Pain Management
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Peripheral Vascular Disease (PVD) / Ischemic Limb Pain
Peripheral vascular disease (PVD) is a condition characterized by decreased blood flow in vessels in the legs, and sometimes in the arms causing pain the affected area. It can occur in any blood vessel outside of the heart, but is most common in the limbs and extremities, especially the fingers and toes. 
Peripheral vascular disease, and the resulting pain caused by insufficient blood flow (ischemic limb pain), has several causes, such as coronary artery disease or atherosclerosis, diabetes or frostbite. Symptoms include numbness, swelling, and sometimes pain, in the affected area. 
The treatment plan for peripheral vascular disease depends upon many factors, such as the severity of the disease, dysfunction and pain, the type and location of the pain, as well as patient’s age, ongoing medical conditions, and ability to tolerate other medical therapies. The doctor will take all of these factors into consideration when prescribing a treatment plan. 
PVD treatment usually involves changes in lifestyle, such as exercise, smoking cessation and weight reduction. When lifestyle changes alone are not enough to control symptoms, medications, angioplasty or surgery to revascularize (resupply blood to) the clogged vessel may be required. 
In general, treatment for ischemic limb pain caused by PVD will follow the chronic pain treatment continuum, and may include neurostimulation for any unresolved neuropathic pain.
Vascular insufficiency can result in significant pain and morbidity. Sometimes, the diseased vessels are so small that bypass surgery could not alleviate the pain. Spinal Cord Stimulation is a very effective treatment modality for this process. This has been used in Europe extensively. However, the use of this device/procedure in the U.S. has largely been neglected secondary to lack of awareness in the general medical community. If you or someone you know who has this disease, let them know that they have some alternatives for treatment.