Poor circulation is linked to a number of health issues, including numbness and tingling in the extremities, joint pain, muscle cramping, digestive issues, skin issues and even cognitive issues. If circulation problems aren’t addressed, they can lead to peripheral vascular disease, a long-term abnormality of the blood vessels that can cause chronic, even life-threatening consequences.
One of those consequences is an increased risk of non-healing wounds (ulcers) on the legs and feet. When a wound doesn’t heal due to poor circulation, it becomes vulnerable to serious infection that can spread to the underlying bone. In individuals with vascular disease, leg ulcers are common. As a result, vascular disease is the leading cause of limb loss (amputation) in the United States1.
Today, we’re exploring the connection between poor circulation and non-healing leg wounds (venous ulcers).
The underlying cause of most leg ulcers is poor circulation, often the result of venous insufficiency2 and/or arterial insufficiency.
Venous insufficiency is the dysfunction of the vein valves, particularly in the legs.
Vein valve dysfunction can interrupt or stall the process of sending blood from the legs back to heart. As blood pools and increases the pressure inside veins, it can cause the veins to become varicosed. Varicose veins are thick, gnarled and often painful. Additionally, fluids can leak into the tissues surrounding the vein. This can lead to the breakdown of tissue and skin, increasing the likelihood that an ulcer will form on the leg.
Venous insufficiency can occur as a result of obesity, pregnancy, smoking, high blood pressure and phlebitis.
Arterial insufficiency is the dysfunction of the arteries that carry oxygen-rich blood from the heart to the rest of the body. Atherosclerosis is among the most common causes of arterial insufficiency. Atherosclerosis is a serious disease characterized by fatty deposits in the arteries that cause reduced blood flow. It is one of the leading causes of heart attack, stroke, aneurysm, and chronic kidney disease.
Peripheral arterial disease (PAD) is a circulatory issue in which arteries become narrow, reducing blood flow to the extremities. The legs and feet are especially affected by PAD. Decreased blood flow to the extremities can lead to skin breakdown and the formation of non-healing wounds. Peripheral arterial disease is commonly caused by atherosclerosis.
If you’ve been diagnosed with any of these conditions, it’s important to pay close attention to wounds or sores on your legs and feet. Typically, ulcers heal within three to six weeks. Ulcers that do not heal within this time period should be evaluated by a doctor.
In people with normal venous and arterial function, the veins and arteries carry blood from the heart to the organs and extremities and back again. The arteries carry blood loaded with oxygen and nutrients away from the heart, and the veins return the blood to the heart after the oxygen and nutrients are removed.
When arteries and veins don’t function properly, this process is interrupted or compromised.
Reduced blood flow in veins or arteries prevents oxygen rich blood from efficiently reaching the legs and feet and traveling back to the heart in a normal manner.
Arterial leg ulcers form when arterial insufficiency prevents the arteries from transporting oxygen-rich blood to the extremities. Lack of necessary oxygen and nutrients in the extremities can cause cells to die, resulting in skin damage and slow healing when a wound forms3.
Venous leg ulcers form when blood backs up and pools in veins that have damaged vein valves. Left untreated, the increased fluid and pressure in the vein can cause a sore to form. These wounds are slow to heal and often become ulcers4.
Individuals with conditions like high blood pressure, atherosclerosis, diabetes, obesity, varicose veins and Raynaud’s disease should be attentive to any signs or symptoms of poor circulation.
These symptoms include:
- Swollen veins in the lower extremities
- A feeling of heaviness in the legs and feet
- Swollen lower extremities (peripheral edema)
- Numbness, tingling or a “pins and needles” feeling in the lower extremities
- Changes in the skin of the lower extremities, including discoloration, itchiness and rash
- Muscle pain in the legs
- Extremities that are frequently or always cold
If you experience any of these symptoms, it’s important to see a vein specialist immediately. Treatment for poor circulation can help you avoid serious issues, like leg and foot ulcers.
A vascular specialist can help individuals with poor circulation find treatment options that alleviate their symptoms and improve their vascular function.
Individuals with vascular disease often need specialized treatment plans, including changes to diet, exercise habits and lifestyle.
Your vascular specialist may recommend treatment techniques like elevating your legs, using compression bandages, losing weight, and getting regular exercise. These techniques can reduce pressure inside the veins and arteries of the legs and improve blood circulation.
For patients experiencing chronic leg ulcers, prevention techniques in the care and cleaning of the feet and legs are vital in preventing these sores from forming. It’s important to check the legs and feet for wounds, and to carefully track the healing process of any sores that appear.
Lifestyle changes that reduce the risk of developing a leg ulcer include losing weight, quitting smoking, exercising more frequently, and utilizing compression stockings and leg elevation on a regular basis.
Georgia Vascular Institute is one of the leading providers of vascular care in the Atlanta area. Our vascular specialist, Dr. Sendhil Subramanian, is a board-certified interventional radiologist who specializes in the diagnosis and treatment of vascular diseases like varicose veins and peripheral arterial disease.
Contact us today to schedule an appointment or to learn more about our services.
"Estimating the prevalence of limb loss in the United States ...." https://pubmed.ncbi.nlm.nih.gov/18295618/.
"Leg ulcers - causes and management - PubMed." https://pubmed.ncbi.nlm.nih.gov/16820817/.
"Ischemic ulcers - self-care: MedlinePlus Medical Encyclopedia." 16 Jun. 2020, https://medlineplus.gov/ency/patientinstructions/000742.htm.
"Venous ulcers - self-care: MedlinePlus Medical Encyclopedia." 16 Jun. 2020, https://medlineplus.gov/ency/patientinstructions/000744.htm.