A smoker’s leg is also known as shop window disease. They are colloquial terms for an arterial occlusive disease and, as the name suggests, occur mostly in heavy smokers. Statistics prove that every tenth man over 55 is affected by these diseases. However, smoker’s leg can also be detected in an increasing number of women.
What is a smoker’s leg?
Smoker’s leg is de facto a peripheral arterial occlusive disease of the iliac or leg arteries. Because it is the second most common disease in smokers, it is colloquially called smoker’s leg. Another name is “shop window disease,” because even after walking for a short time, painful standing is required. Smoker’s leg, to stick with the term, is a lack of arterial blood flow in the extremities (in 90 percent of cases in the lower extremities, the legs) due to occlusion of the aorta, the skin artery. Depending on the severity, affected individuals feel no symptoms or the symptoms are so severe that amputation must be considered.
Causes
In almost all cases, arteriosclerosis, a hardening of the arteries, is the main cause of smoker’s leg because it leads to arterial narrowing. Inflammatory vascular disease tends to be a peripheral condition. The most important risk factors for the development of arteriosclerosis with the aforementioned consequences are smoking, diabetes, high blood pressure or lipometabolic disorders. Heredity, on the other hand, rarely plays a role. As a result of arterial occlusive diseases, certain regions of the body (such as the legs) are no longer supplied with sufficient oxygen and nutrients. This results in feelings of pain or weakness, numbness or pale skin. In these cases, the arteries are already 90 percent calcified. This is also the reason for the different perceptions of symptoms, because those affected often do not notice anything of their suffering – until the simple act of walking becomes a source of pain. What is dangerous is that arterial constriction can also affect the brain and heart. Very often, therefore, strokes and heart attacks are the result, which can lead to death.
Symptoms, complaints and signs
Colloquially called smoker’s leg is an occlusive disease of the veins, which is called in technical language pAVK. The disease occurs more frequently in heavy smokers. The calcification of the arteries causes bottlenecks. The blood cannot flow freely and the tissue is no longer supplied with sufficient oxygen. The symptoms are divided by physicians into four stages. The decisive sign of the disease is pain in the affected limbs. At the onset of constriction, there are no symptoms yet. Initially, pain only becomes noticeable after longer distances of more than 200 meters. In advanced stages of the disease, the legs also hurt after short walking distances. In stage 3, the legs of the affected person hurt even if they are not loaded. In the advanced stage, inflammations and ulcers indicate the beginning of tissue death. The pain on exertion that occurs when walking is often associated with shop window disease. Sufferers must stop frequently, similar to window shopping. If the tissue dies, blackish patches of skin form and infection occurs. Depending on the position of the narrowing, numbness may occur in the limbs or buttocks. Likewise, the limbs below the constriction feel cool.
Complications
Always depending on what stage it is in, smoker’s leg can cause a number of complications and late effects. Initially, smoker’s leg disease causes pain that persists for longer and longer periods of time as the disease progresses and eventually becomes chronic. From the second stage on, prolonged walking is already no longer possible and the affected person can no longer cope with everyday tasks as before. This usually also leads to psychological problems. In the further course, tissue overgrowth, inflammation and necrosis occur – the life expectancy of the affected person is reduced by up to ten years. In addition, deposits that have formed can become detached and block vital blood vessels, which usually results in a stroke or heart attack.In the long term, arteriosclerosis also affects the coronary arteries and the cerebral arteries – here, too, strokes and heart attacks are the result. If the smoker’s leg has to be amputated, this is often associated with circulatory problems, delayed wound healing and phantom pain. Hygiene errors or inadequate follow-up care can lead to inflammation, which is associated with further complications. Last, prescribed medications also carry various risks.
When should you go to the doctor?
