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 Aruna Pradhan, M.D., 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 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 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
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 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 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 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 Pradhan.
(Kelly Bilodeau is executive editor at Harvard Women's Health Watch.)
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