OakLeaf Medical Network Healthy Viewpoints, Winter 2003
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Dr. Brent M. Wogahn

Circulation Problems Can Cause Leg Cramps

Brent M. Wogahn, MD

We all have experienced muscular leg cramps at some point in our lives. Most of the time it is due to overwork or stress on the muscles. Commonly, the weekend athlete in us does too much swimming, hiking, biking or other activity our bodies are not used to. The pain is expected and usually short lived.

However, pain due to arterial insufficiency can affect your lifestyle, job and health. The blood vessels in our legs can, over time, be slowly blocked with atherosclerosis or hardening of the arteries, which decreases the ability of the blood, with its oxygen and nutrients, to get to the legs. Muscular cramps are experienced when the supply of oxygen cannot meet the demand the muscles require. We then have to compensate and either walk slower or rest until the pain goes away. Over time, the pain comes on over shorter distances. Rest subsequently relieves the pain. This type of leg cramping is commonly referred to as řClaudication.Ó

A thorough history and physical examination by your doctor can determine if it is claudication. Individuals with claudication typically complain of the inability to walk during their daily activities. On examination, the pulses in the legs and feet are difficult to find. The feet themselves can feel cool and be painful. Their color can be a pale white to a dark red. The hair on the foot and leg may also be absent suggesting insufficient blood flow. In the worst cases, toes and parts of the foot can be a dark purple or black and may indicate death of the tissues.

There are both invasive and non-invasive tests available to your doctor to help with the diagnosis. An arterial Doppler study can be ordered. Dopplers use sound waves, which bounce off moving red blood cells in the arteries, to produce signals that can be heard. Furthermore, blood pressures can be taken by cuffs placed in different locations on the legs and be compared to the blood pressure in your arm. Major drops in the pressure of the blood flow can be detected and significant blockages can be located.

If the blood flow to your legs is deemed serious enough, an angiogram is done. The radiologist uses a catheter to inject a special dye into the arteries and x-ray pictures are taken. A plan of treatment can then be formulated for each individuals needs.

A wide variety of treatments are used to successfully reduce or resolve the leg cramps. This can involve taking medications or undergoing surgical procedures. The most common is taking an aspirin daily. There are other types of blood thinning agents that can be used as well. Your doctor will have more information about the options available. Arteries can be opened up by insertion of a balloon on a catheter to dilate the blockage, or the vascular surgeon may operate on the vessels directly to clean them. In many cases, however, long segments of arteries are occluded and require bypasses.



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