Circulatory disorders in the legs

Symptoms

Depending on the extent to which the circulatory disorder has already assumed and where it is located, very different symptoms of circulatory disorders can be found in the legs.

Circulatory disorders are often found in the extremities, especially in the legs. Acute circulatory disorders in the arms or legs very quickly lead to severe symptoms. The 6 typical symptoms can be remembered with their English translations as the 6 "P" s.
Which includes:

1. Pulse loss (pulselessness),
2. Pallor and cold (paleness),
3. Muscle weakness up to paralysis (paralysis),
4. Sensory disturbances that show up as numbness (paraesthesia), Please also read our article about this Burning in the toes!
5. Pain (pain) and
6. Shock (prostration).

In addition, pain-related sleep disorders can also occur.

Chronic circulatory disorders of the extremities are referred to in medicine as peripheral arterial occlusive disease (PAOD), colloquially it is often referred to as "intermittent claudication" when the PAOD affects the legs they are no longer adequately oxygenated during exercise, which can cause pain. As a result of this pain, a patient stops walking at regular intervals to allow his muscles a short break until the legs are sufficiently supplied with blood again.

The PAOD is divided into 4 different stages, which are associated with different symptoms.

1st stage: This stage is still asymptomatic.

2nd stage: Here, pain actually only occurs during exercise.

3rd stage: Here pain also occurs at rest, especially when lying down. If someone sits down or stands up, the symptoms improve because the blood flow to the legs increases due to gravity.

4th stage: Here are the Circulatory disorders already so pronounced that they become visible through dead tissue, one also speaks of "Smoker's leg“(Skin discoloration with partly open wounds). The PAOD at the Diabetes mellitus This disease is very often associated with a reduced sensitivity to pain, which is why the PAD is only diagnosed in the late fourth stage.

Circulatory disorders of the intestine lead to stomach painwhich are particularly noticeable after eating, as the intestinal muscles have to work here. Since patients lose their appetite due to the pain, this type of circulatory disorder is often associated with weight loss. If the blockage is acute, for example due to a blood clot that has been dragged around, it can be life-threatening because intestinal tissue dies and the intestine is paralyzed (Paralytic ileus).

When a Circulatory disorder in the heart is present, one speaks of a Coronary artery disease (CHD). It manifests as intense pain in the chest area that is felt to be constricting and terrifying (Angina pectoris). In some cases this pain radiates to the arm or stomach and is associated with a feeling of being unable to breathe deeply. Depending on the extent, these pains only occur under stress or even at rest. In the worst case, the circulatory disorders in the heart lead to a heart attack.

When the brain of Circulatory disorders is affected and as a result is no longer supplied with enough oxygen, very different symptoms can arise depending on the location of the artery occlusion. The most important ones are dizziness, temporary numbness in the extremities, difficulty speaking or seeing, ringing in the ears, Mood swings, Disorientation, confusion and memory disorders. In the worst case, the circulatory disorder in the brain leads to one stroke.

Pain in the legs

The type and time at which pain occurs in the case of a circulatory disorder in the legs depends on the extent to which the vessels are already closed, i.e. how much blood still reaches the legs. The less blood can flow due to the circulatory disorder, the faster symptoms occur.

In stage I of peripheral arterial occlusive disease there is no pain, but the damage in the vessels can already be objectively demonstrated.

In stage II, the first pain occurs on exertion. If the patient then stands for a while, the pain disappears again. This alternation between standing and walking has given the PAOD the popular name of “intermittent claudication”. Doctors also refer to this stage as Claudicatio intermittens, which means intermittent limping. The reason for this is the pain that occurs as soon as the blood flow is no longer sufficient for the supply of the muscles required when walking.

Depending on the progression of the disease, the pain-free walking distance is less or more than 200 meters, corresponding to stages IIa and IIb.

In stage III there is pain that already exists at rest without any strain. Patients also report pain at night, which is relieved by hanging their feet out of bed.

In addition to the pain at rest and during exertion, in stage IV there are skin symptoms, for example so-called gangrene, which are caused by insufficient blood circulation. The localization of the pain depends on the level at which the circulatory disorder begins.

