Arteriosclerosis,Peripheral Arterial Disease and Peripheral Vascular Disease
Often referred to as Peripheral Arterial Disease or PAD, arteriosclerosis is a Greek word that means “hardening of the arteries”. PAD occurs over many years where the arteries develop areas that become hard and brittle as a result of calcium becoming deposited in their walls. As vessels become thickened, a disease known as Peripheral Vascular Disease (PVD) is where there is a loss of elasticity and gradually interferes with blood flow. The process can involve the arteries of cardiovascular system, the brain, kidneys and upper and lower extremities.
PAD and PVD in the lower extremities results in poor circulation to the toes. To a certain degree, arteriosclerosis is a natural part of aging but heredity , lifestyle choices and disease can dramatically affect the onset and severity. These include hypertension, diabetes mellitus, cigarette smoking, male gender, high cholesterol and obesity. In the lower extremities PAD is often detected when there are noticeable changes in the foot such as color, cool temperature, poor healing or when there is intermittent muscle cramping during activity that is relieved with rest. In an advanced stage there may result a dull burning or aching pain in the affected foot wile at rest and it’s common for pain to be located at the metatarsal heads. Pain in the lower limbs from PAD that wakes the patient and is relieved by sitting with the legs in dependency is referred to as rest pain.
The most common form of arteriosclerosis is atherosclerosis which is the buildup of fatty deposits in the innermost lining of large and medium sized arteries anywhere in the body. Collectively, the effects of atherosclerosis on the brain, heart, kidneys, and other vital organs are the leading cause of death and disease in the United States. If a large artery in the leg is greatly narrowed gangrene can occur. In Diabetics atherosclerosis develops earlier and tends to involve arteries below the knees.
Shoes and Footwear
Shoes that minimize the risk of trauma are critical. Shoes that can accommodate the foot and any swelling over the course of the day help reduce the risk of ulceration. Shoes that can accommodate pressure relieving devices like a diabetic shoe insert or an orthotic can also help reduce risk of trauma.