12/10/2013 11:21:00 AM Guest column: Mountain medicine: Leg pain - it might be more than a nuisance
Do your legs cramp up after walking a block or two? Does the cramping go away after resting for a few minutes? If so, you may have Lower Extremity Arterial Disease (LEAD).
The inner lining of the arteries usually is very smooth allowing the blood cells to easily pass through. With LEAD, this inner lining becomes damaged
As LEAD progresses, you may experience muscle pain, numbness or tingling when resting or when you put your feet up on an ottoman or bed. During this stage of the disease it is not unusual for people to sleep in a recliner or with their affected leg dangling off the bed. Beyond this stage, blood flow can become scarce enough to be limb-threatening, causing tissue death.
Signs and symptoms of LEAD include:
thigh or calf pain and cramping that occurs after roughly the same amount of activity, and is relieved with rest;
non-healing wounds on legs and/or feet;
discoloration of the affected leg that changes when dangling and/or elevated;
temperature differences between legs;
changes in leg/foot sensation (numbness, tingling, burning, cramping);
decreased hair growth on the lower leg;
decreasing size of the calf muscle; and
development of dark coloration or gangrene usually on the toes
Risk factors for LEAD include tobacco use, diabetes, high blood cholesterol levels, obesity, sedentary lifestyle, high blood pressure, and/or a family history of heart/artery disease.
It is very important to tell your primary care provider about your leg pain. They will perform a physical assessment of your legs and may recommend further testing. LEAD can be easily diagnosed with non-invasive tests.
Treatment is individualized, consisting of lifestyle changes, medications and/or surgical intervention. Lifestyle changes include: tobacco cessation, controlling blood pressure and cholesterol levels, good diabetes management, dietary modifications, regular exercise and diligent foot care.
Early diagnosis, lifestyle changes and treatments recommended by your primary care provider will slow disease progression.
Charissa Baker, R.N., and Gaylene Montez, R.N., are both certified wound ostomy continence nurses at Flagstaff Medical Center.