There are three different types of PAD: the pelvic type, the thigh type and the lower leg type. The complaints appear in the segment below. This means that pain in the thigh indicates that the narrowing of the blood vessels is in a pelvic artery. In the thigh type, the complaints occur in the lower leg and in the lower leg type on the heel or foot. With regard to pain, it should be noted that diabetics can remain symptom-free for a long time due to the involvement of nerves due to the disease and feel no pain despite massive constriction of vessels. The presence of a circulatory disorder is only recognized in these patients when skin symptoms appear.

In the case of circulatory disorders in the legs caused by an acute blockage of an artery, the pain occurs suddenly and without warning. They are not dependent on movement and do not improve at rest. Often they are accompanied by a feeling of numbness and coldness in the affected extremity. In such a case, a doctor should be consulted as soon as possible.

A circulatory disorder can also occur in the toes. For the most important information on the subject of "Circulatory disorders in the toes", please also read the following article: Circulatory disorder in the toes

What does a tingling sensation in the legs indicate?

Tingling can be a typical sensitive symptom of a circulatory disorder in the legs.
This is a discomfort caused by small sensitive nerve cells in the skin.
If these nerve cells are supplied with too little oxygen, they can lead to erroneous sensations and, in addition to tingling, cause unpleasant pain and numbness.
Often times, the tingling sensation starts at the point with the least natural blood flow, the toes.
In the case of advanced circulatory disorders, the entire legs can be affected and nerve cells can even die off, leaving behind permanent sensory disorders.

Can a tingling sensation indicate a circulatory disorder? Find out more about this here.

Open Legs - What Does It Mean?

An open leg is a wound on the leg that heals poorly and therefore often remains chronic.

Often this wound is located on the lower leg, since the blood circulation is the first to decrease.
The cause of the open leg is an extremely reduced wound healing, which is caused by the circulatory disorder.
Both the arterial and venous blood supply play an important role in the transport of messenger substances in wound healing, in the interaction of the immune system and in providing a healthy wound environment in which the wound can heal.

Open legs are typical secondary diseases of smokers, diabetics and overweight people.
It is important in the treatment to improve the blood circulation around the wound and to avoid infections, as the immune system to ward off pathogens is also impaired by the lack of blood circulation.

You can find more information on this topic under: Open leg - causes & therapy

treatment

Depending on the cause of the circulatory problems in the legs different treatment methods for use. The most common cause of one chronic circulatory disorder in the legs is that peripheral arterial disease (PAOD). According to Fontaine, it is divided into four stages. Treatment depends on the stage of the disease. The basis of any therapy for PAOD in all four stages is the Elimination of risk factors. This includes that Cessation of nicotine use, the Weight reduction, a consistent treatment of previous illnesses such as Diabetes mellitus and high blood pressure as well as the Reduction of increased blood lipid levels.

Furthermore, there are so-called in all four stages Antiplatelet drugs, amongst other things Clopidogrel and ASS, for use. These counteract an excessive and premature aggregation of platelets and prevent thus the Formation of thrombiwhich then constrict the blood vessels and lead to circulatory disorders. The further treatment is then stage-specific.

In Stage II is used in addition to the above treatments intensified walking training set as a conservative therapeutic approach. The training program should be clearly structured and about at least three months at least three times a week for about 30-60 minutes be pulled through. The walking distance can be increased significantly. However, not all patients are suitable for such treatment. Another possibility is the so-called Naftidrofuryl a medicine which is called Vasodilator the Vessels wide and thus promotes blood circulation. The drug is intended for the treatment of stage II PAD.

Cilostazol acts like clopidogrel and ASA as Platelet function inhibitors. If the conservative and medicinal treatments do not improve the symptoms or if the disease even progresses, the Stages two through four peripheral arterial disease with interventional procedures worked. These include percutaneous transluminal angioplasty, or PTA for short, a minimally invasive expansion of the affected vessels, and the Stent implantation. After the expansion of the vessel, a fine, expandable tube made of metal or plastic mesh, called a stent, is used to hold the vessel open.

