Many people experience various non-specific pains in their legs from time to time when walking. Although the reasons for this can often be completely harmless, in some cases the leg pain indicates a dangerous illness.
Do your legs hurt when you walk? Experts in peripheral arterial disease (PAD) point out in an article by the American Heart Association (AHA) that these symptoms can be a sign of PAD. This condition can cause serious complications but is manageable.
Peripheral arterial disease (PAD)
“Leg pain when walking is not necessarily a feature of normal aging,” says Dr. Natalie Evans, a vascular medicine physician at University Hospitals Harrington Heart and Vascular Institute in Cleveland.
Peripheral artery disease (PAD) – also called intermittent claudication – occurs when atherosclerosis (hardening of the arteries) narrows the blood vessels that supply oxygen-rich blood to a person’s extremities, typically the legs and feet.
PAD is similar to coronary artery disease, in which plaque builds up in the heart’s arteries and can lead to a blockage of blood flow. This blockage can lead to a heart attack. Plaque buildup in the arteries leading to the brain can cause a stroke.
The cause of the symptoms is often only discovered late
Often people assume that they just get “slower” as they get older, or they attribute their leg pain to something else.
“Sometimes it feels like radiating back pain or is mistaken for an orthopedic problem,” explains clinical psychologist Kim Smolderen.
“And then they may consult several different doctors before realizing where the pain is coming from, and that’s not just ignorance on the patient’s side, but also on the doctor’s side.”
Do not confuse with thrombosis
What PAD is not: Blood clots in the legs. But in people with PAD, blood clots can form when plaque buildup causes the artery wall to rupture.
PAD should also not be confused with deep vein thrombosis (DVT). DVT occurs in the veins, not the arteries.
Long periods of immobility after surgery, an injury, or while traveling can lead to DVT. Part of the clot can break loose and become lodged in the lung, a sometimes fatal condition called a pulmonary embolism.
PAD may not be as acute as a blood clot, but if left untreated or undetected, it can lead to non-healing wounds, gangrene, or, in severe cases, amputation.
Impact on quality of life
Even if PAD has not yet progressed, it can significantly impact people’s everyday functions, well-being and mental health, says Smolderen. For example, people would be less likely to walk if walking caused pain.
“People also suffer from high levels of chronic stress,” said the expert. “And the overall impact on quality of life is also an important factor.”
The risk factors for PAD are similar to those for heart disease, including older age, physical inactivity, high blood pressure and high cholesterol.
People who smoke have twice the risk of PAD compared to non-smokers, and the same is true for people with diabetes.
“What we need is basic prevention of all cardiovascular diseases, where we prevent people from developing risk factors such as tobacco use and diabetes,” says Evans.
Some patients may need stents inserted to open blood vessels or surgery to bypass blocked arteries. In the most severe cases, amputation may be the only treatment.
But the first line of treatment for many people, says Dr. Evans, be simple and non-invasive: supervised exercise therapy.
“I tell patients that it’s something like cardiac rehabilitation for the legs,” says the doctor. Initial treatment typically involves 30 minutes of total walking time, three days a week for 12 weeks. “People can actually double their pain-free walking distance, which is an incredible improvement.”
It is not clear why supervised exercise therapy is so effective. “Whether it’s because we’re conditioning the muscles to work in a low-oxygen environment or because we’re actually growing new blood vessels isn’t entirely clear,” says Dr. Evans. “What we know is that it works.” (ad)