Keep an eye on circulation

SORE POINTS: The most common symptom of peripheral vascular disease (PVD) is painful cramping in your leg muscles triggered by physical activity.
SORE POINTS: The most common symptom of peripheral vascular disease (PVD) is painful cramping in your leg muscles triggered by physical activity.

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Poor circulation can cause leg pain and in some cases may indicate peripheral vascular disease.

The human body contains two main types of blood vessels – arteries and veins.

Arteries, with the exception of the pulmonary artery and vein, carry oxygenated blood   away from the heart,  and veins  carry deoxygenated blood  to the heart. 

Arterial disease generally relates to blood supply while venous disease generally relate to drainage of blood, according to vascular surgeon Dr Mathew Sebastian, from Vascular HealthCare. 

“Arterial disease usually results from a lack, or restriction, of blood to a given area,” Dr Sebastian said. 

“This usually creates a condition of ischaemia – lack of oxygen to tissues – which will often manifest in pain, such as discomfort or cramp. 

“This is often an exercise-dependent condition where the patient experiences calf aching and discomfort with walking which usually resolves within a few minutes rest, once normal blood supply is restored. 

“The muscles require much more oxygen when exercising than they do at rest; the restricted blood supply cannot cope, and the pain is usually experienced lower in the leg than where the blockage is. Gangrene is a much worse condition and is characterised by tissue death, or necrosis very often complicated by infection as well. Arterial ulcers can occur and are usually painful.”

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Venous disease relates to congestion – through clots which block the drainage of blood out of a limb, such as DVT (deep vein thrombosis), or venous insufficiency where the valves in the vein don’t perform their function correctly, eg, varicose veins. 

“Venous thrombosis is often associated with swelling and pain, dependent on site and extent of the clot,” Dr Sebastian said. 

“Patients suffering venous insufficiency often experience swelling, skin changes and thickening, varicose veins, cramps, eczema and sometimes ulceration and skin break down. Venous ulcers are generally less painful than arterial ulcers.”

Diagnostic methods include  Doppler ultrasound, preferably performed by vascular ultrasound specialists working in conjunction with vascular surgeons, angiography and sometimes other imaging methods like CT and MRI scans.

“Treatment of arterial disease often involves balloon angioplasty and stents, occasionally bypass surgery,” Dr Sebastian said. “Treatment of venous disease often involves compression bandaging and removing or closing down of diseased veins by ablation or surgery.” 

Medical management of risk factors is undertaken between patients and their doctors – GP or vascular specialist.  Treatment of arterial and venous conditions is available through Vascular HealthCare and the Hunter Vein Clinic. 

“We have diagnostic ultrasound for identifying and monitoring vascular disease – arterial and venous – and specialist consultation and surgical interventions to monitor, minimise and correct problems which may arise,” Dr Sebastian said.  

“We serve both male and female patients across all age brackets. Vascular disease usually develops in later life, so most patients seen are over 50 years of age.”

Good arterial health involves control and modification of vascular risk factors.

“Diabetes, smoking, high blood pressure and high cholesterol,” Dr Sebastian said. “Good venous health involves staying hydrated and moving, avoiding sitting or standing for extended time periods. Being within a healthy weight range and regular physical exercise are very important for everything.”