Peripheral Arterial Disease & Tens

[TerryP]

Hello everyone,
I have Peripheral Arterial Disease (PAD) which means I get really bad cramps in my calves and the back of my legs at night when I'm in bed. So much so that it disturbes my sleep and I have to keep getting up to put 'Deep Heat' (other brands are available) on them to calm them down for a couple of hours. I seem to remember reading somewhere that you can use a Tens device on your legs for this purpose but wanted to check if anyone in the forum had used this solution or if anyone is going to suggest its not a good idea.

Thanks for the info either way

Terry

 

[Leadinglights]

Hello everyone,
I have Peripheral Arterial Disease (PAD) which means I get really bad cramps in my calves and the back of my legs at night when I'm in bed. So much so that it disturbes my sleep and I have to keep getting up to put 'Deep Heat' (other brands are available) on them to calm them down for a couple of hours. I seem to remember reading somewhere that you can use a Tens device on your legs for this purpose but wanted to check if anyone in the forum had used this solution or if anyone is going to suggest its not a good idea.

Thanks for the info either way

Terry

Somebody recommended magnesium and I bought some magnesium gel (the sort used by athletes) which certainly helped the cramps in my calves which would happen at night sometimes.
I have been using a TENS on my shoulders and it has helped them but not sure if it works for cramps. I find I am more likely to get cramp if I have not drunk enough or my feet are cold.

 

[Eddy Edson]

Hello everyone,
I have Peripheral Arterial Disease (PAD) which means I get really bad cramps in my calves and the back of my legs at night when I'm in bed. So much so that it disturbes my sleep and I have to keep getting up to put 'Deep Heat' (other brands are available) on them to calm them down for a couple of hours. I seem to remember reading somewhere that you can use a Tens device on your legs for this purpose but wanted to check if anyone in the forum had used this solution or if anyone is going to suggest its not a good idea.

Thanks for the info either way

Terry

Have you talked to a vascular surgeon about the cramps and leg pain at night?

Would be the right person to ask about value and risks of trying a TENS device.

FWIW, I have PAD and I go through periods where I get woken up by calf cramps quite often - painful but they go away quickly. I think mainly due to walking a lot every day, which is hugely beneficial but which does put a lot of stress on calf muscles due to blood flow being a bit insufficient.

Likely not the same thing as your prob.

If you generally get cramps and leg pain lying down I really would talk to a vascular specialist about it, if you haven't done so recently.

 

[TerryP]

Have you talked to a vascular surgeon about the cramps and leg pain at night?

Would be the right person to ask about value and risks of trying a TENS device.

FWIW, I have PAD and I go through periods where I get woken up by calf cramps quite often - painful but they go away quickly. I think mainly due to walking a lot every day, which is hugely beneficial but which does put a lot of stress on calf muscles due to blood flow being a bit insufficient.

Likely not the same thing as your prob.

If you generally get cramps and leg pain lying down I really would talk to a vascular specialist about it, if you haven't done so recently.

Hi Eddy, thanks for the info.. I have not seen my vascular consultant since he put me down for a stent in my left leg (hopefully due in March this year). For me as long as my legs are moving I'm ok, but when stop then the cramps/pain starts (even during the day) but a night it is so much worse. My GP prescribed Quinine, but I didn't get on with it as it made my heart flutter and beat a little too fast, so I stopped taking it. I have tried hanging my feet out of the bottom of the bed (as this is touted as a solution) but my feet get colder than they usually are and putting socks on top of socks is too uncomfortable to sleep with. Ho-Hum 🙂

 

[Eddy Edson]

Hi Eddy, thanks for the info.. I have not seen my vascular consultant since he put me down for a stent in my left leg (hopefully due in March this year). For me as long as my legs are moving I'm ok, but when stop then the cramps/pain starts (even during the day) but a night it is so much worse. My GP prescribed Quinine, but I didn't get on with it as it made my heart flutter and beat a little too fast, so I stopped taking it. I have tried hanging my feet out of the bottom of the bed (as this is touted as a solution) but my feet get colder than they usually are and putting socks on top of socks is too uncomfortable to sleep with. Ho-Hum 🙂

Hopefully the stent will improve blood flow enough to deal with most of it.

