Leg Pain and PAD – An Introduction
Do your legs hurt when you walk? Have your activities or work duties become limited due to painful leg cramps? Do you or someone you know suffer from a non-healing wound or ulcer? You may have Peripheral Artery Disease (PAD). PAD is a progressive disease of the arteries that limits the circulation to your legs and feet. This is what people refer to as “blockages in the arteries”, “plaque”, or “hardening of the arteries”. The medical term is “atherosclerosis”.
Peripheral Artery Disease
PAD is very common, with many people not even aware they have diseased arteries. As people age, nearly 70% over the age of 80 will have PAD. There are many causes of PAD, but the most common are diabetes, cigarette smoking, high blood pressure, high cholesterol, and family history (genes). Diabetes and smoking are especially dangerous. People who have more than one of these risk factors increase their chances of having PAD significantly. Additionally, this problem runs in families and can be inherited.
The symptoms of PAD are fairly reproducible: crampy leg pain or weakness brought on by walking or exercise. Most people state their symptoms improve with short periods of rest. More advanced disease may manifest itself with a non-healing, painful ulcer or wound, or even progress to gangrene of the foot or toes. Some people become so debilitated that they have constant pain, or are unable to walk any longer. Symptoms such as these could even lead to amputation one day, and need more urgent attention. If any of the above scenarios apply to you, then you may have PAD. Diagnosis is relatively straightforward, using a combination of history and physical exam (a doctor’s office visit), and non-invasive ultrasound testing (also performed in the office). Once we have discussed your symptoms and evaluated your ultrasound, we can assess your circulation and formulate a treatment plan.
It is important to know that if you are having symptoms in your legs, there are likely problems with the circulation throughout your body, including your heart and brain. Having a complete evaluation can help you live a longer, healthier life. Therapy for PAD has evolved significantly in the last 20 years. Now there are many new medical options to help slow the disease process, and improve symptoms. Problems that would have required surgery to fix years ago can now be fixed with minimally invasive therapies – some are even performed in the office! Some patients with more advanced disease may ultimately require surgery to repair their circulation. Our physicians are vascular experts who can find the right combination to improve your circulation and your symptoms.
Lee Goldstein, MD, FACS, CWS
Dr. Goldstein is a board certified vascular surgeon at The Vascular Experts, where he uses his expert experience treating carotid disease, abdominal aneurysms (including both open surgery and complex endovascular repair), and both superficial and deep venous disorders. He also has an active interest in wound care, limb salvage, and amputation prevention.
Dr. Goldstein graduated from Yale University School of Medicine and continued his general surgery internship and residency at The Hospital of the University of Pennsylvania. He further specialized in vascular and endovascular surgery at The New York Presbyterian Hospital (Cornell and Columbia Universities). During his career, he has been the Principal Investigator for several national vascular surgery research trials, including the Percutaneous Aneurysm Repair (PEVAR) Trial, and has authored dozens of peer-reviewed research articles and abstract presentations at national meetings.
Please contact Dr. Goldstein at LGoldstein@TheVascularExperts.com with any additional questions.