Peripheral Arterial Disease (PAD)- Claudication, Rest pain & Critical ischemia
What is intermittent claudication?
Intermittent claudication is related to the symptoms caused by obstructions in the arteries of the legs (sometimes called atherosclerosis or 'hardening of the arteries'). These obstructions prevent enough blood from reaching your leg muscles as you exercise or walk. Without adequate blood flow, the muscles are starved of oxygen and this causes pain. When you rest, your muscles are not working as hard and require less blood flow, so the pain goes away.
What causes the arteries to become blocked?
Problems with the arteries tend to become more common as people get older. The health of your arteries is affected by many factors including
- Smoking (by far the most important lifestyle factor)
- High blood pressure
- High blood cholesterol
- Lack of physical activity
- Diabetes
- Being overweight
The factors that contribute to intermittent claudication are the same as those that cause other conditions related to hardening of the arteries, such as heart attacks and strokes. Therefore, your doctor will be concerned not only to treat the pain in your legs and help you walk better, but to keep the arteries throughout your body as healthy as possible.
Will it get worse?
For most people, the condition will remain stable or the symptoms will resolve with regular exercise and lifestyle changes. If the condition becomes more severe it may lead to pain in your feet and toes at rest, especially at night. This is called rest pain. Ulcers and possibly gangrene may develop in a small percentage of people. When this condition occurs it is labelled as critical ischemia. Amputation is rare in patients with intermittent claudication but can be a consequence of this condition.
It is important that health problems such as smoking, high blood pressure, high cholesterol, obesity and diabetes are controlled at an early stage to help prevent the disease progressing. If you have intermittent claudication, it is possible that you also have narrowed or blocked arteries in your heart, even if you do not have symptoms of heart problems. This may cause you to suffer angina or a heart attack in the future. Similarly, narrowed or blocked arteries to your brain may cause you to suffer a stroke.
How can I help myself?
There are several lifestyle changes you can make which will help the condition from worsening. The most important are to stop smoking, take regular exercise and loose weight.
Smoking: The Facts
Smoking affects your circulation and you must stop completely because:
- Smoking causes blood vessels to narrow and become blocked
- Continuing to smoke may also cause a bypass graft or balloon angioplasty to block, with a risk of loosing a leg
Smoking also causes
- Heart disease and stroke
- Lung and other cancers
- Bronchitis
But it's never too late to stop!
As soon as you stop smoking you begin to help your body fight back against disease. Your blood will become richer in oxygen and the pain in your legs will lessen. Your general health will improve and you will feel fitter and more active.
Keep your weight down
If you are overweight, the strain on your circulation will be greater. Therefore you should eat sensibly and exercise to loose weight. It may be possible for you to see a dietician for advice.
Also watch your diet. Eating fatty foods, particularly saturated or animal fats, raises the blood cholesterol. High levels of cholesterol can lead to atherosclerosis.
Eat a healthy diet
You should have a healthy diet, eating plenty of fruit and vegetables. Eat cereals too, which are a good supply of roughage.
Avoid too much fatty food such as butter and dairy products. Some fats, such as those in oily fish, nuts and vegetable fats like olive oil, can have a beneficial effect on your health in moderation. Do remember, however, that even these 'good' fats and oils contain a lot of calories. Try to limit the amount of sugar you eat. Don't add salt to your food at the table
Try to remember the '5 a day rule'- eat at least five different portions of fruit and vegetables each day for a much healthier diet.
If you suffer from diabetes, you must ensure that your blood sugar levels remain controlled.
Take care of feet
Damaged skin and cuts on your feet and legs can lead to infections and non-healing ulcers, particularly if you are diabetic. If this happens, please act promptly by letting your doctor know.
(MI=Myocardial infarction. CV=Cardio vascular, CAD= Coronary artery disease and CVD= Cerebro-vascular disease)
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