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Vascular Dysfunction

Vascular dysfunction or claudication is pain felt, usually in your leg(s), when there is a lack of blood flow to your muscles. 

Common Signs & Symptoms

  • Tight or squeezing pain in the buttock, leg or calf, that occurs during exercise such as walking and is relieved by resting from activity
  • Weakness, fatigue or a heavy tired feeling in your legs
  • Changes in your skin colour - the affected area(s) can become white, blue or bright red
  • Changes in your skin texture - the affected area(s) can be cold, clammy, shiny, flaky and hairless
  • Sensation of a tight band around your thigh
  • Usually affects both sides

Description

Vascular dysfunction or claudication is pain felt, usually in your leg(s), when there is a lack of blood flow to your muscles. It's usually worse after walking or exercise but improves when you rest.

Poor blood flow is usually caused when your arteries are narrow from such things as trauma, degeneration or blood clots. The calf, thigh and arm pit areas are the most common sites for clots. When your muscles receive less blood, the lack of oxygen and build up of waste products causes the pain you feel. This type of pain or heavy tired feelings in the lower legs with exercise may be an indication of peripheral vascular disease.

In the older generation
It is much more common in men than women and affects up to 10 per cent of people aged over 65 . The most common cause of vascular dysfunction is arteriosclerosis (a build up of cholesterol or fatty deposits on your artery walls) which causes your arteries to become hardened or narrow. Most people with vascular dysfunction are at risk of heart attack, stroke and blood clots.

In the young
This usually happens when your blood vessels become trapped as they pass through bulky muscles or suffer from trauma. Some people suffer from their vessels kinking, which blocks the flow of blood or through nerve damage.

You are more likely to suffer from vascular dysfunction if you have diabetes, high cholesterol, high blood pressure, lack of physical activity, high levels of a chemical called homocysteine, a family history of cardiovascular disease or smoke.

This condition can be confused with spinal and foraminal stenosis as they have similar symptoms - both conditions can cause pain in the lower legs with walking and exercise and improve with rest. To find out which one you have you need to find a bike- if you have spinal stenosis, riding a bike will not bring on your leg pain, but if you have vascular dysfunction your pain will develop as you cycle.

Advice & Treatment

For people over 65
There is good evidence that regular exercise can improve your circulation and you will find you are walking further without having symptoms.

Your programme
To take control of your problem, put the time aside and just follow this formula. It’s easier if you make this part of the things you do regularly, like walking to the corner shop:
Week One:
Walk at an easy pace until the pain comes on, then try to walk a little further. When the pain increases to near maximum, stop and rest until the pain disappears, then go back to where you started from. Remember the distance that you walked on this first occasion and walk the same distance for one week.
Week Two:
Increase the distance slightly and do this same distance for the entire second week.
Week Three:
Walk further still and do this same distance for the following week.

It is important to increase the distance walked each week by a small amount to find this programme it easy to follow. You must exercise at least 3-4 times each week and build up your distance over a period of weeks. Initially this can be uncomfortable but you should start to feel real benefit at about 6-8 weeks. It is important to build up your distance gradually so you manage well and keep improving.

Some patients find that flat shoes can make their symptoms worse. A heel raise in your shoes can help you to stick to the programme more comfortably.

In the young
Exercises such as stretches and core strengthening can improve your posture and take pressure off the blood vessel causing problems. If your symptoms don’t get better within 4-6 weeks then you should see a Physiotherapist who is qualified in vascular assessments for an assessment.

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