Why Leg Pain Can Break Your Heart

Every day, you start out walking that one-mile loop. But every day when you walk, your legs start to ache. So you sit down on a bench, and the pain goes away. After a while, you get up and walk home—but by the time you reach the house, the pain is back.

You may think you have leg cramps—a sign of advancing age. But you may well be suffering from intermittent claudication, a symptom of peripheral arterial disease (PAD). (The word "claudication" comes from the name of the Roman Emperor Claudius, who walked with a limp.)

How do you know the difference between ordinary cramps and a real medical problem? Take this quiz:

1. Do you generally get crampy pains in your calves, thighs, or buttocks (something like a charley horse) during exercise?

Yes

No

2. Does your pain always come on after exercising about the same amount?

Yes

No

3. Does your pain go away after resting a few minutes?

Yes

No

4. Do you have numbness, coldness, or tingling in your feet or legs?

Yes

No

5. Are you a smoker?

Yes

No

6. Do you have diabetes?

Yes

No

7. Do you have high blood pressure or high cholesterol?

Yes

No

8. Are you older than 55?

Yes

No

If you answered "yes" to questions 1 through 4, you may have the symptoms of claudication (though not everyone will have the symptoms in question 4). If you answered "yes" to one or more of questions 5 through 8, you may be at increased risk of the disorder. In either case, talk with your health care provider.

Although it can be caused by other conditions, claudication is usually a sign of PAD. PAD is caused when fatty plaque partially block arteries in your legs. When you walk, your muscles need extra oxygen, which they get through your blood. But when your leg arteries are partially blocked, blood can't reach the muscles fast enough to supply that oxygen and remove wastes that build up as your muscles contract. The result can vary from a mild pain to a very painful charley horse. When you stop exercising, your muscles need less oxygen, so the pain disappears.

You often can halt or even reverse claudication with lifestyle changes. If left untreated, it can lead to to pain that continues after you rest, or to gangrene.

Smoking causes trouble because nicotine can narrow arteries. Most PAD patients have a history of heavy smoking. Other risk factors are elevated blood levels of cholesterol and triglycerides; high blood pressure; and diabetes.

Treatment

Both medical and surgical treatments are available, as well as lifestyle changes such as those listed below. Drugs that reduce blood clotting in arteries or surgery may be needed.

What you can do

If you think you may be suffering from intermittent claudication, here are some things you can do right away:

• See your health care provider.

• Quit smoking.

• Walk. Stop walking when it hurts, then get up and walk again.

• Change your diet to lower the amount of cholesterol and fat you eat.

To avoid problems caused by low blood flow to your legs and feet:

•  Don't clip your own toenails. See a podiatrist instead.

• Don't walk around barefoot.

• Buy yourself a really good pair of walking shoes.