PAD, or peripheral artery disease, mainly affects the arteries outside the heart and brain. It is most commonly found in the arteries of the pelvis and legs. PAD is a fairly similar condition to coronary artery disease (CAD) and carotid artery disease. Both these conditions refer to atherosclerosis in certain arteries which, respectively, supply the heart and brain with blood. Atherosclerosis can best be described as a process whereby plaque builds up inside the wall of an artery. Plaque is usually made up from deposits of fats and cholesterol and is known to significantly reduce the flow of blood through an artery.
In the case of PAD, the most common symptoms are painful cramping in the calves, hips and thighs which will usually come about when you are walking, climbing stairs or exercising. This pain will usually go away as soon as you stop exercising, although it is important to realise that this may still take a few minutes. Whenever you are exercising and using your muscles, they need a constant flow of blood. However, if a blockage has been caused due to plaque build up then unfortunately the muscles will simply not get enough blood while they are being exercised. Many people who suffer with PAD, either have no symptoms whatsoever or often the symptoms are mistaken for something else. The main symptoms of severe PAD are leg pain that still continues even when you stop exercising, gangrene, foot and toe wounds that heal extremely slowly or never heal at all, and a marked decrease in the temperature of your foot or lower leg. This can be tested by comparing the temperature with your other leg or the rest of your body.
Many of us simply dismissed leg pain as a sign that we are getting older. We often believe that perhaps we are suffering a little stiffness, arthritis or sciatica. You will find that the leg pain caused by PAD will always occur in the muscles, rather than the joints. If you are diabetic, you may often believe that the pain that you are experiencing is a neuropathy, which is a fairly common symptom of diabetes that typically causes discomfort and pain in the thighs or feet. It is extremely important, if you are suffering from recurring pain that you immediately speak to your doctor or health care professional.
In order to diagnose PAD you will firstly need a physical examination. Your doctor will perform an ankle-brachial index test (ABI) and will also check for weak pulses in your leg. An ABI will help your doctor to determine how well your blood is flowing by comparing the blood pressure in your feet and arms. This is a fairly simple and painless test and only takes a few minutes to perform. You will typically find that the blood pressure in the ankle is at least 90% of the blood pressure in the arm, but this may be severely affected if you are suffering with PAD. If the results of the ABI show that there is an abnormal ratio between the blood pressure of your arms and legs, you may require further testing. These tests include:
It is extremely important that if you do feel any regular leg pain during physical activity and exercise that you immediately visit your doctor. Often PAD can go undiagnosed and this can be very dangerous as it may lead to painful symptoms, risk of coronary artery disease, carotid atherosclerosis and even the loss of a leg. There are also certain risk factors for PAD that you should consider. These may include ageing, a family history of PAD, cigarette smoking, obesity, cardiovascular disease, diabetes mellitus, high blood pressure, high blood cholesterol, stroke and physical inactivity.
There are numerous treatments for PAD which include changing your diet, smoking cessation, medication, certain invasive treatments or surgery and the most effective form of treatment, regular physical activity. Specific exercises will usually need to be recommended by your doctor however just by performing simple walking regimens, leg exercises and a treadmill exercise program your symptoms can dramatically reduce within a very short space of time.
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