Q I have pain in my legs when I walk. Is this serious? — W.B., ANDERSON

A Dr. Bruce Gray at the Greenville Hospital System provided excellent information during a recent phone interview. There are three possible causes of leg pain that your doctor should evaluate. If your leg pain starts while you are walking but stops if you rest for a few minutes, that’s called intermittent claudication -- pain or cramping in the legs and buttock associated with walking or exercise. It is associated with peripheral arterial disease or PAD.

If the pain in your legs is more heaviness and tiredness, and occurs late in the day and is associated with fluid build-up or edema, you may have peripheral venous disease. Raise your legs above the level of the heart for the fluid build-up to go down.

A third condition is associated with spinal stenosis, which is a type of arthritis of the lower spine that causes pain with walking (that does not go away with rest), numbness and weakness. A person has to sit down or change position for the pain to go away, which takes awhile.

PAD, defined as atherosclerosis of the legs, is progressive and is associated with an increased risk of cardiac disease. It is the same disease process that affects arteries throughout the body -- narrowed blood flow because of a build-up of cholesterol on the walls of arteries. Dr. Gray says the risk factors include smoking, diabetes, high blood pressure, high cholesterol and being older than 50.

Intermittent claudication occurs when you use the leg muscles while walking or exercising. The muscles need blood flow to keep them oxygenated. With the artery wall narrowed, there’s not enough blood flow to meet the needs of the muscles, and pain occurs. If you rest, the blood flow and oxygen catch up with the need.

According to Dr. Gray, intermittent claudication is a critical symptom of heart disease. Cardiovascular risk factors are associated with higher risk for heart attacks and strokes. So if you have intermittent claudication, your doctor should evaluate you carefully and begin treatment.

Diagnosis of PAD can be made in the doctor’s office by an Ankle-Brachial Index. The doctor takes a blood pressure reading on your arm (brachial artery) and another at the ankle. The two readings should be the same. If not, a ratio can be calculated by comparing the readings. Another test is a Doppler ultrasound, which uses sound waves to measure blood flow and show which vessel might be blocked or partially open.

Treatment involves statins to manage cholesterol, lifestyle changes (stop smoking, manage your weight and diet, exercise) and managing any existing high blood pressure and diabetes. Dr. Gray suggests that for some patients, aspirin or Plavix may be used as well. An important step is to walk, even with the pain. Walking will improve symptoms over time. Walk until you hurt, stop and rest, then continue walking.

Send your health questions to Debbie Jackson, PhD, MN Clemson University, 302 Sikes Hall, Clemson, SC 29634-5155 or e-mail dbj@clemson.edu.