Arterial circulatory disorders in feet and legs

For years, patients have been complaining about pain in one or both legs during consultation hours, which forces the person concerned to stop after a certain distance. A patient who complains of such pain will certainly be instructed by the doctor to free both legs and lie down on the examination bed. The doctor feels the backs of the feet, the areas below the inner ankles, the hollows of the knees and the groins.

causes

He will then instruct the patient to raise their legs, support their legs under the back of their knees with their hands and roll their feet. In this way, it can be determined if and when pain in the feet or calves occurs, as observed by the patient when walking.

The doctor registers the duration of this foot rolling with a stopwatch and lets the patient stand up immediately as soon as he can no longer roll because of the pain. The feet, which are initially very pale, usually turn red in patches before the color returns to normal.

At the same time, we have described the nature of this disease, which involves circulatory disorders in the legs and their individual parts, muscles, skin, tendons. The vessels are narrowed due to changes in the inner layer and consequently no longer have their normal diameter. The consequence of this is that insufficient blood reaches the muscles and other dependent organs.

Nutrition, especially oxygen supply, is reduced and cramping pains appear. This process of pain can be verified at any time by tying off a finger and moving it at the same time. A constricted vessel can also be roughly compared to an old water pipe that has accumulated rust, scale, or scale; the water only flows out of such a pipe with significantly reduced pressure.

The arterial circulatory disorders occur particularly in men from the age of forty-five, in some cases even earlier. The main causes are arteriosclerotic deposits , the development of which is promoted by inflammatory and allergic diseases , chronic foci of pus, for example on the tonsils or teeth, or by metabolic diseases.

We often observe these pathological changes in heavy smokers . This is not surprising when you consider that nicotine is a pronounced vascular poison.

A reduced adaptability of the vascular system, which is the result of a lack of physical training and chronic lack of exercise, also has a promoting effect . Disturbance of venous return, especially in obese people and those with varicose veins , can also lead to inflammatory changes in the vicinity of the arteries and affect them.

There is a close relationship between arterial circulatory disorders in the extremities and insufficient blood flow in the coronary arteries. It is often a disease of the entire arterial vascular system and only in rare cases of vascular occlusions caused by blood clots ( embolism and thrombosis ).

Symptoms, Ailments & Signs

Impaired blood circulation in the feet and legs is characterized by poor wound healing , tingling , pain and sensory disturbances . The symptoms mentioned can have a variety of causes and are signs of a disease of the feet and legs that requires treatment. But not every symptom that is noticeable in the lower extremities is necessarily caused by an arterial circulatory disorder. Stress , temperature fluctuations or psychological factors also play a role in the contraction of the vascular system.

At the beginning, the changes in the vascular system on the legs are already recognizable, but do not cause any problems in everyday life and therefore often remain undetected by the patient. The circulatory disorders usually occur in the femoral arteries, but can also affect the arteries of the pelvis or lower legs.

If the first symptoms appear, such as numbness , a feeling of coldness in the extremities, tingling or pain when walking or climbing stairs, a doctor should definitely be consulted in order to be able to rule out various diseases of the haematopoietic system.

On this basis, a suitable therapy against the hardening of the arteries can be initiated, since the symptoms, if left untreated, become more and more serious as the disease progresses. In this case, it would ultimately lead to constant pain with movement or exertion such as ” intermittent claudication ” in the lower limbs.

complications

Arterial circulatory disorders in the feet and legs usually progress slowly because the pathological changes in the supplying arteries also slowly change at the same time. As a rule, however, it is a matter of deterioration if the disorders remain untreated and the causes are neither recognized nor eliminated. Sensory deficits are often one of the first complications.

A kind of numbness develops in the legs and feet , and tactile pain sensations are greatly reduced or absent altogether. In more advanced stages, complications occur in the form of pain, which is particularly severe during exertion, such as in the well-known peripheral arterial occlusive disease, which is also known as claudication. Due to the lack of supply to the tissue in the legs and feet, wound healing is disrupted after an injury.

Irreversible tissue death can present as a serious complication. In particularly serious cases, where dead tissue and the inability to restore adequate blood circulation correspond, it may even be necessary to amputate the affected limb. This prevents an impending poisoning of the entire body, which would be immediately life-threatening.

Irrespective of the treatment of the circulatory disorder, the complications that arise correspond to the severity of the arterial supply bottleneck. However, not all complications that have occurred resolve once the irreversibility threshold has been crossed.

When should you go to the doctor?

If you notice repeated numbness or sensory disturbances in the limbs, a doctor’s visit is recommended. Arterial circulatory disorders in the feet and legs are also manifested by paleness, muscle weakness and pain. If these symptoms are noticed – regardless of whether they appear gradually or suddenly – a doctor must clarify the cause. Although there is not always a disturbed circulation, the symptoms at least indicate a disease that needs to be diagnosed and, if necessary, treated.

If the underlying condition is not treated, the symptoms will continue to increase and eventually lead to tissue damage such as the so-called smoker’s leg. A medical examination is required at the latest when symptoms of paralysis are accompanied by severe pain that never completely disappears even when you are resting.

Patients with diabetes or existing arterial disease should speak to their doctor immediately if they experience any unusual symptoms. If dizziness, chest tightness and stabbing pains in the right arm occur, there is an acute danger to life and the emergency services must be contacted. In addition, first aid measures must be taken.

Treatment & Therapy

Of course, it is advisable to take effective measures as soon as the first signs appear in order to prevent the disease from progressing. After a special examination, the treatment plan is determined. If the disease is already advanced, it is now possible to restore peripheral circulation with the help of medication or surgery.

To supplement and continue the clinical treatment, cures are also suitable, with the help of which the bypass circulation existing in all people can be trained and made resilient, so that small vessels are enabled to take over the function of the constricted large arteries. However, the artificial vascular replacement often proves to be superior to all these measures.

