Rest Pain

What is Rest Pain?

The earliest and most common symptom is called intermittent claudication followed by Rest Pain.  Patients usually experience it as a cramp-like muscular discomfort, but PAD can also produce numbness, tingling, weakness, or fatigue. In any form, claudication occurs when muscles are not getting all the oxygen they need. Because muscles need more oxygen when they’re working, claudication begins during exercise and resolves with a few minutes of rest. People with mild blockages can walk substantial distances before the symptoms set in, but patients with severe PAD may experience distress in just a few yards. The location of the discomfort depends on the site of the blockage.

What causes Rest Pain?

More serious than Claudication is a symptom of PAD known as rest pain. It occurs when blockages are so severe that muscles can’t get enough oxygen when they’re at rest. Foot pain is most common. At first, it’s most troublesome when the leg is elevated, particularly in bed at night. But if the disease progresses, the pain can become constant and is no longer relieved by sitting or standing. Patients with moderate to severe PAD can also develop ulcers or other skin problems in their feet and legs.

The most dangerous symptom is known as critical limb ischemia. Ischemia means tissue damage caused by lack of blood and oxygen. In the case of PAD, it can be triggered by a blood clot that blocks a narrowed artery.  

Critical limb ischemia is a true emergency that requires immediate treatment to prevent gangrene, amputation, or death. Although rest pain is much less urgent, it usually requires revascularization (surgery or angioplasty with a stent). But patients with claudication may respond well to lifestyle treatment and medications — which is why early diagnosis and treatment are so important.

Many patients with PAD don’t have any symptoms at all. But diagnosis and treatment are important for them, too. Patients with PAD often have atherosclerosis in other arteries. That’s why they have an increased risk of heart attack, stroke, and cardiovascular death. The more severe the PAD, the higher the risk.

Complications

PAD is a serious condition. Clogged arteries caused by decreased blood flow can cause painful cramping while walking or exercising. Numbness, weakness or tingling in the legs and feet and burning pain in feet and toes are other side effects. In serious cases, Peripheral artery disease of known for causing critical limb ischemia. This is a condition that begins as open sores that do not heal. These sores will progress to tissue depth causing gangrene. Sometimes requiring amputation of the affected limb.

Additionally, a major complication caused by peripheral vascular disease is the risk of a stroke or heart attack. The atherosclerosis that causes the signs and symptoms of peripheral artery disease isn’t limited to your legs. Fat deposits also build up in arteries supplying blood to your heart and brain.

Prevention

The best way to prevent peripheral arterial disease is to maintain a healthy lifestyle. That means:

  • Quit smoking if you’re a smoker.
  • If you have diabetes, keep your blood sugar in good control.
  • Exercise regularly. Aim for 30 to 45 minutes several times a week after you’ve gotten your doctor’s OK.
  • Lower your cholesterol and blood pressure levels, if applicable.
  • Eat foods that are low in saturated fat.
  • Maintain a healthy weight.

PAD Treatments

In order to salvage the limbs, PAD is medically treated with prescribed medications. These medications treat high cholesterol, control blood pressure. As well as, decrease pain while walking in order to increase exercise. They also aim to prevent the buildup of plaque or formation of blood clots.

Peripheral artery disease is also treated using minimally invasive interventional radiology procedures. Angioplasty is opening a blocked artery with a medical balloon, enabling better blood flow. In some cases, the affected arteries need to remain open using a stent, which is a small metal cylinder. This treatment is stenting.

A stent-graft is another procedure. This is when a stent covered with a synthetic fabric is placed in the blood vessels to bypass affected arteries. A third interventional radiology procedure for peripheral artery disease called atherectomy. This procedure uses small catheter at the site of the blockage in order to shave the plaque away from the inside of the artery and remove it from the patient’s body

In some cases, PAD may be serious enough that a medical team has no choice but to perform surgery. This may be the only way to remove blockages or create bypasses around the clogged areas.