No idea if a TENS device would be useful but I doubt it could cause harm - obviously, check the documentation to see if there are any risks.

Gnerally, if it's been getting worse I would tell yr GP and the vascular consultant. Is there any exercise therapy planned? I think this is probably super important - like recovering from a heart attack - and if nobody has said anything I would push them a bit to find out what's possible.

 

[nonethewiser]

Bought TENs machine 2 weeks ago to help with sciatica, it's really helps but leaflet does come with warnings for those with certain heath conditions to check with their Dr first before using.

 

[harbottle]

Hello everyone,
I have Peripheral Arterial Disease (PAD) which means I get really bad cramps in my calves and the back of my legs at night when I'm in bed. So much so that it disturbes my sleep and I have to keep getting up to put 'Deep Heat' (other brands are available) on them to calm them down for a couple of hours. I seem to remember reading somewhere that you can use a Tens device on your legs for this purpose but wanted to check if anyone in the forum had used this solution or if anyone is going to suggest its not a good idea.

Thanks for the info either way

Terry

This started to happen to me before I was diagnosed - it was a nightmare, didn't sleep for months and used to be in pain when lying down in bed. Walking was fine. GPs didn't have a clue what it was, and just told me to go swimming and take pain killers.

How is your blood sugar? The cramps went away completely when I got it down to normal levels (About a week after starting a low carb diet) and hasn't come back since.

 

[TerryP]

This started to happen to me before I was diagnosed - it was a nightmare, didn't sleep for months and used to be in pain when lying down in bed. Walking was fine. GPs didn't have a clue what it was, and just told me to go swimming and take pain killers.

How is your blood sugar? The cramps went away completely when I got it down to normal levels (About a week after starting a low carb diet) and hasn't come back since.

 

[TerryP]

Hi Harbottle, thanks for getting back to me with interesting information.

Mine started before diagnosis as well (which was September 2021) but to be honest I don’t think there has been a time when they have not hurt (it’s probably more about the degree of hurting that I get). My blood sugars before Christmas were way out of control (so I have put on Metformin) which seems to be doing a reasonable job. My target is 5 – 8 (I’m on Gliclazide as well) and I’m there or there abouts most days (sometimes hitting 10.+) but mostly within 2 points of the target (but I’m only measuring twice a day now). I have not gone for a dedicated low card diet specifically, so that might be an option to see if that impact on the discomfort. (To be honest I’m not sure why low carbs would make any difference, but that’s my lack of knowledge rather than me challenging your suggestion).

 

[Leadinglights]

Hi Harbottle, thanks for getting back to me with interesting information.

Mine started before diagnosis as well (which was September 2021) but to be honest I don’t think there has been a time when they have not hurt (it’s probably more about the degree of hurting that I get). My blood sugars before Christmas were way out of control (so I have put on Metformin) which seems to be doing a reasonable job. My target is 5 – 8 (I’m on Gliclazide as well) and I’m there or there abouts most days (sometimes hitting 10.+) but mostly within 2 points of the target (but I’m only measuring twice a day now). I have not gone for a dedicated low card diet specifically, so that might be an option to see if that impact on the discomfort. (To be honest I’m not sure why low carbs would make any difference, but that’s my lack of knowledge rather than me challenging your suggestion).

Carbohydrates convert to glucose so if your intake of carbs is more than your medication and your own insulin production can cope with then you will have excess glucose in your blood which is what will be responsible for symptoms.
If you have an overflowing sink you can bail out the water (taking meds) but unless you turn off the tap (reduce your carb intake) then the sink will still over flow (too much glucose in your system)

 

[harbottle]

Cutting the carbs probably helped get my blood sugar back to normal levels, far more so than the low dose of Metformin I was on (I'm on an even lower dose now, and have been told I should consider stopping it.). In fact, Metformin alone doesn't have a huge effect - it has to be used with lifestyle changes to get levels under control.

