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Leg Pain: A Symptom Not to Ignore

LegIf you’re over the age of 50 and experience leg pain when you walk or climb stairs, don’t ignore it. Studies show that one in five adults over 55 have Peripheral Vascular Disease (PVD), a common circulation problem that can significantly affect your quality of life and long-term health.

“Many people with PVD dismiss these symptoms as a normal part of aging,” said Clinical Cardiologist Elias A. Iliadis, M.D., Medical Director of Noninvasive Vascular Intervention at the Cooper Heart Institute. “Tell your doctor if you’re feeling pain in your legs and discuss whether you should be tested for PVD. Left undiagnosed and untreated, PVD puts you at risk for heart disease and stroke, and other serious, health complications.”

The most common symptoms of PVD are cramping, pain, or a tiredness or heavy feeling in the legs while walking or climbing stairs. Typically, the pain goes away with rest and returns when you’re active again.

PVD is a narrowing or blockage of arteries that decreases blood flow to the legs. The most common cause is the buildup of plaque on the inside of arteries. Plaque is made of extra cholesterol, calcium and other material in your blood. Over time, the plaque builds up along the inner walls of the arteries and prevents the blood from flowing freely to the muscles and other tissues in your legs.

This restricted blood flow is what causes the pain in your legs when you walk or climb stairs. During physical activity, your muscles need increased blood flow. If your arteries are narrowed or blocked, you’re legs aren’t getting the extra blood they need to fuel the exertion. When you’re at rest, the muscles need less blood flow, so the pain goes away.

“Given the nature of these kinds of activity-related symptoms, it’s easy to understand how people in their 50′s or 60′s might just attribute their discomfort to ‘mid-life aches and pains.’ But that’s a mistake. Making the diagnosis of PVD requires a physician’s exam and simple, noninvasive screening tests to determine if it’s PVD and evaluate it’s severity,” Dr. Iliadis said.

The Cooper Heart Institute offers expert physicians and simple, noninvasive tests to diagnose and treat PVD. The screening begins with a physical examination to check for weak pulses in the legs and includes an ankle-brachial index (ABI) test. The ABI is a painless exam that compares the blood pressure in your feet to the blood pressure in your arms to see how well your blood is flowing. If an ABI reveals an abnormal ratio, other diagnostic testing may be recommended.

“As vascular specialists, we perform thorough physical exams and simple tests, such as the ABI or pulse volume recordings, to help define the contribution of vascular disease to leg pain. At Cooper, all patients diagnosed with PVD are treated with medical therapy first, and, happily, most feel better,” Dr. Iliadis said.

28 Responses to “Leg Pain: A Symptom Not to Ignore”

  1. June Napp says:

    Difference between this and restless legs syndrome? My legs, especially, calves, get “crampy” and heavy at times. There’s a constant “tingling” in my leg muscles when I first lay down at night. Am I a PVD candidate?

  2. Denice Ferrarelli says:

    Good and common question. PVD causes leg pain with walking (usually cramping of calfs, thighs or buttocks) and releived with rest. PVD can cause night-time leg pain that reselmbles restless leg syndrome but usually has activity component. Your doctor can help make the diagnosis through the non-invasive testing. A simple ankle brachial index may help make the diagnosis and help define the degree of disease if any. This will help clarifiy the benefits of medical therapy or further testing. Good Luck.
    Be well,
    Elias A. Iliadis, MD, FACC, FSCAI, RPVI
    Associate Director, Cardiac Cath Lab
    Cooper University Hospital
    Assistant Professor of Medicine
    UMDNJ-Robert Wood Johnson Medical School
    856.342.3016

  3. Judy Hozalski says:

    I get pain in the back of my legs only if I climb ALOT of steps. (Several flights). I get really bad pain in the back of my legs when I am sleeping and I go to stretch by legs. The back of my legs pops out and the pain is awful. I have to rub my leg to get it to go back down. Is this a charlie horse or is this being caused by my Lipitor or something else.

  4. Denice Ferrarelli says:

    Judy, your symptoms are very atypical for Peripheral Vascular Disease. The PVD symptoms are usually cramping of the calves or thighs/buttocks with walking or exertion and relieved with rest. Though nighttime cramps are common in many diseases, your symptoms sound less like PVD and more like deconditioning. The symptoms of myalgias from statins (atorvastatin aka Lipitor) are diffuse muscle aches of the upper arms and upper legs and feels like one has the flu. Lastly, depending upon your risk factors, your doctor may wish to confirm the presence/absence of PVD with simple, painless non-invasive vascular testing such as ankle brachial index. Good luck.
    Be well,
    Elias A. Iliadis, MD, FACC, FSCAI, RPVI
    Associate Director, Cardiac Cath Lab
    Cooper University Hospital
    Assistant Professor of Medicine
    UMDNJ-Robert Wood Johnson Medical School
    856.342.3016

  5. James Nagle says:

    I have pains and tingling sensations mainly in my feet and the back of my calves, with general tirdness of my whole legs, this happens not only while climbing stairs but also while sitting and is only relieved by raising my leg to the straight position, there also seem to be a relationship with having pains in my legs and stiffness of my neck, Does PVD effect other parts of the body?

