Is There More To Those Achy Legs?

Have you been suffering from achy legs especially after walking? There could be an underlying Peripheral Arterial Disease.


By Dr. Manisha Yadav

What Are The Symptoms of Peripheral Arterial Disease?

High cholesterol, inactivity, diabetes and smoking can lead to atherosclerosis (deposition of fat in arteries) and arteriosclerosis (hardening of arteries), which can lead to heart attacks and strokes (due to decreased blood supply).

When this ongoing decreased blood flow is happening to your legs, it manifests as leg pain when walking and achiness, burning or discomfort in the muscles of your legs. Other symptoms include:

  • Pale skin
  • Hair loss on legs or feet
  • Your skin is cool to the touch

There also can be an associated numbness or tingling. The pain may improve with rest, but if left untreated the pain can worsen with time, which will eventually lead to pain at rest, just like a heart attack. And later the skin can turn dark and blue due to the dying tissue and can be extremely painful. It can lead to sores which do not heal.

How To Test for Peripheral Arterial Disease

Your doctor may initially test you for the following:

These are are all important tests to consider. If these tests are normal, and if you have high risk factors and symptoms, your doctor should consider checking the blood supply to your legs. High risk factors and symtpoms include:

  • Diabetes mellitus
  • Abnormal cholesterol
  • Coronary artery disease
  • High blood pressure
  • Advanced kidney disease
  • Smoking
  • Cerebrovascular disease

Testing the blood supply to your legs can be done several ways:

  1. Treadmill test. Involves you walking on a treadmill to evaluate at what level of exercise the symptoms are reproduced.
  2. Doppler Ultrasound. It is a handheld device placed over the blood vessels to see if they are blocked or narrowed.
  3. Ankle/brachial index. This involves comparing the blood pressure in the upper arm and the ankle. The normal value is between 1.0 - 1.4. If it is below 0.9, it is considered abnormal.
  4. Arteriography. This test requires the use of a special dye and x-rays to see how wide or narrow the blood vessels/arteries are.
  5. Magnetic Resonance Angiogram. It involves using a MRI to see the location and severity of a blocked blood vessel.

How Can I Treat Peripheral Arterial Disease?

Even if you have Peripheral Arterial Disease, there are many things which can be done to help you!

It begins with your participation in changing your lifestyle like:

  • Eating healthy
  • Quitting smoking
  • Reducing weight
  • Controlling blood pressure
  • Diabetes and cholesterol
  • Engaging in supervised exercise program

Medications can be given to thin your blood (Aspirin, Plavix/Clopidogrel) or dilate the narrow blood vessels (Pletal/Cilostazol, Trental/Pentoxifylline).

Surgical therapies include:

  • Angioplasty: blood vessel is dilated by using a catheter
  • Thrombolytic therapy: involves giving a medicine to dissolve the blood clot which is blocking the artery
  • Bypass surgery: bringing blood supply from another blood vessel

The treatment for Peripheral Arterial Disease needs to be modified according to the individual’s risk factors and disease severity. So, please don’t ignore your achy legs and check with your doctor and have your pulses checked to see if you are at risk for Peripheral Arterial Disease.