The pain was so bad some mornings I woke up screaming in the morning, but they went away as soon as I started walking. Sitting down at work was hard work as well, as was driving. It all went literally overnight. The medical professionals have really failed to give me a reason!

 

[Eddy Edson]

Hi Harbottle, thanks for getting back to me with interesting information.

Mine started before diagnosis as well (which was September 2021) but to be honest I don’t think there has been a time when they have not hurt (it’s probably more about the degree of hurting that I get). My blood sugars before Christmas were way out of control (so I have put on Metformin) which seems to be doing a reasonable job. My target is 5 – 8 (I’m on Gliclazide as well) and I’m there or there abouts most days (sometimes hitting 10.+) but mostly within 2 points of the target (but I’m only measuring twice a day now). I have not gone for a dedicated low card diet specifically, so that might be an option to see if that impact on the discomfort. (To be honest I’m not sure why low carbs would make any difference, but that’s my lack of knowledge rather than me challenging your suggestion).

To me your symptoms seem pretty much as expected for PAD which has gotten bad enough to need stenting - so due to insufficient blood flow. The low carb stuff is probably a red herring at this point.

 

[harbottle]

Yes, I only had pains for around 4 months before I was diagnosed - it was something that just started in Spring 2021, around 4 months before I was diagnosed with T2. I'm not even sure it was PAD, but it certainly sounds like your experience.

 

[Eddy Edson]

Yes, I only had pains for around 4 months before I was diagnosed - it was something that just started in Spring 2021, around 4 months before I was diagnosed with T2. I'm not even sure it was PAD, but it certainly sounds like your experience.

If it just went away, it certainly isn't PAD.

 

[harbottle]

@Eddy Edson did you have a weak pulse in the leg as part of your PAD? My pulse was strong when the DN checked it out shortly after I was diagnosed. I did have a cold knee, though.

I used to get twitching muscles in my thighs - I could see them moving. It was like an alien under my skin.
That all went as well.

 

[Eddy Edson]

@Eddy Edson did you have a weak pulse in the leg as part of your PAD? My pulse was strong when the DN checked it out shortly after I was diagnosed. I did have a cold knee, though.

I used to get twitching muscles in my thighs - I could see them moving. It was like an alien under my skin.
That all went as well.

I have a completely blocked left femoral artery and 50%+ stenosis in the right. Pulse in my left ankle only detectable with Doppler. It's like CAD, except in the leg.

It's not something that goes away or regresses, unfortunately. The "classical" symptom early on is cramping in the calf after walking for a short distance which goes away quickly when you rest. As the stenosis progresses ypu can get pain & cramping at rest. At this point you really need to have an intervention, like a stent, or maybe a bypass, to restore some blood flow.

I avoided that by walking a lot and developing a big network of "collateral" vessels - lots of new blood vessels snaking all through the leg, giving enough blood flow to operate fairly normally (can't run tho), little cramping these days, certainly no resting pain. I think I got lucky in terms of how easily that collateral network developed.

Anyway, it's not a transient thing & it's not the same as neuropathy (though the two often go together, for various reasons, including the fact that insufficient blood flow dmages nerve fibres).

 

[harbottle]

Thanks, that’s interesting.

I didn’t get a pain when walking - in fact, walking made any pain go away, and I could walk/cycle for miles without any pain at all.

Sorry, TerryP, I have hijacked your thread.

 

[TerryP]

I have a completely blocked left femoral artery and 50%+ stenosis in the right. Pulse in my left ankle only detectable with Doppler. It's like CAD, except in the leg.

It's not something that goes away or regresses, unfortunately. The "classical" symptom early on is cramping in the calf after walking for a short distance which goes away quickly when you rest. As the stenosis progresses ypu can get pain & cramping at rest. At this point you really need to have an intervention, like a stent, or maybe a bypass, to restore some blood flow.

