Fall is a time when many Texans want to get outside and enjoy the cooler temperatures. It’s the perfect time for hiking, biking, golfing and other outdoor activities, but individuals suffering from exercise-induced leg cramps may find themselves on the sidelines missing out on their favorite activities.
In his practice, Dr. Russell Lam routinely works with patients who present with painful leg cramps caused by physical activity. These patients are typically diagnosed with extremity vascular disease, also known as lower extremity peripheral artery disease (PAD).
The walls of our arteries are typically smooth, but patients with PAD experience damage to the arteries, which allows plaque to accumulate. This process, known as atherosclerosis, causes the arteries to become blocked and narrow, leading to a decrease in blood flow. When the muscles don’t get the oxygen they need from the bloodstream, they begin to cramp, causing pain, known as claudication, in the calves during walking and other physical activity.
For many patients, relief from this pain is only achieved when they stop physical activity, leading many to avoid exercise. A sedentary lifestyle, however, can actually make lower extremity PAD worse. Studies have shown that regular exercise can help the vascular system create new pathways to deliver oxygen to muscles. This process is known as collateralization.
If possible, patients should increase their walking distance gradually to help with the collateralization process. When leg pain develops, they should stop and rest and begin walking again once the pain has passed. Patients who work their way up to 45 to 60 minutes of walking per day typically see improvement in their pain levels.
Some patients, however, may need additional interventions. There are a variety of medicines doctors may prescribe to help improve blood flow and reduce the risk of complications from atherosclerosis, such as blood clots, heart attack and stroke. If medications and other therapies don’t reduce symptoms sufficiently, then surgical treatments should be discussed.
If surgery is recommended, your vascular surgeon will use ultrasound to locate the area or areas where your blockage is located. The surgeon will then use angioplasty and stenting or open surgery. The type of treatment used will depend on the location and amount of blockage.
The risk factors for PAD are similar to the risk factors for heart disease. They include smoking, high blood pressure (hypertension), high levels of blood cholesterol or triglycerides, obesity, sedentary lifestyle, diabetes and a family history of heart disease or arterial disease.
- Discoloration of the affected leg or foot when dangling (from pale to bluish-red)
- Diminished or absent pulses in the affected leg or foot
- Temperature difference in affected leg or foot (cooler than other extremity)
- Change in sensation (numbness, tingling, cramping, pain)
- Presence of non-healing wound on affected lower extremity, and/or
- Shrinking of calf muscles.
The information contained in this article is not intended to be used as a substitute for medical advice. Patient results will vary based on risk factors, age, disease and medical history and are not guaranteed in any way.