http://www.earthclinic.com/CURES/peripheral-artery-disease.html
"While many people with peripheral artery disease have mild or no symptoms, about one in 10 experiences leg pain when walking (intermittent claudication).
Intermittent claudication is characterized by muscle pain or cramping in your legs or arms that's triggered by activity, such as walking, but disappears after a few minutes of rest. The location of the pain depends on the location of the clogged or narrowed artery. Calf pain is most common.
The severity of intermittent claudication varies widely, from mild discomfort to debilitating pain. Severe intermittent claudication can make it hard for you to walk or do other types of physical activity.
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MANIFESTATIONS OF PERIPHERAL VASCULAR DISEASE
(i.e arterial and venous disease)
1. Acute ischaemia of a limb ( usually leg)
Sudden onset of severe pain in a pale, cold, pulseless limb which also starts to feel numb and tingly. At first the skin is pale, it then becomes blue and then if the obstruction is not relieved, gangrene sets in with the skin turning black. (thrombosis at an atheromatous plaque or embolus ). (Very rarely – phlegmasia cerulea dolens -> massive thrombosis of all venous outflow from a limb leading to gross swelling and obstruction of arterial supply).
2. Chronic limb ischaemia (usually manifestations in the legs)
Cramp like muscle pain ( mostly in the calves) on walking and relieved by rest (intermittent claudication). As the obstruction progresses the walking distance without pain becomes shorter and shorter -> rest pain -> ulceration of feet which does not want to heal -> gangrene : black, cold periphery of the limb often with a clear line of demarcation.
Signs and symptoms of ischaemia :-
Ø cold
Ø the skin of the foot may be pale or blue
Ø capillary filling after blanching with light finger pressure is delayed
Ø the skin becomes thin and shiny and there is loss of hair
Ø nails become brittle (trophic changes)
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http://www.heart.org/HEARTORG/Conditions/More/PeripheralArteryDisease/Symptoms-and-Diagnosis-of-PAD_UCM_301306_Article.jsp
The pain of PAD usually goes away when you stop exercising, although this may take a few minutes. Working muscles need more blood flow. Resting muscles can get by with less. If there's a blood-flow blockage due to plaque buildup, the muscles won't get enough blood during exercise to meet the needs. The "crampy" pain (called "intermittent claudication"), when caused by PAD, is the muscles' way of warning the body that it isn't receiving enough blood during exercise to meet the increased demand.
Many people with PAD have no symptoms or mistake their symptoms for something else.
Symptoms of severe PAD include:
- Leg pain that does not go away when you stop exercising
- Foot or toe wounds that won't heal or heal very slowly
- Gangrene
- A marked decrease in the temperature of your lower leg or foot particularly compared to the other leg or to the rest of your body
Many people dismiss leg pain as a normal sign of aging. You may think it's arthritis, sciatica or just "stiffness" from getting older. For an accurate diagnosis, consider the source of your pain. PAD leg pain occurs in the muscles, not the joints.
Those with diabetes might confuse PAD pain with a neuropathy, a common diabetic symptom that is a burning or painful discomfort of the feet or thighs. If you're having any kind of recurring pain, talk to your healthcare professional and describe the pain as accurately as you can. If you have any of the risk factors for PAD, you should ask your healthcare professional about PAD even if you aren't having symptoms.
Diagnosing PAD
PAD diagnosis begins with a physical examination.
Your healthcare provider will check for weak pulses in the legs. Your physical examination may include the following:
- Ankle-brachial index (ABI): a painless exam that compares the blood pressure in your feet to the blood pressure in your arms to determine how well your blood is flowing. This inexpensive test takes only a few minutes and can be performed by your healthcare professional as part of a routine exam. Normally, the ankle pressure is at least 90 percent of the arm pressure, but with severe narrowing it may be less than 50 percent.
View an illustration of ankle-brachial index testing
Watch a video about ankle-brachial index testing
If an ABI reveals an abnormal ratio between the blood pressure of the ankle and arm, you may need more testing. Your doctor may recommend one of these other tests.
