Leg Pain : The Lull Before The Fatal Storm
17 Nov 2007
"Have you ever heard of Matthews Law?" I asked a journalism student who recently interviewed me. Her assignment was to find out what young people and others could do to prevent health problems. The timing of the interview couldn’t have been better as I was just writing a column about peripheral arterial disease (PAD), a prime example of Matthews Law. And how many know about the ABI test?
Coronary artery disease, the number one killer, always gets prime coverage, for good reason. A sudden severe pain in the chest may be the last pain you ever have on this planet. Half of its victims die before reaching a hospital emergency.
Compare this to leg pain and most people don’t get too excited. Patients initially pass it off as a simple leg cramp. But when it keeps recurring while walking this symptom starts to get higher priority, and for good reason.
A report from the Mayo Clinic says that eight to 10 million Americans have PAD, but 80 percent are unaware of the disease. And for some it’s a walking time bomb.
PAD is the result of atherosclerosis (hardening of arteries) and, in part is a disease of aging. But the stage is often set earlier in life by faulty lifestyle. The major contribution is childhood obesity. And that’s when Matthew’s Law triggers the clicking time bomb.
Matthew’s Law states that it’s the sum of all your bad habits that eventually causes trouble. That one medical problem such as obesity leads to diabetes, atherosclerosis (hardening of arteries) and a multitude of other obese related diseases. And we know that obese children usually become obese adults.
But how are heart attack and pain in the legs related? A heart attack occurs when coronary arteries become narrowed due to fatty deposits which shut off blood supply. But atherosclerosis isn’t a localized disease so if coronary arteries are compromised there’s a good chance the leg’s arteries are also unhealthy.
Luckily the leg’s arteries are much larger than coronary vessels so pain in the legs while walking is not going to cause death. But it is a great warning sign that there may be trouble in the heart.
A report from Duke University in Durham, North Carolina claims that five percent of men and two percent of women over the age of 50 have PAD. This increases the risk of heart attack six times. So leg pain should be a great wakeup call to improve one’s habits. It could prevent a lethal heart attack or in extreme cases gangrene and amputation of legs.
Today physicians are often so busy that they may ask if you’re having headaches or chest pain, but fail to question if you’ve noticed leg pain. But even if PAD is not severe enough to cause cramps there is a non-invasive test to diagnose this condition, the anti-brachial index (ABI) test.
Blood pressure is tested at the usual place in the arm, but also at the ankle. If there is a blockage in either leg the blood pressure will be lower at the ankle.
If PAD is diagnosed, treatment is the same as for early heart disease. Patients must lose weight, control diabetes and hypertension, stop smoking, lower blood cholesterol and exercise their legs. Aspirin and Plavix may be prescribed to decrease the risk of a blood clot cutting off circulation.
Doctors, at the moment, are not seeing young people with PAD. But don’t hold your breath. It may not be too long before this happens.
How quickly things change! Fifty years ago 10 percent of diabetes was due to obesity. Now its sky rocketed to 90 percent and its being seen more and more in young children.
Today every 45 seconds a new case of diabetes is diagnosed in North America. It will take draconian measures to stop this trend and I don’t see this happening. Surely today we should have compulsory daily physical education in our schools.
I hope the journalism student left with the message that for young and old alike the key word is prevention, prevention, prevention. Unless this word gets out we will be facing an economic disaster of unprecedented proportions.
