A Vascular Cause of Low Back Pain

The first symptom of PVD is typically painful leg cramping during exercise that is relieved with rest. This usually occurs after a certain length of walking time, which gets shorter as the disease progresses. This experience is similar to symptoms reported by patients with spinal stenosis, and as such, individuals with PVD may find themselves consulting with a doctor of chiropractic about what they suspect is a musculoskeletal condition. So how does a doctor of chiropractic differentiate leg pain from PVD from leg pain from spinal stenosis associated with dysfunction in the lumbar spine?

One study that administered questions to patients with either neurogenic claudication (NC) or vascular claudication (VC) found that specific symptoms could help in the diagnostic process. For example, if standing still does not trigger pain, NC could be ruled out. On the other hand, NC is likely if standing triggers or increases pain, bending or leaning forward relieves pain when symptoms are above the knees, and sitting provides relief. Patients with VC are more likely to experience leg pain down to the calf that is relieved by standing still. For a definitive diagnosis, a referral for more advanced diagnostics may be required.

Doctors of chiropractic frequently treat patients with spinal stenosis with neurogenic claudication and will refer a patient to a vascular specialist or their medical physician if PVD is suspected so the patient can be provided with appropriate care.