BAD Circulation

by admin on March 30, 2015

Many people who come into my office report that they have poor circulation in their feet (and often hands.)  Often there is a long family history of circulatory problems.  Usually, this is mentioned as an aside from the primary reason for the appointment, but sometimes, circulation is really the cause of the pain/symptoms that person is seeking help for.  Despite being common, I find that most people are misinformed about circulatory diseases and how they are treated.  So here is a basic overview of circulatory diseases and what they may mean for you!

First of all let’s review how circulation works.  There are basically 3 different types of blood vessels; arteries, capillaries, and veins.  Arteries are what the heart pumps into, pushing the flow of blood out and around the body to all the different organs and extremities.  Veins are what return that same blood to the heart.  The capillaries are the tiny little blood vessels that connect arteries to veins, and are so small that the blood flows slowly through them, allowing the body to take out oxygen and nutrients as the blood passes by.  Three different blood vessels mean that there are three main types of circulatory disorders, one for each type of blood vessel.

PADArterial disease is probably the most well-known because of its effects on the heart.  Arteriosclerosis (hardening of arteries) and atherosclerosis (plaque build-up) are the two major diseases of the arteries that affect humans.  Arteriosclerosis hardens the arteries and often, when coupled with high blood pressure, those arteries harden in a squeezed position.  In atherosclerosis, cholesterol plaques build up in the blood vessel to narrow or even close the artery completely.  Complete blockage of the artery is serious, and leads to heart attack (heart arteries), stroke (brain arteries) or gangrene (leg arteries.)  In the early stages, arterial disease can be treated with blood thinners and cholesterol-lowering medication.  In the late stages, a catheter is sometimes use to “Roto Rooter” the artery clean, or a stent is used to push the artery back open.  In cases of complete blockage, surgical bypass is sometimes necessary.

Vein disease, on the other hand, is a completely different animal.  It has nothing to do with cholesterol or blood pressure.  Instead, Veinsvein disease is more mechanical in nature.  Veins in the legs have valves in them, which help to push the blood up against gravity towards the heart.  Over time or with injuries, these valves can become damaged.  When this happens, the veins are no longer able to push the blood back up toward the heart, and instead pools in the veins in the leg.  This causes varicose veins, which are large, visible veins in the legs.  Besides being unsightly, however, varicose veins can cause pain, numbness, ulcers, fatigue, chronic swelling, and blood clots (which can potentially be life-threatening.)  Initial treatment is usually with compression socks, which help to externally squeeze the blood back up.  Some people are unable to wear the socks (they are notoriously difficult to put on) so there are options for laser surgery that can help to close these veins and fix the problem.

Lastly, and perhaps the least well-known, are capillary diseases.  The capillaries are so small and numerous thaRaynaudst individual blockages or dysfunctional vessels do not make a difference.  Rather, the problem here is in regulation of blood flow.  Each group of capillaries is called a capillary bed, and flow of blood through them is controlled by a valve in the last artery that leads into them.  Unlike vein valves which are entirely mechanical and do only one thing, these tiny arterial valves can open or close depending on what the brain, (or circulating hormones), tell them to do.  Injuries to the nerves or abnormal levels of hormones make these valves get stuck, either open or closed, resulting in too much blood flowing through an area or too little.  This means a red, swollen, warm foot or a cold, purplish-blue tingly one.  Capillary diseases usually are treated with medications that help to tighten or relax the arterial valves, depending on what the root cause is.

I hope this long-winded explanation of the basics of circulatory disease was helpful.  Fortunately, diagnosis and treatment of these diseases is fairly straightforward.  So if you are worried you might be showing signs of circulatory disease and want to know more, and answer is a quick appointment away!

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