When Is Leg Pain Serious?

A challenging hike, a long bike ride—even sitting too long. There are many causes behind occasional leg pain, and they are usually not much to worry about. But one serious reason your legs may hurt that can easily go undetected is peripheral artery disease, or PAD. Hackensack Meridian Medical Group vascular surgeon Caron R. Rockman, M.D., explains how to tell when leg pain may be serious and when to see your doctor.

What Is Peripheral Artery Disease?

PAD is a type of coronary artery disease that affects the blood vessels that supply the legs and feet. In people with coronary artery disease (CAD), plaque can clog up the blood vessels that supply the heart. The same types of blockage limit blood flow to the legs and feet in people with PAD. Having one type of artery disease puts you at risk of the other.

Certain risk factors can increase your chances of developing PAD, including:

• Genetics
• Smoking 
• High cholesterol and/or blood pressure
• Being overweight
• Lack of physical activity
• Having diabetes
  
  

What Does PAD Leg Pain Feel Like?

Leg pain while walking is a common symptom of PAD called claudication. When you move, your muscles need more blood. If the vessels are blocked, the lack of blood can cause a cramping or painful feeling. It typically stops when you rest.

However, almost half of people with PAD have no leg pain. They may feel muscle tightness or weakness. Symptoms can occur in the thigh or buttocks but usually in the calf. The pain affects muscles but not joints.

More serious symptoms of PAD include:

• Skin that’s cool to the touch
• Cold or numb toes
• Pale skin tone when you raise your leg
• Ulcers or sores that don’t seem to heal—or even gangrene, when tissue dies
• Hair loss on the legs
  
  

When to See a Doctor for Leg Pain

PAD may cause cramps when you move, but sudden nighttime leg cramps are not a sign of vascular disease, says Dr. Rockman. 

“If you’re having leg pain when walking with any other symptoms of PAD, “start by seeing your primary care doctor, who will do a physical exam to assess pulses in the feet,” she adds. “If there is a concern, very easy, noninvasive tests can check your leg circulation.” People with poor circulation should be referred to a vascular surgeon.

If you don’t have a primary care doctor, find one at Hackensack Meridian Medical Group. Many offer online appointment scheduling. 

Treatments for PAD

Treating PAD can improve your quality of life by relieving pain, and in the most severe cases can save someone from needing an amputation. However, making the diagnosis of PAD could also save your life.

Without appropriate medical treatment, artery blockages in other locations such as the coronary arteries or carotid arteries can lead to stroke or heart attack. Thankfully, PAD is treatable.

Noninvasive Treatments

There are some lifestyle changes you can make to get PAD under control.

• Do more physical activity: “Pain when walking may be uncomfortable, but walking will eventually help ‘collateral’ blood vessels to form to overcome blockages, so try to stick with it,” says Dr. Rockman. Ask your doctor about supervised exercise through a rehabilitation program or local community center.
• Keep a healthy diet: Some people with PAD have high cholesterol that can be lowered with diet or medications when necessary. Choose unprocessed foods, and eat plenty of fruits, vegetables, whole grains, low-fat dairy, poultry and fish. Cut down on red meat, sugar and salt.
• Quit smoking: Medications and smoking cessation programs can help.
• Control your blood pressure: Work with your doctor to keep an eye on your blood pressure. Get an at-home monitor to check it between visits. Diet and exercise should help keep it at a healthy level.
• Take an antiplatelet medication: The most common is aspirin, but your doctor can suggest a prescription drug.
  
  

Surgical Treatments

When PAD becomes severe, Dr. Rockman suggests two types of surgery:

• Angioplasty and stent: During these types of minimally invasive procedures, a surgeon widens arteries in your leg using a balloon. Your doctor then may choose to place a stent, or tiny metal tube, to keep the arteries open.
• Peripheral artery bypass surgery: This procedure “reroutes” blood flow around a blocked artery.

If you have ongoing leg pain and aren’t sure why, remember that the earlier you find out the cause and treat it, the better your outcome.

Next Steps & Resources:

• Meet our source: Caron R. Rockman, M.D.
• Make an appointment with a vascular surgeon near you, or call 800-822-8905.
• Learn more about vascular care at Hackensack Meridian Health.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.