Why do I have shooting pain in my calves after walking?

Question

Hi doctor,

I am a 60-year-old known diabetic. For two years, I have had severe leg pain when I walk, even for a small distance.

I have shooting pain in my calves after just 10 minutes of walking.

Doctors have diagnosed it as calcification of nerves. I have attached my reports for your reference.

My current medications include Metformin 1000 mg twice daily, Insulin 15 units twice daily, Met XL 2 twice daily, Ramipril 0.5 mg twice daily, Glimiken 2 mg once daily, Cilostazol 50 mg twice daily, and DMT 30 twice daily.

Stress and rest tests, nuclear tests, MRI of the lumbar spine, MDCT abdominal angiogram, Holter test, 2D echo (normal), and myocardial perfusion scan were performed.

Results show generalized extensive calcification of arterial blood vessels with no significant narrowing of the vessel walls.

EMG test conclusion: No electrophysiological evidence of a lower motor neuron lesion.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

You are having intermittent claudication due to a peripheral arterial disease, as demonstrated by your arterial ultrasound (attachment removed to protect patient identity). I am hoping it is a Doppler ultrasound. It appears that your diabetes is under control, and you do not have heart failure.

I understand that you have no history of a heart attack either. Peripheral vascular disease is less likely, but sciatica is also possible. You have a normal EMG, but there is no MRI and nerve conduction study available. If the ankle-brachial index is normal, then a nerve conduction study has to be taken.

Increase the Cilostazol to 100 mg twice daily if there is no history of heart failure, heart attack, and not taking two blood thinner agents together.

If taking Aspirin only, then it is safe to increase the dose to 100 mg twice daily. I would encourage you to take 81 mg of Aspirin daily.

Also, do exercise grading. It is a three-month program that will gradually build your exercise tolerance.

I hope this helps you.

Take care.

Regards.