immune system

Dr Xand van Tulleken told viewers ‘it can be like a heart attack for your legs’

A BBC doctor has given a worrying update for anyone who has woken up in the morning with a pain in the leg. Appearing on BBC Morning Live, Dr Xand van Tulleken told viewers they should ‘never’ just write symptoms off as what happens due to ageing.

Many people get aches and pains, but specific discomfort in the legs should be investigated, he said. Host Helen Skelton said: “We’re looking at protecting our health now, though. And if you started this morning with a pain in your leg, you’re not alone.

“It’s thought that one in five people over the age of 60 is living with a blood vessel disorder.“ Dr Xand said “It’s really important that no one should ever regard any symptoms they have as just part of getting older. If you have a symptom and you don’t know why you have it, you need to get an explanation.

“Whether it’s shortness of breath or pain in your legs. There are lots of different causes for pain in your legs, but this morning we’re talking about peripheral arterial disease, which is a sort of intimidating medical term, but really we mean just peripheral, meaning it’s at the outside of your body. It’s in your legs rather than being in your heart or your brain.”

Arterial disease might be the cause – and that’s a condition which can mean there are serious health issues at stake beyond just aching legs. Dr Xand said “Arterial disease is the same problems that gives us heart attacks and strokes. Your blood vessels narrow over time. They can calcify, they harden, they clog up with cholesterol, and you are left with a narrower space for blood to flow through and that means that you’re not getting a sufficient blood supply to your legs and that can give you leg pain.

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“And you can think of it a little bit like in the same way that some people get angina, they get heart pain when they exercise, when they move around. This is a bit like angina for your legs. And sometimes if those blood vessels completely clog off, it can be like a heart attack for your legs.”

The NHS says many people with PAD have no symptoms. However, some develop a painful ache in their legs when they walk, which usually disappears after a few minutes’ rest. The medical term for this is “intermittent claudication”.

The pain can affect 1 or both legs, range from mild to severe, and usually goes away after a few minutes when the person rests their legs.

Other symptoms of PAD can include:

• hair loss on your legs and feet
• numbness or weakness in the legs
• brittle, slow-growing toenails
• ulcers (open sores) on your feet and legs, which do not heal
• changing skin colour on your legs, such as turning paler than usual or blue – this may be harder to see on brown and black skin
• shiny skin
• in men, erectile dysfunction
• the muscles in your legs shrinking (wasting)

The NHS adds: “The symptoms of PAD often develop slowly, over time. If your symptoms develop quickly, or get suddenly worse, it could be a sign of a serious problem requiring immediate treatment.”

Dr Xand added: “The quality of the pain is quite specific. I mean, the way that people describe it and it typically wouldn’t be a pain that you’d get when you’re just sitting still, much like angina. It’s the pain that comes from not getting enough oxygen to your muscles. Those blood vessels aren’t working. And so, people tend to describe a kind of deep, heavy ache, like they’re just not, and you can almost feel that thing of just not getting enough.

“It’s a bit like if you’re lifting weights at the gym, if you go beyond your limits, you know, your muscles really start to hurt. It’s a similar thing. The pain is called claudication, but it’s that kind of pain. And typically, if you rest, it’ll go away again. So, that’s the that’s the kind of pain, but there are other changes that you can look for as well.”

He said people might see changes in their legs which could indicate the problem. Dr Xand said: “If you do look at your legs, you may see some changes if you don’t have a good enough blood supply. So, things like loss of hair on your legs would be an examples. The hair the hair can’t grow anymore because you’re not getting enough nutrients to your leg.

“Cold feet, the warm blood from the middle of your body is no longer reaching your feet. Ulcers or cuts are not healing because your immune system carried in your bloodstream is not reaching those and so you’re getting skin breakdown. You’re not getting antibodies and white blood cells and things like that. Changes in skin tone. So, your skin may look kind of mottled and gray as if it’s not getting enough blood. And then your toenails, you may think, I haven’t cut my toenails in a while. Well, are they just simply growing because they’re not getting the nutrients from the bloodstream that they need. So, those are things that might be a clue.”

Tackling the problem

A main cause is smoking, Dr Xand said, and also making sure people get cholesterol, blood pressure measured and check if you have diabetes. He said exercise is a good way of trying to improve the situation: “This may sound a bit a bit paradoxical, may sound like it’s hard to exercise, you’re getting pain when you exercise, but doing some exercise can stimulate the growth of new blood vessels. It can help those blood vessels open up.

“It will lower your cholesterol. It will lower your blood pressure. It will lower your stress. It will improve your blood sugar. You get so many wins from doing a bit of exercise.”

More information from the NHS here.