Got leg pains? It may be caused by LEAD

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, causing cholesterol and other substances to progressively build up on the wall of the injured vessel. This narrows the vessel and makes it rough, slowing and eventually blocking blood flow. Another name for this vessel damage is atherosclerosis. When vessels of the legs are affected by atherosclerosis, it is called LEAD.

Most people begin to notice they have LEAD when their hips, thighs or calf muscles cramp up after a certain amount of sustained activity. The blood flow is adequate for casual movement, but during heavier activity the damaged arteries cannot supply the extra blood flow the muscles need. A few minutes of rest usually relieves the pain.

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;

• Thickened toenails;

• Decreasing size of the calf muscle;

• 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.

Amy Stilley, R.N., B.S.N., is a certified wound, ostomy and continence nurse at Flagstaff Medical Center. Is there a health topic you'd like to know more about? Please write to Mountain Medicine, c/o Flagstaff Medical Center, Public Relations, 1200 N. Beaver Street, Flagstaff, AZ 86001, or visit FlagstaffMedicalCenter.com.

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