12 doctors weighed in:
On a daily basis my grandma has intense pain in her legs. She's almost 90. Doctors say it's circulation related and give pain meds. What will help?
12 doctors weighed in

Dr. Peter Kurzweil
Internal Medicine
8 doctors agree
In brief: First, a diagnosis
Hx & px, in the hands of an experienced competent clinician gives the answer probably >90% of the time: the tool between the ears is the most important one physicians have (and the least paid for).
Elderly female, severe, both legs are key hx given; also , what makes it better or worse, describe pain..Tests wil confirm: lumbar stenosis, pvd, peripheral neuropathy...Then we'll know what will help.

In brief: First, a diagnosis
Hx & px, in the hands of an experienced competent clinician gives the answer probably >90% of the time: the tool between the ears is the most important one physicians have (and the least paid for).
Elderly female, severe, both legs are key hx given; also , what makes it better or worse, describe pain..Tests wil confirm: lumbar stenosis, pvd, peripheral neuropathy...Then we'll know what will help.
Dr. Peter Kurzweil
Dr. Peter Kurzweil
Thank
1 comment
Dr. Ralph Morgan Lewis
history and physical
Dr. Nassir Azimi
Clinical Lipidology
3 doctors agree
In brief: Depends
Neuropathy can cause pain as can spinal disease.
Arterial insuffiency from pad can also cause pain. She would need a doctor to examine her and do some tests to differentiate.

In brief: Depends
Neuropathy can cause pain as can spinal disease.
Arterial insuffiency from pad can also cause pain. She would need a doctor to examine her and do some tests to differentiate.
Dr. Nassir Azimi
Dr. Nassir Azimi
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Dr. NAMIRAH JAMSHED
Internal Medicine - Geriatrics
3 doctors agree
In brief: Multifactorial
Most problems in elderly are multifactorial.
Intense pain at rest is possibly circulation, and rest pain if not treated under these circumstances could start showing up as gangrene. Other more common problems are neuropathy (nerve pain) , and referred pain from arthiritis. One can start by checking the circulation first, do a good neurological exam and also some basic blood work.

In brief: Multifactorial
Most problems in elderly are multifactorial.
Intense pain at rest is possibly circulation, and rest pain if not treated under these circumstances could start showing up as gangrene. Other more common problems are neuropathy (nerve pain) , and referred pain from arthiritis. One can start by checking the circulation first, do a good neurological exam and also some basic blood work.
Dr. NAMIRAH JAMSHED
Dr. NAMIRAH JAMSHED
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1 comment
Dr. David Rosenfeld
I agree. A proper neurologic exam is imperative.
Dr. Pedro Hernandez
Internal Medicine - Geriatrics
2 doctors agree
In brief: Part 2 leg pain
If the drs told u she has poor circulation most likely she is not a candidate for surgery or procedures ( bypasses or stents) to improve her circulation so the only thing possible is to put her on Aspirin or other ( plavix, (clopidogrel) aggrenox, pradaxa, or even warfarin but more risky)and maybe cholesterol pills if tolerated.
If pain is severe no choice but to treat the pain. Others :neuropathy, arthritis..

In brief: Part 2 leg pain
If the drs told u she has poor circulation most likely she is not a candidate for surgery or procedures ( bypasses or stents) to improve her circulation so the only thing possible is to put her on Aspirin or other ( plavix, (clopidogrel) aggrenox, pradaxa, or even warfarin but more risky)and maybe cholesterol pills if tolerated.
If pain is severe no choice but to treat the pain. Others :neuropathy, arthritis..
Dr. Pedro Hernandez
Dr. Pedro Hernandez
Thank
Dr. Peter Kurzweil
Internal Medicine
2 doctors agree
In brief: Answer disappeared
I was in process of making a very long and detailed answer on my ipad, when it disappeared.
Was it saved anywhere? It was my most comprehensive answer yet. Upset...

In brief: Answer disappeared
I was in process of making a very long and detailed answer on my ipad, when it disappeared.
Was it saved anywhere? It was my most comprehensive answer yet. Upset...
Dr. Peter Kurzweil
Dr. Peter Kurzweil
Thank
Dr. Pedro Hernandez
Internal Medicine - Geriatrics
1 doctor agrees
In brief: PVD vrs Others
If she has had signs of atherosclerosis in any part of the body like coronary arteries causing angina or heart attacks, or strokes or mini-strokes, or if she has carotid disease or stenosis is very likely she has pad or peripheral vascular disease caused by cholesterol plaques.
This causes pain in the legs after walking but progresses until pain is at rest. The legs may be colder, toes bluish.

In brief: PVD vrs Others
If she has had signs of atherosclerosis in any part of the body like coronary arteries causing angina or heart attacks, or strokes or mini-strokes, or if she has carotid disease or stenosis is very likely she has pad or peripheral vascular disease caused by cholesterol plaques.
This causes pain in the legs after walking but progresses until pain is at rest. The legs may be colder, toes bluish.
Dr. Pedro Hernandez
Dr. Pedro Hernandez
Thank
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