Painful Calf: I was diagnosed with GCA after... - PMRGCAuk

PMRGCAuk

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Painful Calf

Wengen profile image
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I was diagnosed with GCA after 5 months of painful symptoms (my Doctor has never heard of GCA). 4 months after the symptoms started (I had had no treatment for GCA at this point) I developed a pain in my right calf when I walked fast or uphill. It has not gone away (9 months later). Has anyone else had symptoms like this? I am wondering whether it is linked to the GCA which was untreated for so long. Steroids have not made any difference to it.

Interested in hearing your replies.

Wengen

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Wengen
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PMRpro profile image
PMRproAmbassador

It could be claudication pain - does it come on when walking, stop when you stop and return when you walk again? If so, it is because the blood supply to the calf muscles is not good enough to support exercise. GCA can lead to arterial disease and blockage which may not be relieved by the pred relieving the general level of inflammation. Get your GP to check your ankle pressures and the ABIndex (relationship between arm BP and ankle BP). If he's heard of it of course! If the pulses/index aren't right he should refer you to a vascular surgeon for assessment.

Wengen profile image
Wengen in reply to PMRpro

Thank you for your reply. It is claudication pain. I have seen a Vascular Surgeon who suggested it might be something quite rare called "Systic Advential Disease", more common in young men in their 20s - I am an older female! I am waiting to hear back from him after having an angiogram to help with diagnosis. I can't help thinking it's linked to the GCA though. Can arterial disease be improved by diet or exercise do you think?

Many thanks

PMRpro profile image
PMRproAmbassador in reply to Wengen

I don't think diet will do much once an artery is damaged. In the case of most peripheral arterial disease you can try "walking through the pain" and training the muscles to be more efficient at using what IS available to them as well as creating what is called collateral blood supply - new vessels form to bypass the blockage. You walk until it hurts and then, rather than stopping immediately to rest, you walk a bit further. Doing this repeatedly can improve performance by up to 25% in some cases. I'm surprised he didn't suggest it but that is usually suggested for diabetics or smokers who are the most likely to suffer from peripheral arterial disease.

It could well be linked to the GCA - GCA causes damage to the arteries, depending on which arteries are affected, and given the way they diagnose it in the UK it is unlikely they did any imaging of your arteries in the thorax, abdomen and legs. GCA can affect any artery with an elastic layer in its wall, not just arteries in the head though you'd think it sometimes they way they talk. They have no idea what causes CAD so why not something autoimmune? That it more often occurs in young men contradicts the concept of GCA per se doing it, that is found in patients generally over 50, but a similar effect could be caused by another action.

I found a case report for cystic adventitial disease in a 43 year old woman - closer to you as a phenotype I have no doubt!

Wengen profile image
Wengen in reply to PMRpro

Many thanks - your comments have been very helpful.

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