The most common cause of peripheral vascular disease (PVD) is peripheral artery disease (PAD) which refers to the narrowing of blood vessels outside of the brain and heart, usually experienced in the lower extremities. Other diseases may affect the vascular system such as Lupus and Raynaud’s disease. Pain is associated with decreased blood flow and thus, oxygen to your tissues, limbs and organs.
Pain with PVD may be experienced with activity or with rest. When occlusion of the blood vessels is severe, pain at rest may occur secondary to not having enough blood and oxygen to the extremities. This is commonly felt in the feet while laying flat, face up.
Other symptoms include changes in skin color (deep red/purple when the legs are down such as while sitting), numbness, tingling, and coolness in the affected limb. If occlusion of the blood vessels is critical, then painful ulcers and gangrene may develop.
The most common risk factors for the development of PVD and PAD include high blood pressure, high cholesterol and triglycerides, cigarette smoking, diabetes, kidney disease, inactivity and obesity.
On your initial visit, you and your Center for Pain Management doctor will craft a customized treatment plan based on a thorough history and physical. This plan may involve a combination of medications to help alleviate pain and/or injection therapy. Your provider may suggest performance of a lumbar sympathetic block for your lower extremities or stellate ganglion block for your upper extremities to not only help alleviate the pain you are experiencing, but also help restore some blood flow to the occluded areas.
Your doctor may also prescribe a combination of medications to include anti-convulsants (nerve-stabilizing medications) and anti-depressants to help with associated nerve pain, topical patches and creams for pain with intact skin, and possibly low-dose opioid medication. If the pain persists, despite the initial treatment options, your provider may suggest a spinal cord stimulator trial.