Pain in Your Legs? It Might Not Be Your Muscles
If you are experiencing pain in your legs while walking or exercising,
it might be more than muscle strain. Pain in one or both legs during exercise
that usually goes away when you stop exercising is the primary early symptom
of a serious condition known as peripheral vascular disease (PVD).
PVD is caused by blockages in the blood vessels – primarily the arteries
that carry oxygen-rich blood from the heart to the rest of the body, but
also in some rare cases the veins that carry blood back to the lungs and
heart. These blockages result in a loss of blood circulation to the body’s
extremities, particularly to the legs and feet. People who have PVD also
are more likely to experience other cardiovascular conditions such as
heart attacks and strokes.
“The body’s vascular system is all interconnected,” says
cardiologist Ash Jain, MD, who serves at Washington Hospital as medical
co-director of Vascular Services, as well as medical director of both
the Stroke Program and Invasive Vascular Imaging.
“Blockages of blood vessels in the legs can indicate circulatory
problems elsewhere in the body, including the heart and the brain,”
Dr. Jain notes. “Approximately 50 percent of patients who have PVD
also have vascular blockages elsewhere in the body. People with PVD have
a higher rate of early mortality. PVD also is a major reason for amputation
of the legs.”
Diagnosing PVD can be as simple as performing a painless, non-invasive
“Doppler” ultrasound investigation of the patient’s
“We have found that it is very valuable to screen for PVD and discern
circulation problems in the legs,” says vascular surgeon John Thomas
Mehigan, MD, FACS, medical co-director of Vascular Services and medical
director of Off-site Community Education at Washington Hospital. “Because
PVD can be related to multiple other conditions, screenings for PVD can
give us important information about the patient’s whole health condition.”
For people in the community who might benefit from PVD screening –
especially anyone over age 50 who is experiencing leg pain while walking
or exercising – Washington Hospital will offer free ultrasound screenings
of leg circulation on Saturday, June 6, from 10 a.m. to 1 p.m. The screenings
will be provided in the Conrad E. Anderson, MD Auditorium located in the
Washington West Building at 2500 Mowry Avenue in Fremont. Dr. Jain and
Dr. Mehigan will be available to interpret the screening results. Individuals
interested in the free screenings must sign up in advance by calling (800) 963-7070.
The risk factors for PVD are similar to those for heart disease and strokes:
- Family history of cardiovascular disease
- High blood pressure
- High cholesterol
People who have any of these risk factors for arterial disease should be
screened for PVD, even if they are not experiencing any symptoms. In addition
to Doppler ultrasound, screening for PVD might include a painless test
called an ankle-brachial index that can be performed in the physician’s
office to measure and compare the blood pressure in the arms and legs.
When the blood pressure is significantly lower in one or both legs than
in the arms, it may indicate PVD.
Additional testing might include angiogram imaging, with a contrast agent
injected into the artery prior to taking an x-ray to show arteries in
the legs and any blockages that may be present. Angiogram imaging may
be combined with computed tomography (CT) or magnetic resonance imaging
“When someone has PVD, the first line of treatment is to make lifestyle
changes to lower the person’s risk factors,” says Dr. Jain.
“Exercise is key, even though patients with PVD may not be inclined
to exercise because of pain in their legs. Other lifestyle changes might
include stopping smoking, controlling your blood pressure, improving your
diet and managing blood sugar levels if you have diabetes. Various medications
to control blood pressure, cholesterol and diabetes also may be useful.”
If lifestyle changes and medications do not control a patient’s PVD,
other treatments may be appropriate. For patients with pronounced PVD,
treatment might include angioplasty, a non-surgical procedure in which
a “balloon” is inserted to open up blocked arteries. Wire
mesh tubes called stents also can be inserted non-surgically to keep arteries
open. If the condition is more severe and the person has disabling pain,
surgery might be considered to open up blocked arteries or to replace
the blocked portion of an artery.
“The bottom line is that a simple cramp in your leg when you are
walking may be related to other conditions that need to be diagnosed and
treated,” says Dr. Mehigan. “Early treatment of PVD could
not only help ease the pain in your legs, but it also may save your life.
We want to help you and your primary care physician to understand and
improve your overall health condition.”
If you are interested in the free sonogram leg screenings for PVD on June
6, you must sign up in advance by calling (800) 963-7070.