 Today we'll be talking about leg pain. It's a very common problem. I see patients from both sexes All ages coming with leg pain and they always wonder what are the causes and how do we diagnose the Problem and how do we treat it? So we need to know first the anatomy We have the skin covering muscles joints, bones, nerves You have arteries and you have veins Any one of those organs or more than one could cause pain For example, people who have shiggles on the skin could cause pain. People of arthritis, they could have pain People who have low back pain from a disc disease that could radiate down the leg could have pain. On the other hand very commonly Missed diagnosis is pain that comes from veins and arteries. So let me expand on that Our veins bring the blood back to the heart and The arteries take the blood from the heart to the leg and to the organs. This blood has oxygen So if you have a blockage in those vessels that are taking the blood down the leg You will have pain in the leg when you walk. We call it Clodications. So you may have heard the word clodication, which means pain with walking due to obstruction in the arteries of the leg We diagnose this problem by doing few simple tests in the office One is measuring the pressure in the ankle compared to the pressure in the arm. They should be equal If the pressure in the ankle is lower than the arm, then you have a blockage and Depends how much lower it tells you how severe the blockage is On the other hand we can do ultrasound where we look actually at the vessel and the blood flow that will measure the speed of blood in the artery and The diameter of the vessel and how much blockage we have This test will have more accuracy in localizing the blockage and help us to treat it with angioplasty How do we treat it? Well, we do what's called angiogram So we go from the groin or sometimes from the ankle sometimes from the wrist with tiny little tube under local anesthesia and some sedation We go to the area that we want to image which is usually the artery and we inject dye and follow it with x-ray That will show me the actual blockage and how bad and how many blockages and how severe Basically, it does mean the whole story At that moment we decide how to treat it. So if it is severe more than 70% We will do things like a theractomy or taking the plaque out Sometimes we do laser to melt it sometimes we shave it with a rotational device gone as rotarouter and We put a balloon to enlarge the vessel sometimes we put a stand To keep the vessel open recently actually we have new balloons That are coated with medicine this medicine spread from the balloon to the tissue to the cells over 60 seconds Prevents the tissue from regrowing and block the vessel. So basically it keeps the vessel open longer So we look for the short term results by doing the angioplasty We also do things to keep the vessel open for the long term so it doesn't keep coming back Obviously walking and physical exercise is very helpful also in preventing this blockage from coming back