Within the past month, I have seen several patients in our clinic complaining of leg cramping/pain after walking an extended distance. One of the major concerns is peripheral arterial disease. Approximately 8 to 12 million people are affected by peripheral artery disease (PAD) or occlusive disease of the legs. Patients are usually male and over the age of forty. There is an increased risk of mortality (death) over 5 years in patients with symptoms. It is estimated that 2 to 5 percent of patients with PAD will eventually require surgery of the affected limb. Smoking, diabetes, obesity, high blood pressure, high cholesterol and high homocysteine levels are some of the most common risk factors. Treatment for PAD includes medication, exercise, angioplasty and vascular bypass surgery.
Walking is also used to increase the endurance of the leg muscles. PAD diminishes blood flow to the legs. Diminished blood flow means decreased oxygen to the muscles in the legs, creating what is commonly called claudication. Patients with PAD complain of calf pain (claudication) when walking only a few blocks. The combination of antiplatelet therapy and slowly increasing the endurance of the muscles can decrease these symptoms. The American Heart Association states that regular exercise can reduce leg pain symptoms in 4 to 8 weeks. Antiplatelet therapy is a form of anticoagulation (blood thinner) which affects the ability of the platelets to form a blood clot. PAD is the result of atherosclerotic plaques and blood clots blocking the arteries in the leg. With the use of antiplatelet medication such as Plavix or low dose aspirin, the platelets are less likely to stick to atherosclerotic plaques in the arteries.