Leg pain when you walk? Don’t ignore it

Walking is often touted as a perfect exercise to improve multiple aspects of health. But what if walking causes leg pain? Many people shrug off leg pain when they walk as a normal part of aging. In some cases, though, it’s the sign of peripheral artery disease (PAD), which can put heart and brain health at risk. While PAD doesn’t usually run in families, it’s more likely to occur as people age, or among people who smoke or have high blood pressure, high cholesterol, or diabetes.

What causes leg pain if you have PAD?

People with PAD have fatty deposits in arteries outside the heart — most often in their legs. Pain occurs because these deposits block blood flow to the muscles, impairing their ability to work properly.

Doctors used to think PAD mostly affected men. But when researchers began to include more women in their studies, they learned that the condition is just as common in women, affecting one in every 10 women over age 50 and one in every five over 60, says Dr. Aruna Pradhan, a cardiologist and assistant professor of medicine at Harvard Medical School.

Pay attention to the pattern of leg pain

The cramping and pain in the calves, thighs, hips, or buttocks that people with PAD experience during movement is called intermittent claudication. It’s different from exercise-related soreness, because it occurs only during movement and stops after short periods of rest, says Dr. Pradhan. Muscle soreness caused by exercise lasts for hours or days after a workout, and can still hurt whether you’re moving or standing still.

PAD pain also affects just the muscle — not the joint. “It might happen when you are walking up a flight of stairs or up a hill, and you might find yourself frequently stopping for breaks,” says Dr. Pradhan. As PAD blockages worsen, cramping can start to occur in your legs even when you are sitting or lying down.

While leg pain when walking is a common symptom of PAD, not everyone who has PAD has symptoms. Some people just experience weakness without cramping or pain, but it follows the same pattern: worsening with exercise and easing with rest.

In some cases, people notice other changes, such as

  • slow-healing sores on the feet
  • coldness in one or both feet
  • a change in color on the feet
  • slow growth of leg hair or toenails.

Talk to your doctor about leg pain when walking

While PAD isn’t the only reason you might experience leg pain while walking, it’s important to consider. Having PAD increases your risk of other cardiovascular problems. The fatty buildup in arteries of the leg might also be accumulating in the arteries serving the heart and brain. This makes a person with PAD far more likely to have a heart attack or a stroke than someone without the condition.

If you’re experiencing symptoms of PAD, a simple test called an ankle-brachial index, or ABI, can help your doctor make a diagnosis. Your doctor will use a special cuff to measure the blood pressure in your ankle, and then compare that against the blood pressure in your arm. These readings should match if your arteries are clear. Lower pressure in the ankle is a PAD tip-off.

Your doctor can perform this test at your annual physical. If your doctor suspects you have PAD, he or she might want to follow up with an angiogram, which uses MRI or x-rays to take images of your arteries to look for blockages, says Dr. Pradhan.

Treating PAD: Lifestyle changes and more

PAD treatment starts with lifestyle changes, including avoiding tobacco products, exercising regularly, and eating a diet rich in fruits, vegetables, whole grains, and healthy fats.

One of the worst things you can do if you have PAD is to sit still. “One of the problems with PAD is that people are taught when they have pain to avoid it,” says Dr. Pradhan. “So, [people] who start feeling pain in their legs when they walk may think they’re getting old and stop walking. That’s exactly what you don’t want to do.”

If you have pain, or other symptoms, see your doctor to find out why it’s occurring. “Once PAD is diagnosed and you know why you are having symptoms, doctors encourage people to do more physical activity to help keep them functional,” says Dr. Pradhan.

In addition to lifestyle changes, your doctor may also prescribe a medication to treat PAD. The drugs most often prescribed for people with PAD are statins, to keep more fatty deposits (plaque) from accumulating; aspirin, to prevent clots; and medications to control high blood pressure. If your blockage is severe, your doctor may also recommend a procedure to clear the blockage or to reroute blood flow around it.

As with many other health conditions, identifying PAD early is crucial. “The longer you wait, the harder it is to treat,” says Dr. Pradhan.

Related Information: Walking for Health

Comments:

  1. Hayley Stewart

    Hey Kelly,
    Thanks for the informative blog.
    As I am also running an integrated health center in McAllen, TX & We provide their primary care & chiropractic services to all the peoples of different age group in McAllen to get Relief from their back pains, headache, Leg pain, shoulder pain & any other major pain. I found your blog very useful & learn a lot from your blog & try to apply to apply your ideas to provide relief to the people who are suffering from Leg pain.

  2. Dave Bishop

    My father, who is 90, was diagnosed with PAD a year ago after complaining of much pain and weakness in both legs when walking. He went to a highly reputable vascular facility, and after much testing was told that he had 100 percent blockage of the femoral artery in one leg, and 80 percent in the other. He was told that he was not a candidate for either bi-pass surgery or for angioplasty to clear out his arteries. He was told that he would likely eventually have amputations. Thank God, he got a second opinion from another practice, was diagnosed with Critical Limb Ischemia, and had three separate outpatient surgeries on each leg to clear out upper and lower arteries, and today he is in much less pain and is much stronger, living independently in his own home. Get second opinions!

  3. azure

    PAD detection and diagnosis may be a problem for health care providers if a person also has diabetes. In at least one case I’m aware of a person with insulin dependent diabetes was diagnosed with neuropathy in his lower extremities, even though he consistently reported throbbing pain (more in one LE then the other) when he walked. He also reported numbness but repeatedly reported pain that severely limited walking.
    It wasn’t until the person had a non-healing wound on a foot, for over a month, that he was tested for and discovered to have PAD, in both legs, although there is only one blockage in the person’s other leg. This was a person with a history of coronary artery disease (double bypass 7 years before) so checking for PAD perhaps should’ve happened sooner then it did. It’s particularly difficult for low income people in rural areas to find specialist treatment–perhaps a specialist (whether an endocrinologist or other specialist) would’ve thought to test for PAD sooner. In this case, it was a podiatrist who was treating the wound who strongly recommended testing for PAD asap.

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