  6. Kristen says:

    My calves always seem to be swollen however, when I go to the doctor to get it checked, they tell me I don’t have edema in my legs (I’m happy about), but I must have some type of circulation problems. I’m always walking around and on my feet and my legs always look swollen but not edemic. I have cankles for goodness sakes. I doesn’t matter how much I work out, it is always there. Either it’s genetics or I have some type of problem. I will probably make an appointment to put my mind at ease.

  7. Ashley says:

    I went to the doctor for a pain in my thigh two months ago and the doctor said it was a pulled muscle. She said it would heal in a month and told me to stay off my bike for a while, which i did and it still has not healed. I now have a little pain in my knee. Does anyone know what this is? Thanks

  8. Seth says:

    Good info by Dr. Iliadis. So, many may think they have common RLS if they don’t have the testing done.

  9. Mary Anderson says:

    A few years ago my legs and feet began feeling “heavy” when I walked. My feet would feel almost like lifting cynderblocks when I tried to walk. Once I got down on the floor to clean something and found I could not get back up. The feelings I was having in my lower back and my legs was indiscribable. I felt totally helpless. Could this be PVD? An MRI of my lower back didn’t show anything.

  10. Denice Ferrarelli says:

    Dear Mary,
    I understand your concerns and leg symptoms are confusing at times. Peripheral vascular disease is the reduction of blood flow to the legs caused by blockages in the arteries. The blockages are caused by smoking, diabetes, high blood pressure and cholesterol (same risk factors that cause blockages in the heart arteries). Typical PVD symptoms are weakness of legs, cramping with walking and night time restless legs. Other signs can be hair loss, poor nail growth and discoloration of lower legs and feet. However, PVD can exist when there are no or limited symptoms. Given your symptoms and the atypical nature of your symptoms, I would consider vascular testing to rule out both lower extremity and aortic disease. Non-invasive testing is painless and can determine whether any reduction in blood flow exists and whether it is significant enough to cause symptoms. I hope this helps and wish you good health.”

    Be well
    Leo
    Dr. Iliadis
    Elias A. Iliadis, MD, FACC, FSCAI, RPVI
    Medical Director, Noninvasive Vascular Lab; Clinical Cardiologist; Director, Vascular Intervention Program
    Cooper University Hospital

    ________________________________________

  11. Cindy W says:

    the past month I have been having sharp pains in my legs, mostly my left. It is from my shin up through the outer/front side of my thigh to my buttock area. It is worse at night. The pain is so severe, it wakes me up. Heat and rubbing help for awhile, but it comes back. Tonight I am having difficulty walking because of the pain in the buttock area. I have the pain most of the time, but nights are so much worse.

  12. Paulina says:

    When I climb the stairs (8 flights) my legs, knees and thighs feels very weak, achy and tired. I have to stop at the third floor landing and rest before continuing to the 4th flr. I’ve been doing the exercise for a month since I started 20 mg of lipitor, I thought it would build up my muscles but to no avail. the only good thing is my cholesterol went from 279 to 151 in a month. i have a doctor’s appt this friday and would like your opinion so i can suggest to my physician.

  13. Krista Tobin says:

    Paulina,
    Thank you for your comment. Unfortunately, we do not diagnose or give second opinions via this website. We suggest you speak with your doctor about these concerns. Thank you.

  14. Srikanth says:

    I am just 30 years old guy,i am feeling too much leg pain when i woke up and also evening times…what could be the cause…?

  15. Rich says:

    56 and leg pain & weakness is becoming unbearable…..can hardly stand….acute weakness…..pain on a 9 or 10……only relief is hot tub and rest….very active person who goes to the gym two or three times a week….father had PAD…can someone give me some slue as to what I am dealing with here…

  16. Cooper University Hospital says:

    Sirkanth,
    Thank you for your comment! Depending on you health history the leg pain can be stemming from various issues. We suggest talking to your doctor about the pain or scheduling an appointment with a Cooper specialist. You can request an appointment here or by calling 1.800.8.COOPER (1.800.826.6737).
    Thank you!

  17. Shirley says:

    I am 53, fit and healthy, not overweight (approx. 50 kilos) but smoke (10/day). I have pain/aches in my legs when walking up stairs or slopes or when walking fast/long distances. It feels as though I’ve run a marathon and am pushing myself one step too far! My legs feel like jelly and if I push myself they get ‘clumsy’. I am ok on flat ground.
    Over the past 6 months I’ve had a barrage of tests (including MRI scans, lumbar puncture, blood tests, x-rays etc etc) and consultations with a neurologist and orthopaedic specialist. Everything is normal! My doctor initially ruled out PVD as my ankle pulses are normal (although I do get cold feet and hands) and I am fit and healthy and not overweight. All orthopaedic and neurological causes have now been ruled out. Do you think it could be PVD. I do have a strong maternal family history of heart disease and am a smoker. Am very frustrated! Your advice would be much appreciated.