Long-term success can also be achieved without surgery in those patients who come for treatment early and are willing to undergo long-term treatment with all its consequences for the individual’s lifestyle.

It is particularly important that the patient works at home under the guidance of the doctor and trains his vascular system daily according to a fixed plan. The best training is movement. The most favorable loads are: at least twice a day, rolling exercises that are carried out three times in a row to below the pain threshold.

To do this, we lie relaxed on our backs and lift our legs slightly bent. We hold the back of the knees with our hands and move the feet in a circular motion, possibly also the entire lower leg. It is advisable not to do this exercise on a full stomach.

If it is found to be too strenuous, especially by older people, it is advisable to sit down in a comfortable chair, hold only one leg with both hands and do the rolling exercises one after the other. In any case, it is important to get up after the pain occurs and wait until it has subsided and any discoloration that may have occurred has normalized again.

Other effective measures against circulatory disorders are special foot exercises, regular walking training, hiking, cycling, jogging and swimming, although the performance limit indicated by the pain must not be exceeded. All exercises must be carried out in such a way that we achieve the best possible blood circulation through the alternation of tension and relaxation.

The exercises mentioned can be supplemented by dry brushing. The lines begin at the bottom of the legs, each on the inside. Don’t forget the soles of your feet! Always brush in the direction of the heart, i.e. arms and legs upwards, until slight reddening and a feeling of warmth occur.

The following scheme has proven itself: right leg to the buttocks, left leg to the buttocks, right arm and right shoulder, left arm and left shoulder, back and hips from the buttocks upwards, circling the stomach in a clockwise direction, upper body from the shoulder to the breastbone and along the ribs.

Outlook & Forecast

Arterial circulatory disorders in the feet and legs have a good prognosis. Medical treatment provides various options that lead to the elimination of the disorder. However, it should be noted that without medical care, the disease can be fatal.

If a thrombus blocks the blood vessels, there is a risk that it will detach and be transported to another location via the bloodstream. There he can obstruct various supply lines and trigger a blood stasis. Stagnation of the blood causes damage to the vessel walls.

In severe cases, there is a risk of a stroke , which can lead to lifelong impairments or death. If the circulatory disorder in the feet and legs is diagnosed early, there are good prospects of a cure.

The vasoconstriction can be eliminated by the administration of medication or by an operation. The patient is symptom-free within a few days or weeks. There is a normal blood supply and the symptoms are eliminated.

The cooperation of the affected person is important to ensure that the vasoconstriction does not occur again. Sufficient exercise, a healthy lifestyle and measures to promote blood circulation should be carried out independently. If the legs are hardly moved over a longer period of time or if a rigid posture is adopted, the risk of health problems increases.

Alternating baths according to Kneipp

Other circulation-promoting measures are the temperature-controlled alternating Kneipp affusions, which are carried out on the healthy leg or arms. We start with a pour of about 36 to 38 degrees, add a cold pour of about 20 to 24 degrees and finish the pour warm. After that we go to bed.

Only as the training progresses and after the symptoms have improved – you can tell by the faster rewarming – is another cold cast followed and then run. Increasing partial baths, also on the healthy leg, or if both legs are affected, on the arm, as well as increasing hip baths are recommended.

Cover your legs with blankets. These baths generally start at 36 degrees and increase the temperature over the course of 20 minutes to a maximum of 41 degrees. Afterwards, a rest period of at least 30 minutes is recommended.

These measures – as simple as they may seem and as easy as they are to carry out – have proven to be cheap and effective. However, the patient has to visit his doctor at regular intervals, who works out a fixed daily schedule with him and repeatedly encourages him to carry it out regularly.

Success with this disease can only be expected if the treatment is followed consistently for months or even years and if all damaging factors are strictly avoided. The reduction in symptoms is the reward for consistent treatment and regular vascular training. The person concerned will notice that he can cover longer and longer distances without pain. The ultimate goal, however, is to preserve the performance and functionality of the vessels.

aftercare

If there is an arterial circulatory disorder in the feet and legs, specific follow-up care should be observed. It is important that after the diagnosis and therapy, the doctor’s instructions are carefully followed. This tells the affected person certain behaviors that alleviate the symptoms as much as possible. You should also make sure that the so-called support stockings are always worn.

These ensure that the blood is distributed properly in the legs and feet. Adequate fluid intake should also be considered. Drinking a lot is important to distribute the blood well in the body. Regular walks in the fresh air and light sporting activities also get the blood circulation going again. If affected persons are prescribed medication, it is imperative that they take it.

And exactly according to the doctor’s instructions. If these things are taken into account during the aftercare of the circulatory disorder, there is nothing standing in the way of alleviating the symptoms. However, if these are not observed, this can lead to a deterioration in the state of health.

You can do that yourself

In the case of a complete occlusion of vessels, measures that do not involve either surgery or medication usually do not help. This also applies if the circulatory disorder is caused by an embolism or an inflammation.

However, those affected by a circulatory disorder in the lower extremities can do a lot to slow down the progression of arterial narrowing and promote the formation of new capillaries. If the condition is caused by arteriosclerosis, those affected can often improve through a healthier everyday life.

Factors that promote arteriosclerosis should be eliminated if possible. Cigarettes and excessive alcohol consumption should be avoided. The same applies to eating large amounts of fat . Instead, a healthy diet rich in vitamins and minerals and low in fats should be achieved. Sufficient liquid is also important, as this improves the flow of the blood.

Movement is essential to maintain blood flow to the affected extremities. Walking for at least 30 minutes a day prevents further narrowing of the arteries, is good for the circulatory system and makes you feel better. Other sports are also suitable. Along with a healthier diet and more exercise, you should reduce any excess weight you may have.