to prevention, but most importantly you should stop smoking immediately, as smoking is the leading cause of plaque build-up in blood vessels. Regular exercise consisting of, at minimum, briskly walking for 30 minutes, three times a week is also an effective preventive measure.
Beyond preventive measures, medications such as aspirin that reduce clotting and statins that help control cholesterol levels may slow the accumulation of plaque buildup.
Treatments can include ballooning of blocked vessels, placement of a stent – which is a type of metal scaffolding to keep the vessel open, or removal of the plaque through a “roto-rooter” device. All of which are highly effective, minimally invasive outpatient vascular procedures.
More involved procedures such as creating new blood piping to obtain blood flow in key areas may be necessary in more advanced disease. Your vascular surgeon can provide both minimally invasive outpatient procedures or more complex surgical therapies, all of which are tailored to your specific condition.
PAD isn’t new, we are just now better able to identify the condition early and prevent its complications. Awareness of the disease and effectively communicating symptoms to your healthcare provider are vital to early diagnosis and treatment that could significantly lower your risk of heart attack, stroke, or loss of limb.
For more information about PAD, visit the Peripheral Arterial Disease (PAD) Fact Sheet at cdc.gov
Dr. Omar P. Haqqani, MD is the Chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.