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By Bryan C. Kramer, MD - February 24, 2020
Peripheral Artery Disease (PAD)
Rest Pain occurs when the amount of arterial blood flow and oxygen that can be delivered to the tissues is SO MINIMAL, that the muscles and other tissues hurt even when they are not doing anything.
This is a critical situation- when you get to this point, you barely have enough arterial flow to keep the tissues alive.
Rest pain is noticed mainly at night in bed.
After lying down, about an hour later the top of the foot starts to hurt, and it wakes you up from sleep.
The ONLY thing that makes it better is dangling the foot off the side of the bed- NOT walking around, which would make it worse.
The reason dangling the foot down off the bed helps is that gravity helps to trickle a little more blood flow to the foot and relieves the pain.
People who have rest pain also cannot walk more than a few steps without stopping.
Sometimes people with rest pain will sleep in a chair with their foot on the floor.
IMMEDIATE EVALUATION BY A VASCULAR SURGEON IS VITAL- without treatment, you may lose your leg below or above the knee.
Treatment- Even though the leg is in jeopardy, both minimally invasive (balloons and stents) and open surgery (bypass surgery) have a role in treatment. Your vascular surgeon may be able to fix this problem without an incision- but you need to see them immediately!
Bryan C. Kramer, MD