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Leg Pain: When to Worry

By: James M. Estes, MD, Director of Vascular Surgery Services

Estes_James.jpgNot all leg pains are created equal. Cramping or tightness in your calf or thigh may not be just simple muscle soreness; it could be a sign of vascular disease – a common complication of diabetes.

Vascular disease is often described as a “hardening of the arteries” caused by fatty deposits in the blood vessels that block the flow of blood. When these blockages are in the heart’s arteries, they can cause heart attacks. When they occur in the legs, it can cause leg pain, foot ulcers, and sometimes lead to amputation.

Cramping sensations that occur consistently during light exercise – like walking – could be caused by reduced blood flow to the muscles due to this buildup in the arteries. It is considered a mild blockage when this pain goes away with rest. Leg cramps that occur at nighttime are generally not associated with blockages.

More severe blockages in the arteries of the legs can cause ulcers or gangrene, and people with diabetes are more susceptible to these serious complications, especially when they also experience a loss of sensation in the foot called sensory neuropathy.

“Danger signs” of infection or poor circulation include wounds or ulcers on the foot or leg that do not heal; blue, white, or deep red discoloration of the foot; and continuous pain in the foot that is only relieved by standing or hanging the foot off the side of the bed. If left untreated, these severe blockages can lead to infections and amputations.

Prevention is best. Working closely with your physician to treat high blood pressure, elevated cholesterol, and diabetes greatly reduces your chance of developing vascular disease. Diabetics should also be diligent about foot care in order to prevent callouses and blisters that could lead to infection. Smoking dramatically accelerates the build-up of plaque in the arteries, so it’s time to quit.

Fortunately vascular treatment, including minimally invasive options that do not require surgery, is very successful at restoring circulation to the legs. Talk to your doctor if you have concerns about leg pain.

Dr. Estes is a board certified vascular surgeon. He was named one of Boston’s “Top Docs” from 2010 to 2014. Learn more at or call 603-516-4265.

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