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Poor Circulation in Legs

This write-up provides information on the contributing factors for poor circulation in legs.
Loveleena Rajeev Jan 22, 2019
Blood is a specialized body fluid that performs the vital function of transporting oxygen and nutrients to various parts of the body.
While the oxygenated, nutrient-rich blood that is pumped by the heart is carried by the arteries to the cells, tissues, or the organs of the body, the veins deliver deoxygenated blood from various parts of the body to the heart. The pulmonary veins are an exception, as they carry oxygenated blood from the lungs to the heart.
If the arteries supplying blood to a particular part of the body become partially or completely blocked, a host of distressing symptoms could arise due to the reduced blood flow.
Circulatory problems could also arise if the valves present in the veins are not working properly. Under such circumstances, the deoxygenated blood is prevented from returning to the heart. This causes the blood to collect in the veins.
Peripheral Vascular Disease (PVD) is an umbrella term that is used for the medical conditions associated with the blockage of the large arteries that are not located within the heart or the brain. Peripheral vascular disorders are often characterized by reduced blood flow to the legs and feet. 
People who make poor lifestyle choices are more likely to be affected by circulatory problems. Poor blood circulation is often observed in the elderly, or people who are affected by certain medical conditions.

Contributing Factors

Peripheral Artery Disease

Peripheral Artery Disease (PAD), which is characterized by narrowing and hardening of the peripheral arteries, is often the main reason behind poor blood circulation in legs. This condition is characterized by ischemia, which refers to inadequate blood supply to tissues. Ischemia may be acute or chronic.
It may be caused by atherosclerosis (hardening of the arteries due to the buildup of plaque (fatty substance) on the walls of peripheral arteries) or the formation of blood clots. When the arteries harden, it becomes difficult for the blood to flow through them. This could also cause arterial stenosis, which refers to the narrowing of the arteries. 
Reduced blood flow could also be caused by blockage of the peripheral arteries due to the formation of a blood clot. Blood clots may form due to the rupturing of arterial plaques. While thrombus refers to a blood clot that may form in the artery, embolus refers to a blood clot that may travel from its place of origin to the artery.

Risk Factors

Obesity is believed to be a risk factor for PAD. Intermittent claudication (limping or impairment in walking) may worsen in case of obese people who are affected by PAD. Heavy smokers or those who are anemic, are also at a risk of suffering from PAD.
People who are bedridden or physically inactive could also suffer from poor circulation in legs and feet. Medical conditions that may put a person at a risk of developing poor blood circulation in legs and feet include:

➞ High blood pressure
➞ High cholesterol
➞ Diabetes
➞ Heart disease
➞ Stroke
➞ Kidney disease
➞ Prolonged use of beta blockers

Conditions Associated With Poor Blood Circulation in Legs

Poor circulation in the legs could be observed in peripheral vascular disorders affecting the arteries and veins.

Buerger's Disease

Buerger's disease or thromboangiitis obliterans is a rare disease where arteries and veins in the arms or legs suffer inflammation. Blockage of blood vessels by blood clots has an adverse effect on circulation. Those affected may experience pain, discoloration of skin, or claudication. Infection or gangrene are complications associated with this disease.

Deep Vein Thrombosis

Deep Vein Thrombosis (DVT) is characterized by the formation of a blood clot in a vein that lies deep within the muscles. The clot usually develops in the vein that runs through the calf and the thigh muscles. This condition may cause pain and swelling in the affected leg.
Discoloration of the skin may also be observed. Pulmonary embolism is a life-threatening complication of DVT, wherein the blood clot breaks off and travels to the lungs, thereby causing a blockage.

Thrombophlebitis

The term 'phlebitis' refers to the inflammation of a vein. Thrombophlebitis is said to occur when the inflammation is caused by a blood clot. Blood clots could form in the event of an injury to the vein.
People affected by blood clotting disorders are also at a greater risk of developing this condition. Blood clots are likely to form in case of people who have been bedridden for a long period. Thrombophlebitis can also lead to DVT.

Varicose Veins

The term 'varicose veins' refers to enlarged or twisted veins that can be seen under the skin. These are mostly found in the legs. Since veins carry deoxygenated blood, varicose veins are blue in color.
Varicose veins develop when the valves in the veins don't work properly, and blood collects in the veins instead of flowing towards the heart. Varicose veins may sometimes cause pain or swelling in the legs.

Symptoms and Diagnosis

Poor blood circulation shows many different signs and symptoms. These include:

➞ Claudication (onset of leg pain and cramping while walking)
➞ Weakness, and a constant feeling of fatigue in the legs and feet
➞ Pain is felt while walking or exercising, and is relieved with rest
➞ Bluish discoloration of the skin on the legs, especially on the calf muscles
➞ Numbness or a tingling sensation in the legs or feet
➞ Swelling of the feet or even the entire leg
➞ Cold hands or feet
Medical help must be sought by one who is experiencing these symptoms. Certain diagnostic tests are conducted by the doctors to ascertain the underlying cause. These include:

➞ Doppler ultrasound
➞ Angiography of the arteries in the legs
➞ Magnetic resonance angiography or CT angiography
➞ Comparison of the blood pressure levels of the arms and the ankles

Treatment Options

The treatment would vary, depending on the underlying cause and the severity of the blockage. It may involve drug therapy, surgery, physical therapy, etc. Lifestyle changes are an integral part of the treatment. Here are some of the treatment options that might be recommended:
➞ If the blood circulation is affected due to the development of blood clots, the treatment may involve the use of anticoagulants or clot-busters.
➞ If the arteries have become narrow, the treatment may involve surgical procedures such as peripheral artery bypass surgery, angioplasty, revascularization (blood vessel graft for restoring blood supply), atherectomy (removal of plaque buildup with a cutting device), or endarterectomy (open surgery for the removal of plaque).
➞ People affected by intermittent claudication may be prescribed medicines that dilate the affected artery.
➞ A balanced diet and proper exercise regimen will help strengthen circulatory system.
➞ If poor circulation is due to medical conditions like diabetes, hypertension, heart disease, kidney disease, etc., treating the underlying disease is necessary.
While drug therapy or other treatment options can help to alleviate the symptoms, affected individuals must make a few lifestyle changes. Since obesity is a risk factor for PAD, there's a need to stay physically active and follow a low-fat and high fiber diet to control weight. 
It would be best to quit smoking as that will lower the risk for various medical conditions that may cause poor circulation. If left untreated, poor circulation in legs and feet can lead to gangrene. Thus, medical help must be sought by a person who has been experiencing any of the aforementioned symptoms.
Disclaimer: This is for informative purposes only, and should not be used as a replacement for expert medical advice.