Does lower limb pain on standing indicate arterial disease?

Question

Hi doctor,

About a month ago, I felt pain in the back of my calves when I stood up and walked. Over the past month, this pain (stinging and about level two) goes to the front of my calves, front and back of my thighs, sometimes reaching all the way to my buttocks and lower back. My regular doctor is baffled by this and recommends physical therapy. I would like to know more about what this condition is before I proceed. Kindly give your opinion.

Answer 1

Hello,

Welcome to icliniq.com.

Sorry for the problem you are facing. Let me try and proceed towards the condition, if possible, by asking you few questions.

1) Is the pain unilateral or bilateral that is in one or both limbs involved?

2) Is the pain occurs after walking a certain distance beyond which it is very difficult to walk and subsides after taking a rest?

3) Or is the pain present even at rest and at the initiation of walking or movement?

4) Any chronic history of smoking, diabetes, hypertension, or atherosclerosis?

5) Any tingling or pins and needles like paresthesia in the affected limb?

6) Do you feel any pain or stretching in the mentioned area while raising the leg while you are in a supine position?

7) Any swelling or edema or visible blood vessel swelling do you notice?

8) Any color change of the affected limb?

Please answer the above questions to guide you accordingly.

Answer 2

Hi,

Welcome back to icliniq.com.

Chronic arterial disease is one of the differential diagnoses. Your medical history also points towards it, but it should be investigated first. To rule out this, you need to do a duplex USG (ultrasonography) scan lower limb, whether the pain is due to the above condition or not. Ankle-brachial pressure index also guides towards it.

I hope this was helpful.