Do Your Legs Hurt When You Walk?

Washington Hospital Seminar Focuses on Peripheral Vascular Disease

If your legs hurt when you walk, you could have peripheral vascular disease (PVD). While it might feel like just a muscle cramp, it could actually be the result of restricted blood flow in the arteries.

“Patients often massage the area in their leg that hurts, thinking it’s just a cramp,” said Dr. Gabriel Herscu, a vascular and endovascular surgeon who is a member of the Washington Hospital Medical Staff. “With PVD, the reason it cramps is because the muscle is not getting enough blood to it and it reacts by cramping. The pain is brought on by walking, but relieved by resting.”

According to Dr. Herscu, PVD is caused by atherosclerosis in about 99 percent of the cases. Atherosclerosis occurs when fatty deposits called plaque build up in the artery wall, restricting blood flow. When an artery is blocked or narrowed, the part of the body it supplies does not get enough blood and oxygen.

You can learn more about this potentially life-threatening disease at an upcoming seminar titled “Pain When You Walk? It Might Be PVD” on Tuesday, June 28, from 1 to 3 p.m. Dr. Herscu will present the seminar with Dr. John T. Mehigan, a vascular surgeon and medical director of the Vascular Center at Washington Hospital. It will be held d at the Conrad E. Anderson, MD, Auditorium at Washington West, 2500 Mowry Ave., in Fremont. You can register online at www.whhs.com or by calling (800) 963-7070. Know the Signs

The seminar will focus on the symptoms, diagnosis and treatment of PVD. The most common symptom is painful cramping in the hips, thighs or calves when walking, climbing stairs or exercising. Symptoms can also include numbness and tingling in the lower legs and feet, and ulcers or sores on the legs or feet that don’t heal. The major risk factors are age, diabetes, smoking, high blood pressure and high cholesterol.

“Generally PVD can be diagnosed by medical history and a physical exam,” Dr. Herscu explained. “We confirm it with pressure testing and other testing procedures.”

Dr. Mehigan and local cardiologist Dr. Ash Jain will be providing PVD screening at Washington Hospital on Saturday, June 25, from 10 a.m. to 2 p.m. The screening measures blood flow in the leg and foot by comparing blood pressure in the ankle to blood pressure in the arm.

Other diagnostic procedures will also be discussed at the seminar, including angiography. An angiogram is an imaging procedure wherein a tiny tube is inserted into a small incision in the groin. Dye is injected into the arteries and doctors can actually see the location and severity of the blockage.

“Angiography is the gold standard,” Dr. Herscu added. “It is the most accurate diagnostic procedure for PVD, but it’s not without risks. That’s why it’s only used in select cases of PVD. Just because you have arterial blockages doesn’t mean that you need an angiogram. You generally get an angiogram only when you have lifestyle-limiting leg pain, ulceration or gangrene.”

Treatment Options

There are a number of treatment options available for PVD depending on how severe it is and how much impact it’s having on quality of life. Dr. Herscu said surgical procedures to open up the artery are called for in more severe cases of PVD.

“Generally if you are having mild symptoms and the pain in your leg is not keeping you from participating in normal activities, there is no danger to avoiding surgical procedures and angiography,” he added. “However, severe PVD, with constant pain, ulceration or gangrene, can lead to the loss of your leg and even death, so it’s important to talk to your doctor about your treatment options. If you have diabetes, PVD is not something you can ignore. People with diabetes have weakened immune systems and damaged nerves, so they end up with more complications.”

PVD is medically treated with aspirin and statin medications that are used to lower cholesterol, according to Dr. Herscu. These help to thin the blood so clots don’t form on the damaged arterial wall. He said statins are important even if you don’t have high cholesterol because they reduce inflammation and stabilize plaque so it doesn’t rupture and form a blood clot, which can clog the artery.

Lifestyle choices are also important when it comes to managing PVD. If you smoke, quit. Exercise can help you maintain a healthy weight and reduce inflammation. Dr. Herscu recommends 30 minutes of aerobic exercise at least three times a week. Eat a diet that is high in fruits and vegetables and low in fat and cholesterol. Keep blood pressure and cholesterol under control, and if you have diabetes, stay on top of your blood sugar levels.

“Lifestyle choices can’t replace medication, but they can help reduce your risk and avoid serious complications,” Dr. Herscu added.

For more information about other Washington Hospital programs and services that can improve your health, visit www.whhs.com.