- Doppler and Ultrasound (Duplex) imaging: a non-invasive method that visualizes the artery with sound waves and measures the blood flow in an artery to indicate the presence of a blockage. View an illustration of Doppler ultrasound imaging.
- Computed Tomographic Angiography (CT): a non-invasive test that can show the arteries in your abdomen, pelvis and legs. This test is particularly useful in patients with pacemakers or stents. View an illustration of CT imaging.
- Magnetic Resonance Angiography (MRA): a non-invasive test that gives information similar to that of a CT without using X-rays.
- Angiography: (generally reserved for use in conjunction with vascular treatment procedures) During an angiogram, a contrast agent is injected into the artery and X-rays are taken to show blood flow, arteries in the legs and to pinpoint any blockages that may be present. View an illustration of a peripheral angiogram.
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http://en.wikipedia.org/wiki/Peripheral_vascular_disease
Classification
Peripheral artery occlusive disease is commonly divided in the Fontaine stages, introduced by René Fontaine in 1954 for ischemia:[2][3]- mild pain when walking (claudication), incomplete blood vessel obstruction;
- severe pain when walking relatively shorter distances (intermittent claudication), pain triggered by walking "after a distance of >150 m in stage IIa and after <150 m in stage II-b";
- pain while resting (rest pain), mostly in the feet, increasing when the limb is raised;
- biological tissue loss (gangrene) and difficulty walking.
- Mild claudication
- Moderate claudication
- Severe claudication
- Ischemic pain at rest
- Minor tissue loss
- Major tissue loss
[edit] Symptoms
About 20% of patients with mild PAD may be asymptomatic; other symptoms include:[1]- Claudication - pain, weakness, numbness, or cramping in muscles due to decreased blood flow
- Sores, wounds, or ulcers that heal slowly or not at all
- Noticeable change in color (blueness or paleness) or temperature (coolness) when compared to the other limb
- Diminished hair and nail growth on affected limb and digits.
[edit] Causes
Risk factors contributing to PAD are the same as those for atherosclerosis:[1]- Smoking - tobacco use in any form is the single most important modifiable cause of PVD internationally. Smokers have up to a tenfold increase in relative risk for PVD in a dose-related effect.[citation needed] Exposure to second-hand smoke from environmental exposure has also been shown to promote changes in blood vessel lining (endothelium) which is a precursor to atherosclerosis.
- Diabetes mellitus - causes between two and four times increased risk of PVD by causing endothelial and smooth muscle cell dysfunction in peripheral arteries.[citation needed] Diabetics account for up to 70% of nontraumatic amputations performed, and a known diabetic who smokes runs an approximately 30% risk of amputation within 5 years.[citation needed]
- Dyslipidemia (high low density lipoprotein [LDL] cholesterol, low high density lipoprotein [HDL] cholesterol) - elevation of total cholesterol, LDL cholesterol, and triglyceride levels each have been correlated with accelerated PAD. Correction of dyslipidemia by diet and/or medication is associated with a major improvement in short-term rates of heart attack and stroke.[citation needed] This benefit is gained even though current evidence does not demonstrate a major reversal of peripheral and/or coronary atherosclerosis.[citation needed]
- Hypertension - elevated blood pressure is correlated with an increase in the risk of developing PAD, as well as in associated coronary and cerebrovascular events (heart attack and stroke).
- Risk of PAD also increases in individuals who are over the age of 50, male, obese, or with a family history of vascular disease, heart attack, or stroke.
- Other risk factors which are being studied include levels of various inflammatory mediators such as C-reactive protein, homocysteine.
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http://www.buzzle.com/articles/calf-muscle-cramps.html
Leg and feet muscle cramps are very common. Cramps in the calf muscles that cross two joints are common in men and women. A sudden, painful and involuntary contraction of a muscle or even a few fibers of a muscle, is known as 'spasm' and when a forceful spasm sustains for a few seconds or minutes, it is called 'cramp'. The hardened muscle can be felt and if it does not release on its own, you have to help relax the muscle by manual stretching or massage.
What Causes Calf Muscle Cramps?
