What to know about smoker's leg

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Smoker’s leg refers to symptoms in the leg resulting from a condition that doctors call peripheral artery disease (PAD). PAD causes narrowing of the blood vessels, which reduces blood flow to the arteries in the leg. It can also affect blood flow to the:

• arms
• stomach
• brain

According to the Centers for Disease Control and Prevention (CDC), more than 6.5 million people in the United States aged 40 years and above have PAD. PAD is more common in African Americans than in people belonging to other racial groups.

PAD is most often due to atherosclerosis, a buildup of plaque in the arteries, which restricts blood flow outside the heart.

When a person develops smoker’s leg, they are likely to experience pain in the legs when walking. This symptom occurs due to insufficient blood in the limbs.

The most common cause of PAD is atherosclerosis. Atherosclerosis occurs when fatty deposits build up inside the arteries, restricting blood flow to other parts of the body.

Blood clots may also form on the artery walls, decreasing the size of these blood vessels and sometimes blocking them.

Although doctors often consider atherosclerosis to be a heart-related issue, symptoms can occur throughout the body, including in the legs.

Other factors that may increase the chances of developing smoker’s leg include:

• smoking
• being over the age of 60 years
• having overweight or obesity
• diabetes
• high blood pressure
• high cholesterol
• a family history of PAD, heart disease, or stroke
• chronic kidney disease or being on dialysis

Many people with smoker’s leg experience no signs or symptoms. However, some people may have leg pain when walking, which the medical community refers to as claudication. The severity of claudication ranges from mild to severe.

The most common symptom of PAD is muscle pain or cramping when walking, especially in the:

• buttocks
• hips
• thighs
• calves

Walking may trigger the symptoms, which usually disappear a few minutes after resting.

Other symptoms may include:

• leg weakness
• hair loss on the feet and legs
• coldness in the lower legs or feet
• sore feet, toes, or legs
• discoloration of the legs
• shiny, pale skin on the legs, which may appear bluish in some people
• toenails growing slowly
• decreased or absent pulse in the feet
• erectile dysfunction

The treatment for smoker’s leg typically involves lifestyle changes and medications. These treatments help manage symptoms and stop the aggravation of atherosclerosis.

Lifestyle changes

People can adopt certain measures to help reduce the symptoms of smoker’s leg. These include:

• Engaging in regular physical activity: A doctor may recommend regular physical activity under a supervised trainer. Leg exercises, walking regimens, and treadmill exercise programs may decrease symptoms.
• Stopping smoking: Cigarette smoking is the most common risk factor for PAD. Quitting smoking may help slow the progression of PAD and reduce the risk of complications.
• Reaching or maintaining a moderate body weight: People with overweight or obesity have an increased chance of developing smoker’s leg.
• Eating a balanced diet: Many people with PAD have high cholesterol levels. Eating a balanced diet that is low in cholesterol and trans fats and rich in vegetables and fruits can help lower cholesterol levels in the blood.
• Avoiding certain cold medications: Over-the-counter medications containing the decongestant pseudoephedrine constrict blood vessels, which may worsen symptoms.

Medication

A doctor may prescribe medications to reduce pain and other symptoms of smoker’s leg, including:

• cilostazol (Pletal) to reduce claudication symptoms
• daily aspirin therapy or clopidogrel (Plavix) to reduce blood clotting
• statins, such as rosuvastatin (Crestor) or atorvastatin (Lipitor), to reduce cholesterol levels
• angiotensin converting enzyme inhibitors to lower blood pressure levels
• medications to manage blood sugar levels, in people with diabetes

Angioplasty and vascular surgery

If routine changes and medications do not work, a doctor may recommend angioplasty, stenting, or vascular bypass surgery.

Angioplasty involves inflating a balloon across the narrowing to increase the size of the diseased artery. In doing this, it helps increase blood flow throughout the body.

Stenting involves placing a hollow metal tube into the affected artery and deploying it across the narrowing to unblock the artery.

Vascular bypass surgery involves reconnecting blood vessels to redirect blood flow from one area to another. Surgeons use this technique to allow blood to pass around a blockage.

A person can help reduce the risk of developing smoker’s leg by:

• quitting smoking
• maintaining a moderate weight
• eating a balanced diet
• exercising regularly
• managing blood pressure and blood sugar levels

Lifestyle changes and medications often help treat and prevent smoker’s leg. However, some symptoms may require immediate medical intervention.

A person should see a doctor immediately if they have:

• leg pain or numbness when walking
• pale or discolored limbs that have a very weak or absent pulse
• PAD symptoms and are over the age of 50 years with a history of smoking or diabetes

Smoker’s leg is the term for PAD that affects the lower limbs, causing leg pain and cramping. The condition results from the buildup of plaque in the arteries and, in rare cases, the development of blood clots.

Lifestyle changes, such as quitting smoking, reaching or maintaining a moderate weight, and eating a balanced diet, may help prevent smoker’s leg.

However, if a person has difficulty walking or their legs become pale or discolored with no pulse, they should seek immediate medical attention.