Medicinal is the PAD in the Stages three and four With Alprostadil, a prostaglandin. The drug improves resting pain, ensures faster healing of ulcers, i.e. deep and often weeping wounds, and reduces the amputation rate. In addition, stages three and four are used to treat PAOD operative care with bypasses as well as the Thromendarterectomy, that means the operational recanalization of the clogged vessel.

At acute circulatory disorders is a Immediate hospitalization required. There the closed vessel is opened again as soon as possible. are Muscle tension help responsible for the circulatory disorder relaxing measures such as heat treatments and massages.

How can you measure a circulatory disorder in the legs?

The suspected diagnosis of a circulatory disorder in the legs can already be made on the basis of the clear symptoms and complaints.
To confirm this, simple tests can corroborate the suspicion and concrete measurements of the blood flow precisely define the extent of the disease.

First, you should try to feel the pulse at different points on the leg.
A blood pressure measurement with the help of a cuff and a stethoscope can also show the level of the leg at which the restriction is present and how severe the circulatory disorder is.

Another inexpensive examination that can be carried out quickly is Doppler sonography, with which more precise statements can be made about the blood flow and the degree of blockage in the vessels.

Angiography, radiological imaging of the blood vessels of the leg, can be performed to complete the diagnosis.
This can show the blood flow and constrictions of the vessels particularly precisely.
The extent of the disease, however, depends on the symptoms and effects on the patient, regardless of the measured blockage, since the subjective complaints can vary widely.

This doctor treats the circulation problems in the legs

Circulatory disorders in the legs can be traced back to numerous causes.
The therapies can also vary greatly depending on the stage of the disease, which is why the disease must be monitored by doctors from various disciplines.

Often there are many risk factors behind the disease that have to be reduced, treated and medically adjusted by an internist.
In addition to being overweight, smoking and family history, diseases of the blood vessels are often also caused by lipid metabolic diseases, high blood pressure and diabetes.

These must be treated by the respective specialist and checked occasionally to prevent the disease from getting worse.
In advanced stages, surgical therapies may be necessary, in which plastic surgeons take over the treatment.

What is a stent

A stent is an interventional therapy that provides immediate relief from the symptoms of the circulatory disorder.
The insertion of a stent is a symptomatic therapy of circulatory disorders in the legs, which can be carried out in the case of acute constrictions and rapid worsening of symptoms.
It is an alternative to bypass surgery, but it cannot be used for all types of circulatory disorders.

During the procedure, the doctors push a catheter into the blocked vessel under X-ray control and inflate a balloon in the constriction, which expands the constriction.
The vessel can then be held open by a small wire tube, the stent.

What is a bypass?

An advanced surgical measure in the treatment of circulatory disorders in the legs is the installation of a bypass.
The vascular pathways are relocated in such a way that the blocked area in the arteries is bypassed and the legs can be completely supplied again via the rest of the existing vascular system.

In many cases, a gentler stent therapy can replace a bypass, in some cases a bypass operation is still necessary.
Here too, the symptoms improve immediately after the operation.

Nevertheless, the risk factors and the underlying disease must continue to be treated, otherwise further blockages arise at the bypass or in new places in the leg and cause new symptoms.

Test circulatory disorder feet

homeopathy

Depending on the symptoms present, different homeopathic remedies can be used to alleviate circulatory disorders. At changing circulatory disorders like intermittent claudication, they come Monk plant (Espeletia grandiflora) and tobacco (Tabacum) to use. The latter is also suitable for use at Numbness and tingling in the extremities as well cold fingers and toes, dizziness and Circulatory weakness.

The circulatory disorders go with further symptoms such as one Burning sensation or numbness hand in hand, is suitable Secale cornutum, in German ergot, for treatment. Is the PAD already in one advanced stage and longer pain-free walking is no longer possible at all, she creates Queen of the Night (Cactus grandiflorus) Relief.

At poorly healing wounds due to circulatory disorders that are common in diabetics Beech tar (Creosote) for an improvement of the complaints. Furthermore, to relieve side effects of a circulatory disorder, the Boarwood (Abrotanum), Toothpick herb / bishop's herb (Ammi visnaga) and Copper arsenite (Cuprum arsenicosum) can be used.