In the case of a smoker’s leg, a doctor should always be consulted. This is the only way to prevent further complications and complete death of the leg. There is usually no self-healing in this disease and, in most cases, a significant deterioration of the patient’s general condition. The doctor should be consulted in the case of smoker’s leg if the affected person suffers from severely calcified arteries, which is manifested by a bluish coloration of the legs. Likewise, pain may occur in the legs or other limbs, not only during movement, but also in the form of pain at rest. Furthermore, ulcers and other skin manifestations on the legs often also indicate smoker’s leg if the affected person smokes frequently. In some cases, patients suffer from numbness. Usually, a general practitioner or an orthopedist can be consulted for smoker’s leg. Whether treatment is possible cannot be generally predicted. However, the affected person must stop smoking in any case to ensure healing.
Treatment and therapy
The treatment of shopfloor disease aims to counteract the worsening of the smoker’s leg and thus prevent amputations, strokes, heart attacks, or death. The causes of the disease are addressed: nicotine avoidance is strongly advised, diabetes must be treated, and cholesterol levels must be lowered. In addition, consistent walking training is prescribed: This means regular walking up to the pain threshold in order to push it further and further out. Walking improves blood circulation in the body and new capillaries and blood vessels are formed that can re-supply the affected leg. In addition, exercise has a positive effect on all other risk factors: on diabetes, on cholesterol, on blood pressure and on quality of life by increasing painlessness. Walking is therefore considered one of the most important therapies. Drug or surgical treatment methods are also considered: for example, the placement of a bypass, drugs to inhibit clotting or vascular stretching.
Prevention
Smoker’s leg can be improved or prevented in advance by avoiding nicotine and foods high in fat or sugar, by consistent exercise, and by treating pre-existing conditions such as high blood pressure. Regular exercise through endurance sports such as jogging, cycling or Nordic walking is one of the best ways to stay healthy, as it has a positive effect on all other risk factors and also counteracts obesity. If symptoms occur, those affected should go to the doctor immediately and point out a possible smoker’s leg. The earlier treatment begins, the better the chances of recovery.
Aftercare
Follow-up care for smoker’s leg aims to prevent the condition from worsening and to reduce pain. Depending on the stage of the disease, a variety of complications occur that require follow-up care to avoid becoming chronic. From the second stage on, prolonged walking becomes difficult. As a result, the affected person is so restricted that he usually needs help in everyday life. These limitations can lead to psychological problems that should be treated with psychotherapy to improve the mental state. It is crucial to eliminate the main cause of the smoker’s leg and lead a healthy lifestyle. Nicotine should be completely avoided. Furthermore, a healthy diet without fat and sugar should be led. The serves to lower cholesterol levels and treat existing diabetes. To improve the overall blood circulation and reduce pain, regular endurance units, for example in the form of walking, jogging, cycling, are important. In some cases, drug treatment with anticoagulant medication may be appropriate. In some cases, surgical measures such as a bypass are also necessary. In severe cases, the smoker’s leg must be amputated.Here, optimal hygiene and control must take place in the aftercare in order to reduce inflammation and complications. Furthermore, control appointments with the doctor are urgently advised in order to check the course of the disease. Unfortunately, the prognosis of smoker’s leg is rather poor. Tissue overgrowth, inflammation and necrosis reduce the life expectancy of sufferers by up to ten years. The risk of dying from stroke or infarction increases.
Here’s what you can do yourself
This disease, also called arterial occlusive disease, occurs most often in smokers. To avoid amputation, it is imperative that the affected person stop smoking. If the smoker’s leg is due to other causes, such as diabetes, a lipid metabolism disorder or high blood pressure, these underlying diseases must be treated with medication or better controlled. Even if it hurts, patients affected by smoker’s leg need to get plenty of exercise. Daily walks up to the pain threshold are obligatory. The distances covered should increase daily. With the movement of the legs, blood circulation improves and new vessels are formed. Walking training is not only the most effective way to prevent amputation, but also has a positive influence on underlying diseases. With the increased blood flow in the legs, pain also decreases, which significantly improves the quality of life. Daily walking also helps to reduce existing excess weight. Too much weight puts unnecessary strain on the legs, so dieting is often advised. In any case, a smoker leg patient should not only avoid nicotine, but also fatty and sweet foods. This has a positive effect on the underlying diseases. Furthermore, the patient should drink plenty of water to thin his blood. This prevents the formation of clots, which are a dreaded complication of smoker’s leg.
