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How a Structured Walking Program Might Lessen Your PAD Leg Pain

If you have peripheral artery disease (PAD), the cramping and discomfort it can cause in your calves, thighs and buttocks can impact your life. You may find yourself scaling back on walking, not exercising as much as you used to and even limiting your daily activities because of the pain.  

A treatment called supervised exercise therapy (SET) might have you feeling better and moving more in just 12 weeks. Daniel Miller, DO, a vascular surgeon with Banner Health Clinic in Chandler, AZ, answered some of our questions about SET and PAD.  

What is peripheral artery disease? 

PAD is a condition where the arteries in your legs or arms become narrowed after plaque builds up in them. It’s more common in the legs. If you have PAD, you might notice muscle cramping when you’re active. That’s because your muscles aren’t getting enough blood flow or oxygen. You may also have poor wound healing in the legs or arms that are affected. PAD puts you at higher risk for heart attack and stroke. 

How can supervised exercise therapy help with PAD? 

Even though exercise causes pain, it can also be used to treat PAD. The discomfort or cramping in your leg that strikes when you walk or exercise usually goes away after you rest for a few minutes. SET helps increase the length of time you can walk or exercise before the pain forces you to take a break. 

“Supervised exercise starts with an evaluation by a vascular surgeon,” Dr. Miller said. He points out that being evaluated by a vascular surgeon doesn’t mean you’ll need surgery.  

A surgeon may recommend a couple of noninvasive tests: 

  • Ankle brachial index. This test measures the blood pressure at your ankle and arm and compares the two. A lower number in your ankle could point to PAD. Your doctor may perform this test before and after you walk on a treadmill to see how exercise affects your readings. 
  • Arterial duplex ultrasound. This test uses sound waves to image your arteries. Your doctor can review the images to see whether your arteries are narrow due to PAD.  

Your doctor can use the results of these tests to help develop a supervised exercise program, like cardiac rehab. While everyone’s plan is different, you’ll probably walk on a treadmill, with rest breaks, for 30 to 60 minutes three times a week for 12 weeks. You may also walk on your own at home on other days. And a nutritionist may meet with you to counsel you on healthy food choices that can reduce your risk for PAD complications. 

With the program, you work closely with a health care provider to gradually increase the distance you can walk or the length of time you can exercise before you start to experience symptoms of PAD. Many people have a goal of 30 to 45 minutes of pain-free walking. Medicare and many private insurance plans cover supervised exercise.  

In some cases, your doctor may also prescribe medication that can help you improve your walking distance before you experience pain. But this medication isn’t appropriate for everyone. For example, you can’t take it if you have congestive heart failure. 

What other treatments are available for PAD?

For many people, SET is enough to alleviate symptoms. If supervised exercise doesn’t get your pain and cramping under control or isn’t something you’re able to try, there are other treatment options to consider:

  • Medications, including those that treat high cholesterol, high blood pressure, high blood sugar and blood clots.
  • Minimally invasive procedures such as angioplasty and stent placement. With these procedures, your doctor threads a small catheter from your thigh to the site of the blockage and inflates a tiny balloon there to push back the plaque and widen the artery. They might also place a stent to help keep the artery open.
  • Graft surgery, where your doctor bypasses the blockage in the artery with a blood vessel taken from another part of your body.
  • Clot-dissolving drugs delivered to the blocked area.

The bottom line

Treating your leg pain from PAD with supervised exercise therapy or other options can make a big difference. “People are surprised at how much these treatments can improve their lifestyles,” Dr. Miller said. “Being able to exercise and perform daily tasks easily can improve many aspects of your health and your quality of life.” 

You can evaluate your personal risk for PAD with the Banner Health online screening test. If you would like to connect with a health care provider who can assess your leg pain and help you develop a treatment plan, reach out to Banner Health. 

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