What Is Peripheral Artery Disease (PAD)?, Symptoms, Causes, Diagnosis & Physiotherapy Treatment Of Peripheral Artery Disease (PAD)

WHAT IS PERIPHERAL ARTERY DISEASE (PAD)?

Peripheral Artery Disease (PAD) is where narrowed arteries reduce blood flow to the limbs, usually the legs. This happens due to atherosclerosis, where fatty deposits (plaques) build up in the arteries, restricting circulation.

WHAT ARE THE SYMPTOMS OF PERIPHERAL ARTERY DISEASE (PAD)?

There can be various symptoms of Peripheral Artery Disease (PAD), a few are mentioned here:
1. Leg pain or cramping during walking (claudication)
2. Numbness or weakness in the legs
3. Coldness in the lower leg or foot
4. Slow-healing sores on the feet or legs
5. Weak or absent pulse in the legs or feet

Risk Factors:
1. Smoking
2. Diabetes
3. High blood pressure
4. High cholesterol
5. Obesity
6. Sedentary lifestyle

WHAT ARE THE CAUSES OF PERIPHERAL ARTERY DISEASE (PAD)?

There can be various causes of Peripheral Artery Disease (PAD), a few are mentioned here:
1. Atherosclerosis – The most common cause, where fatty deposits (plaques) build up in the arteries, narrowing them and reducing blood flow.
2. Smoking – Damages blood vessels and accelerates plaque buildup.
3. Diabetes – High blood sugar levels can damage blood vessels and nerves.
4. High Blood Pressure (Hypertension) – Puts extra strain on artery walls, leading to damage and narrowing.
5. High Cholesterol – Excess cholesterol can form plaques that restrict blood flow.
6. Obesity – Increases strain on the cardiovascular system, leading to arterial damage.
7. Sedentary Lifestyle – Lack of physical activity contributes to poor circulation and arterial stiffness.
8. Age (Over 50 Years Old) – The risk of PAD increases with age due to natural arterial wear and tear.
9. Family History of Vascular Disease – A genetic predisposition can increase the likelihood of developing PAD.
10. Inflammatory Conditions (e.g., Rheumatoid Arthritis, Lupus) – Chronic inflammation can damage arteries and promote atherosclerosis.

Pathology
PAD is primarily caused by atherosclerosis, where fatty deposits (plaques) accumulate in the arterial walls, leading to narrowing and hardening of the arteries. This reduces blood flow, particularly to the legs.

DIAGNOSIS OF PERIPHERAL ARTERY DISEASE (PAD).

1. Ankle-Brachial Index (ABI) – Compares blood pressure in the ankle and arm to assess circulation.

2. Doppler Ultrasound – Uses sound waves to detect blood flow blockages in the arteries.

3. Treadmill Exercise Test – Evaluates walking ability and symptoms during physical activity.

4. Segmental Pressure Measurement - Measures blood pressure at different points in the legs to locate blockages.

5. Angiography (CT or MRI Angiography) – Uses contrast dye and imaging to visualize narrowed arteries.

6. Duplex Ultrasound – Combines traditional ultrasound with Doppler imaging to assess artery structure and blood flow.

7. Blood Tests – These check cholesterol, blood sugar, and inflammatory markers that contribute to PAD.

TREATMENT FOR PERIPHERAL ARTERY DISEASE (PAD).

Medications: Antiplatelet, Cholesterol-lowering drugs, Blood Pressure Medications,

Blood Sugar Control Medications, Cilostazol (Pletal), Pentoxifylline, etc.
(Note: Medication should not be taken without the doctor's prescription.)

PHYSIOTHERAPY TREATMENT FOR PERIPHERAL ARTERY DISEASE (PAD).

Thermotherapy (Heat Therapy):
Thermotherapy (Heat Therapy), improves circulation and reduces muscle spasms.

Transcutaneous Electrical Nerve Stimulation (TENS):
Transcutaneous Electrical Nerve Stimulation (TENS) helps in pain relief by stimulating nerve endings and improving circulation.

Low-Intensity Laser Therapy (LILT):
Low-Intensity Laser Therapy (LILT) promotes microcirculation and tissue healing.

Pneumatic Compression Therapy:
Pneumatic Compression Therapy enhances blood flow and reduces swelling by intermittently compressing the limb.

Neuromuscular Electrical Stimulation (NMES):
Neuromuscular Electrical Stimulation (NMES) activates muscles to enhance circulation and prevent muscle wasting.

Hydrotherapy (Contrast Bath Therapy):
Hydrotherapy (Contrast Bath Therapy), alternating hot and cold water immersion, stimulates blood flow and reduces ischemic pain.

Exercise Therapy:
Though not a modality, exercise therapy improves blood circulation and reduces ischemic pain over time.

Circulation-Enhancing Exercises:
Passive Range of Motion (PROM) –Helps maintain joint mobility without increasing pain.
Ankle Pumping Exercises – Stimulates blood flow to the lower limbs.
Isometric Exercises – Muscle contractions improve local circulation without excessive strain.

Supervised Walking Program
Short, frequent walks with rest intervals improve endurance and collateral circulation.
Supervised Exercise Therapy (SET): Helps increase pain-free walking distance
Strength & Endurance Training: Enhances muscle function
Balance & Gait Training: Reduces fall risk

PATIENT EDUCATION.

The patient is asked to avoid prolonged leg elevation as it reduces blood flow. Also advised to do regular exercises and gentle leg movements to prevent stiffness. Tight clothing or compression stockings are to be avoided. Daily foot inspection for cuts, ulcers, or colour changes should be done, and proper footwear should be worn to prevent pressure sores.

Peripheral Artery Disease...

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