These home remedies help against circulatory disorders in the legs

In principle, circulatory disorders in the legs are often advanced diseases of the vascular system, the therapy of which consists in the urgent medical adjustment of the risk factors.

However, home remedies can also be used against acute complaints and alleviate the current complaints.
Alternating baths, hot foot showers but also massages, Kneipp courses and saunas can be used.

They stimulate the skin or raise the body temperature in such a way that the blood vessels in the leg expand reflexively and blood flow increases.
Uncomfortable tingling or even pain can temporarily subside.

Circulatory disorders after surgery

Circulatory problems in the legs can after operations occur. The reason for this can be a direct damage to a vessel be on the legs during an operation, for example. During an operation on the main artery, a Form clotswhich then loosens and enters the leg via the bloodstream. If the clot is too big for the vessel, it can develop into one Constipation with resulting circulatory disorders come.

Need after surgery longer lay times respected or will the leg for better healing for a longer period of time immobilized, the Risk of thrombosis. Blood flow disorders can also be triggered by venous thrombosis, since the outflow via the veins is disturbed. As prophylactic measure is therefore with expected prolonged immobility Heparin given to prevent thrombosis.

Circulatory problems in the legs due to smoking

Smoking is one of the most important risk factors for diseases of the cardiovascular system and also plays a major role in the development of circulatory disorders in the legs.
The ingredients of tobacco have been shown to lead to calcification of the arteries and thus to heart attacks, strokes and circulatory disorders in the legs. Smoking also promotes diabetes mellitus.
In the treatment of risk factors for vascular diseases, smoking cessation is the first and probably the most important step.

Read more on the subject at: Circulatory disorders caused by smoking

Circulatory disorders due to diabetes

Diabetes mellitus is what is known as “diabetes”.
It can be congenital or acquired and can be traced back to numerous causes.

The frequent type 2 diabetes mellitus often arises from obesity, smoking, unhealthy diet and the so-called "metabolic syndrome".
All of these are factors that cause damage to the vascular system and, in the long term, can lead to blockages in the arterial blood vessels.
In the long term, diabetes mellitus also changes the blood vessels, which calcify from the inside and can cause blood flow problems in several areas of the body.

The most important therapy consists in careful drug treatment of diabetes and a reduction in risk factors such as smoking, obesity and an unhealthy diet.

Can you fly with circulatory disorders in your legs?

The decision to fly must be made depending on the stage of the disease in the event of a circulatory disorder in the legs.
In principle, there is a lower oxygen content in an aircraft, which is why oxygen-related damage to the feet and legs can occur more favorably.

If the circulatory disorder is so advanced that tingling, pain and numbness in the toes occurs without external influences, the situation can worsen significantly during the flight, so that parts of the toes sometimes die off.
If the pain only occurs after walking a few hundred meters, a flight can probably take place after consultation with the doctor.

Furthermore, it must be discussed with the doctor whether thrombosis prophylaxis is necessary.
Since long periods of sitting in a confined space also significantly increase the occurrence of blood clots, possible precautions must be taken in the event of circulatory disorders.

Circulatory disorders in the legs during pregnancy

Circulatory disorders during pregnancy are in most cases due to the situation of the child and are often harmless.
As the child grows in the abdomen, arteries and nerves can be pinched off when the pressure in the pelvis increases.
This often manifests itself in very uncomfortable pain, tingling and numbness in the leg.

With the birth, the symptoms subside at the latest.
If there are any additional symptoms, further possible causes must be investigated with the doctor.

When is an amputation threatened?

Every fourth patient who already has leg pain at rest due to the circulatory disorder is at risk of amputation.
In these stages of the disease, those affected can no longer lay their legs horizontally in bed, nor can they cover distances on foot, as tingling, pain and numbness occur in the leg even at rest.

In very many cases the disease develops in such a way that so-called "necrosis", the death of the tissue, occurs on the feet.
In this case, the affected areas must be amputated to prevent severe inflammation.
Even in earlier stages, preventive measures urgently need to be taken, as the disease cannot be cured, only stopped.