The most common causes for calf muscle cramps are as follows:
- Doing a New Activity: A sudden change in daily activity can lead to leg cramps. If you suddenly start playing tennis or if you suddenly decide to climb a hill or you opt for swimming, for which your muscles are not ready, it can lead to calf muscle cramps while sleeping or while working. Read more on foot cramps at night. Sudden increase in the workouts increases the stress level which can also cause calf muscle cramps.
- Altered Neuromuscular Control: Calf muscle cramps can be a result of disturbed muscle coordination and control. High or low sodium or potassium levels result in the altered salt levels in the blood stream and can lead to calf muscle cramps. To know more about the nerve disorders causing foot cramps, read more on peripheral neuropathy.
- Pregnancy: During pregnancy, increasing stress on the muscles of the legs and feet and hormonal changes can lead to calf muscle cramps. Vitamin deficiency during pregnancy can also cause calf muscle cramps.
- Poor conditioning: Lack of healthy diet and proper and regular exercises can lead to muscle cramps. Lots of care has to be taken and muscles are to be trained properly keeping in mind the goal of muscle building, right from the childhood.
- Muscle fatigue: Too much of exercise or over-training for the athletes, overstraining of the muscles in any activity can lead to muscle fatigue, resulting in calf muscle cramps.
- Dehydration: Insufficient supply of water to the cells of the body can result in various complications and calf muscle cramps can be a result of dehydration.
- Environmental Toxins: Fast industrialization, releasing environmental toxins (e.g. lead poisoning) can be an important cause of calf muscle cramps.
- Fatigue: Fatigue due to diseases like cancer, liver cirrhosis, diabetes, renal failure, Parkinson's disease etc. can cause calf muscle cramps.
- Peripheral Vascular Disease: Poor circulation of blood and narrowed leg arteries are noticed in peripheral vascular disease, causing calf muscle cramps.
- Sedentary Lifestyle: Obesity and weakened muscles are observed in most of the people who enjoy a sedentary lifestyle and this can cause calf muscle cramps.
- Foot Problems: Persistent foot problems like achilles tendonitis or plantar fasciitis are the causes of leg pains, leading to calf muscle cramps.
- Hyper Flexible Joints: Those who have hyper flexible joints, generally have to face the problem of calf muscle cramps.
- Excessive Exercise: The lower availability of calcium in blood during higher rate of breathing, while performing any type of cardiovascular exercises leads to calf muscle cramps.
- Alcohol Abuse: Alcohol abuse leads to calf muscle cramps.
- Shoes: Foot and leg cramps are commonly observed when shoes do not fit perfectly.
- Drugs and Medication: Calf muscle cramps can be noticed as a side effect of certain drugs and medicines.
- Injuries: Injuries to leg or foot muscles can cause calf muscle cramps.
- Flat Feet: It is observed that flat feet causes foot pain and can lead to calf muscle cramps.
As prevention is better than cure, with regular exercises (including stretching exercises of muscles for warming up and cooling down exercises after the workouts), you can keep yourself fit and active, so that the chances of muscle spasm are less. If the question how to prevent cramps in leg is haunting you, try to avoid any extra or drastic stress on legs or feet, to avoid the calf muscle cramps. Following are the simple remedies for reducing the pain due to calf muscle cramps.
- When the calf muscle cramp occurs, slowly pull the foot away from the cramping position. Hold it softly with your hands, till the cramp disappears. Then you can massage it till 5 to 10 minutes, to reduce the pain. Then try to stretch it gently.
- Compress the affected area around the calf muscle with an elastic bandage and this can provide the necessary relief.
- Dehydration can be avoided by drinking lots of water and other liquids like fruit juices, milk etc. which can reduce the chances of calf muscle cramps.
- Over the counter medicines or specific pain killers can be taken under the guidance of a physician.
- Massage with oil or ointment definitely helps reduce the pain and muscle fatigue.
- A balanced diet can help you avoid the nutritional deficiencies.
- You can apply ice to the calf area which will offer the numbness effect and this can reduce the calf muscle cramp pain.
- Sufficient rest to the affected area is necessary to relieve the pain.
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