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Chronic Pain in Your Legs May Be Due to Poor Blood Circulation (Part 1)

Swollen-ankles

BY AZEEZ ADEWOLU POPOOLA ADEDUNTAN

B.SC (HONS), MBCHB**, MD, RVT, FACS, FICS

CONSULTANT VASCULAR SURGEON

CONSULTANT GENERAL SURGEON

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In this edition, we will turn our attention to one of the many causes of chronic pain in the legs, called by physicians-Peripheral Vascular Disease (PVD) or interchangeably PAD (Peripheral Arterial disease).

While there are many causes of chronic pain in the legs (lower extremities),such as pain from inflammation of the bone called osteoarthritis, from inflammation of the muscles called myositis/myalgia,from inflammation of the nerves-called neuritis/neuropathy,from degenerative joint disease of the back called lumbago/sciatica,to that resulting from many disease states such as diabetes, kidney diseases, or from hormonal glands such as the one in the front of our neck called thyroid/Parathyroid diseases, the most deadly in terms of limb loss and threat to life is pain in the legs due to lack of blood as borne out by remembering our previous aphorism-“life is blood and blood is life.”

schematic blood flow

Schematic representation of blood flow in our body

 

Peripheral artery disease (PAD) narrows arteries in the legs, limiting blood flow to your muscles. It can take you by surprise, causing no symptoms at all -- or symptoms you may think are something else.

PAD is usually caused by atherosclerosis, the same disease process that causes heart attacks and strokes. And even mild peripheral artery disease is an important signal that atherosclerosis might be affecting vital arteries elsewhere.
What is Atherosclerosis?

Atherosclerosis simply means hardening of the artery-the blood pipe that carries oxygenated blood and food to our tissues. Atherosclerosis is a disease process that occurs throughout the arteries of the body. Common causes include high blood pressure, high cholesterol, cigarette smoking, and lack of exercise.

Over the years, plaques made of cholesterol and debris gradually obstruct the arteries.When atherosclerosis narrows the long arteries of the legs blood flow to the leg muscles becomes inadequate when the muscles are working. Muscle pain, called intermittent claudication, can result. Claudication typically comes on with exercise, and is relieved with rest.

Depending on the arteries that are affected and where the blockage is, different muscle groups can be affected:

Buttock and hip

Thigh

Calf (most common)

Foot (less common)

But pain can be atypical and occasionally attributed to something else. Some patients describe burning or numbness. There also can be severe blockages with no pain at all. Often this is because the body grows blood vessels that "bypass" the blockages, called collateral circulation.

Other signs and symptoms of peripheral artery disease include:

Wounds that heal poorly

Legs are cooler than the arms

Shiny skin over the legs

Loss of hair on the legs

Decreased pulses in the feet

Atherosclerosis causes peripheral artery disease, coronary artery disease, and strokes through the same general process. For this reason, the risk factors for peripheral artery disease are the same as for heart attacks and strokes:

Diabetes

Abnormal cholesterol

Cigarette smoking

High blood pressure

Diabetes seems to be particularly important in the development of peripheral artery disease. People with diabetes have worse peripheral artery disease, and tend to improve less with treatment.

We will discuss the Diagnosis, risk factors modification and treatment of this type of pain in the legs, in our next edition, as PAD is now on the rise in Sub-Saharan Africa, exemplified by Nigeria, due to aping of white men diet, life styles and dietary habits evidenced by Pizza restaurants, Hamburger restaurants, that have dotted our major towns and cities in recent time.

Thank you and best wishes for good health, from “NIGERIAN ALERT “to our readers, as Health is Wealth.