  18. stephen says:

    I’m 63 yrs old. Considered ‘healthy and strong’. Don’t smoke nor drink. Have had problems with L1/L2 from previous injury at age 14. Then a flair up in 94 from an auto accident from the rear. I attempt to keep my lower back muscles strong as well as others. I have lower leg pain (left leg) at the calf to a point at times that I can not apply another step. I can stop for a few seconds and it goes away. I usually walk anywhere from 4 to 12.5 miles at any given day at least 3 to 5 days a week. Indoors or out. I walked 12.5 miles just the other day with little to no problems with slight pain the first 4 to 5 miles after that almost no pain at all?
    My right leg at a bit lower than my heart is 108/84, can’t find one for my left leg? My B/P at the arm is 117/75. This is a normal number over the past several years. My weight is 78-79 kilos. Perhaps nerve damage at the lumbar area??
    been told that if I can still walk like that, nothing wrong. Used to run and swim 5 miles a day…I enjoy walking now, even with the pain. Any suggestions?

  19. rashmi says:

    if PVD, which specialised doctor we should show?

  20. JJ says:

    I am 30 yrs old and for at least the last 3 months my legs always have this feeling of soreness (as of now best way I can describe this). I dont get tired walking around from place to place but they always feel as if I have either finished doing a leg workout or have been running. Now the feeling has seemed to get more noticeable over the months. Also working in IT I am normally sitting down for 8 hrs. If I get up and walk around my legs seem to feel better but once I sit down after a few minuets the feeling comes back. Would this be a sign of PVD.

  21. Chassy says:

    I just turned 30 on July 2, but ever since March both my thighs hurt. It’s not the bone, but feel like it could be muscle issues. I cannot walk up 2 stairs w/o being out of breath. Also, my right thigh goes numb & tingled when I lie on my left side & subsides when I lie on my back or right side. I went to the Dr & she ordered blood work, MRI, & X-rays, but of course it showed nothing ( being a x-ray technologist I knew that w/ regard to the x-rays). Also, she said she wanted me to see a Neurologist b/c i have delayed reflexes; after i got my lab results back she wanted me to schedule an liver ultrasound, but it like moving hell & high water for them to set my Ultrasound & Neurologist appt up. But i’m really worried because I cannot walk up stairs w/o some type of assistance & feeling totally embrassed. I’m stressed b/c I don’t have a clue what’s going on & my Dr office is terrible I’m never going back, I’m
    looking for a new Dr. I need some insight!!! Help me

  22. Chassy says:

    Oh, an i’m a healthy 5’2 113 lb. female. I have NEVER had any health concerns expect for occasional chest palpitations. And chest Xray came back normal twice

  23. Chassy says:

    Oh. I have fallen at least 3 times since this all started & when I try to run I cannot b/c I feel as though I’m losing my balance & about to fall.

  24. Amy says:

    i have had lower back pains over the years, however this time the front of my lower legs are tingly and my upper thigh on the side gets terrible pains. My doctor told me it’s all apart of the lower back pain. When i am walking or climbing stairs my leg just gives out and i go down and sometimes it is hard to stand on the left leg because the pain is so bad. So my question is what can I do to make this go away?

  25. carla says:

    For The Last Several Weeks, I’ve Noticed That EveN A Few stairs Are Very Difficult. It Feels Like I’ve Been Running Flights Of Stairs. My Upper Legs Feel Exhausted And Numb. It’s Kind Of Scaring Me.

  26. Felecia Winters says:

    I get cramps in my legs at nite, but now I”m not only getting cramps in my legs i’m also getting heat sensations in my left leg (calf) during the day off and on, but not at nite. Whats going on with me? What can I do about this?

  27. Adam P says:

    I’m only 32 and walking up steps and up hills began to cause me pain in all my leg muscles and buttocks. It progressed slowly and I ignored it for a while. Doctors looked for all sorts of things without success. Than while ct scanning my lower back they spotted a major blockage in my lower aorta. About a week later my kidneys started HURTING due to blood pressure from the blockage, for the next 15 days until I was operated on. Do not ignore leg pain when walking steps as I did. It can cost you your life!

  28. Tom W. says:

    I am reading all these posts and some of this sounds familiar. I am a 48 year old male, tri-sport (swim,bike,run) participant. I usually run about 7-12 miles per week, swim 1 mile, and bike about 40 miles per week. I recently started experiencing pain in my calves after a run but only noticed it when I am climb stairs. I thought maybe it was a change in the weather or that I ran a lot harder that day. The latter point of running harder doesn’t add up as I am talking a 30 second to 1 minute difference over a 30 minute run. If it were the weather, I think I would crap during the run, not after. Another thing is that my hands and feet are either very warm or very cold, which causes discomfort while lying down at night. Any insight into my symptoms is very much appreciated.

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