Prof. from the Department of Interventional Radiology at Yeni Yüzyıl University Gaziosmanpaşa Hospital. Dr. Aylin Hasanefendioğlu Bayrak gave information about the causes and treatment of walking pain.
Leg pain, which can occur even in very short walking distances, which causes movement restriction in people, goes away with rest but starts again with movement, is defined as walking pain among the people. Walking pain, the most prominent feature of which is onset during walking and disappears when resting; especially when going up and down stairs and slopes.
What causes pain, what is the underlying mechanism?
The arteries in our legs function like pipes that carry clean blood to our muscles. In cases where the leg muscles are used intensively, such as walking, the leg arteries expand to meet the increased oxygen and energy needs of the muscles. Plaque formation on the vascular wall, which we call atherosclerosis, causes very serious vascular stenosis in some patients due to reasons such as smoking, blood pressure, diabetes, and high cholesterol. In fact, every vein in the body gets its share from this situation and causes different complaints in different organs in the patient. The increased blood demand of the muscles during walking cannot be adequately met due to the stenosis created by these plaques in the vessels and causes pain. As the amount of stenosis in the arteries increases, muscle pain occurs within a shorter walking distance. The presence of walking pain may be a sign of serious vascular stenosis in middle and elderly people, blood pressure patients and people with additional diseases such as diabetes.
How is the diagnosis and treatment of leg pain originating from the artery?
Developing technology and new techniques make it possible to treat arterial stenosis and even occlusions with closed surgery. Interventional Radiology outpatient clinics are one of the shortest ways to get a quick diagnosis of your disease and to arrange your treatment without delay. So much so that a middle-aged or elderly patient with additional diseases such as blood pressure and diabetes can apply directly to the Interventional Radiology outpatient clinic by saying 'there is probably a narrowing in my leg veins' if they also have complaints of walking pain. Interventional radiologists are physicians who specialize in the diagnosis and treatment of vascular diseases.
The first step for diagnosis is Doppler Ultrasonography examination. Doppler ultrasonography examination should definitely be performed by a Radiology Specialist. With a good Doppler ultrasonography examination, the narrowed or occluded areas in your vessels are detected and reported. If necessary, vascular stenosis can be viewed in more detail with the drug given from the arm by methods such as Computed Tomography. The next thing to do is to choose the appropriate treatment.
Angiographic methods, which are usually performed by entering the inguinal vein in the treatment process, have now become indispensable. This procedure is known as closed surgery, and is performed by the Interventional Radiologist in angiography units under sterile conditions in an environment that resembles an operating room. Vascular stenosis and occlusions are usually treated in one session with balloon or stent applications with this method. These procedures are done with a small skin incision like a pinhole. The best part is that with this treatment, which we call closed surgery, the patient is discharged the next day and can return to his daily work.
The easiest period of treatment is the earliest period when the problem is detected. Untimely treatment leads to longer stenosis or complete occlusions, which can make treatment more challenging and difficult. In addition, in patients who are not treated in this period, it evolves over time, even during the period of resting pain, which we call resting pain, as long as there is pain, which requires urgent treatment. Again, neglected stenosis/occlusions can lead to foot wounds after a while, which is a situation that needs urgent intervention. Especially in diabetic patients, in the presence of foot wounds, intervention should be done without losing any time. If it is neglected after the wound is formed, it causes gangrene in the toes and the gangrenous tissue, which we call amputation, must be cut and removed.