I avoided that by walking a lot and developing a big network of "collateral" vessels - lots of new blood vessels snaking all through the leg, giving enough blood flow to operate fairly normally (can't run tho), little cramping these days, certainly no resting pain. I think I got lucky in terms of how easily that collateral network developed.

Anyway, it's not a transient thing & it's not the same as neuropathy (though the two often go together, for various reasons, including the fact that insufficient blood flow dmages nerve fibres).

Hi, the pulse issue is exactly the same for me (Left ankle with left leg blockage). Just out of interest would a left leg blockage affect the right leg as well? My Vascular consultant didn't say in fact he didn't talk to me he talked at me. . I'm interested to know how far 'walking a lot' is? Again I did ask what exercise I should be doing, but no one was really willing to specify.

 

[TerryP]

Thanks, that’s interesting.

I didn’t get a pain when walking - in fact, walking made any pain go away, and I could walk/cycle for miles without any pain at all.

Sorry, TerryP, I have hijacked your thread.

No need to apologise about taking over the thread. I have learnt loads from all the responses here, and to be honest up until this point I haven't really had anyone to chat with who also has PAD, so its been a bit of a lonely and scary place to be.

 

[Eddy Edson]

Hi, the pulse issue is exactly the same for me (Left ankle with left leg blockage). Just out of interest would a left leg blockage affect the right leg as well? My Vascular consultant didn't say in fact he didn't talk to me he talked at me. . I'm interested to know how far 'walking a lot' is? Again I did ask what exercise I should be doing, but no one was really willing to specify.

I don't think a blockage in one leg would effect the other? But it's common to have problems with both legs, one worse than the other. Eg: I have a completely blocked left femoral artery, most of the way from groin to knee, and 50%+ narrowing (but not actual blockage) in the right. On CT angiogram imaging, I have a big twisty snaking bundle of collaterals bypassing the long, long left blockage and a couple of little collaterals doing a short bypass of the narrowing in the right. Without the blockage in the left leg I'd still feel the effects of the narrowing in the right, but as it is the bigger problem kind of masks the smaller one.

"Walking a lot": I've always enjoyed walking & so reaching the point where I could only do a couple of hundred metres before stopping was a big deal. Having worked out that walking is the best therapy for PAD, I started to really push things. By 12 months after diagnosis I was averaging around 8,000 steps per day; 11,000 by year 2.

At that point I'd achieved a lot of the collateral development & my vascular surgeon lost interest; no opportunity for him to wield a scalpel, I'd dealt with things as far as he was concerned.

The last two years I've averaged 14K steps per day and so far this year I'm averaging around 16K. Walking speed has also increased progressively: from < 100 steps/minute to 115-125 now.

I think maybe I grow collaterals more easily than lots of other people, or at least that's the sense I get from reading studies. In practical terms, it hurt like hell starting out, but I could see meaningful improvements in walking distance reasonably quickly, so the pain/gain picture was kind of favourable. But it seems to vary a lot from person to person.

Anyway, finding some activity you can build up, even if not walking, would I think give you more comfort that you have a level of control over things, in addition to just being generally good for your health and outlook.

Talking at you and not explaining things is nothing like the standard of care & in your position I'd really push for them to do a better job. They should be giving you a detailed explanation of the disease, what your situation is, why they are stenting, and what kind of risk factor modifications you should be lstriving for, and they should be giving you time and space to consider and ask questions. They should definitely be giving you advice about exercise, ideally referring to you a structured exercise program if available in your area.

But unfortunately inadequate care for PAD seems to be a general problem in lots of places, including here in Oz. It's seen as less serious than CAD, incorrectly, and not as sexy.

I found that educating myself about the disease was more useful than any advice I was getting from HCP's. You've probably been to the NHS site: https://www.nhs.uk/conditions/peripheral-arterial-disease-pad/treatment/ Being in Oz I get to pick & choose and I actually find that US guidance is usually more thorough and informative. This from the American Heart Association is a good starting reference: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000470

Best of luck! Let us know how you get on.