Dr. Kunal Arora is a seasoned Vascular and Interventional Radiologist based in Mumbai at the Endovascular Care Center. With a wealth of experience exceeding 5 years, he excels in non-surgical, minimally invasive treatments for a range of conditions. Dr. Arora's focus areas encompass varicose veins, DVT, peripheral arterial disease, embolization, oncologic intervention, hepatobiliary interventions, and dialysis AV fistula salvage. Peripheral Vascular Disease (PVD) is a condition characterized by circulation issues in blood vessels outside the heart, predominantly affecting the legs and feet. Here is a concise and informative blog on PVD treatment in Mumbai:

Understanding Peripheral Vascular Disease

Peripheral Vascular Disease (PVD) involves the narrowing, blockage, or spasms in blood vessels, impacting blood flow to organs. Commonly affecting arteries due to atherosclerosis, PVD can lead to symptoms like leg pain during exercise and non-healing wounds.

Causes and Symptoms

Causes of PVD include plaque buildup, inflammation, injuries, and radiation exposure. Symptoms range from leg pain to ulcers, numbness, and skin changes. Risk factors include smoking, diabetes, high blood pressure, and family history of heart disease.

Diagnosis and Stages

Diagnosis involves medical history, physical exams, and tests like ABI, Doppler ultrasound, MRA, CTA, and angiography. Stages range from asymptomatic to ulcers or gangrene based on severity.
Peripheral Vascular Disease (PVD) progresses through different stages, each indicating the severity of the condition and guiding treatment decisions. Here is a detailed overview of the stages of Peripheral Vascular Disease:

• Stage I: Asymptomatic -At this stage, individuals with PVD may not exhibit any noticeable symptoms.
• Stage IIa: Mild Claudication -Patients experience mild leg pain during exercise, known as intermittent claudication.
• Stage IIb: Moderate to Severe Claudication -Progressing from mild claudication, individuals may experience more pronounced leg pain during physical activity.
• Stage III: Ischemic Rest Pain -At this stage, patients may experience pain in their legs even at rest.
• Stage IV: Ulcers or Gangrene -The most severe stage of PVD is characterized by the development of ulcers or gangrene.

Understanding these stages is essential for healthcare providers to tailor treatment plans effectively based on the severity of the disease. Early detection and appropriate management can significantly improve outcomes for individuals with Peripheral Vascular Disease.

Treatment Options

Treatment aims to manage symptoms and improve artery health. Lifestyle changes like quitting smoking and medication for blood thinning are common. In severe cases, revascularization through endovascular or surgical procedures may be necessary.

Endovascular Treatments

Interventional radiologists perform minimally invasive procedures like angioplasty, stenting, atherectomy, and thrombolysis to restore blood flow in blocked arteries. These procedures offer benefits such as quicker recovery times and lower risk of complications compared to traditional surgery.

Prevention Strategies

Preventing PVD involves lifestyle changes like quitting smoking, regular exercise, healthy diet, managing blood pressure and cholesterol levels, controlling diabetes, maintaining a healthy weight, limiting alcohol intake, taking prescribed medications, and attending regular check-ups for early detection.
By understanding the causes, symptoms, diagnosis methods, treatment options, and prevention strategies for PVD in Mumbai, individuals can take proactive steps towards managing this condition effectively.
For those seeking consultation or wishing to schedule an appointment with Dr. Kunal Arora, the process is simple. Patients can reach out to his private clinic located in SRV Hospital, Goregaon, Mumbai. Additionally, appointments can be scheduled by contacting +91 90040 93090, ensuring accessibility for individuals in need of his expertise.
Click here to know more.

I had my caudal injections done on Tuesday. Wednesday I had virtually no pain aside from the soreness down my leg that I've had the last few months. I treated it with Baclofen and Acetaminophen, pain went away.
Took a nap because I'm scared to sleep because the last few months, when I sleep, I wake up in so much pain I'm screaming.
Now laying in bed with a very heavy soreness. Tailbone hurts again. Leg hurts again. I don't know what to do because I felt amazing all day yesterday. I took it easy. I wore jeans and went to appointments.
IDK what I am going to do. Neurosurgeon that I saw won't operate because he says I am at risk of re herniation. I am obese, and I need to lose weight. I'm trying to lose weight but I can't exercise if I'm stuck in bed. They give me Lyrica which makes me gain weight and makes me so freaking hungry I can't stand being awake and I can't sleep the symptoms away.
I can't win.
Is there a chance the injection is still needing time to work? Why was I pain free and now in pain again? Any theories on what happened?
Assessment: - Lumbar disc degeneration L4 - L5 - Lumbosacral disc degeneration L5-S1 - Herniated disc of L5 - S1 - Lumbar spondylolisthesis (L5 - S1) - Lumbar stenosis without neurogenic claudication - Lumbar radiculopathy

No pictures, they haven't given me any. I figured as I puzzle through this, it might be useful to share for others.
Impression
IMPRESSION:

1. Large L5-S1 right paracentral disc protrusion displacing the right S1 nerve.
2. L4-L5 left paracentral disc protrusion displacing the left L5 nerve.

FINDINGS: There is mild dextrocurvature with no vertebral compression fracture or subluxation. The lowest thoracic vertebra bearing diminutive riblets is designated T12 with five lumbar vertebrae. The distal cord terminates at T12.

Narrative

EXAMINATION: MRI SPINE LUMBAR WITHOUT CONTRAST
CLINICAL: Low back pain. Right flank pain.
TECHNIQUE: MRI lumbar spine without contrast. Comparison was made with CT from 1/31/2024.
Disc levels: T12-L1, L1-L2, L2-L3 and L3-L4: Normal.
L4-L5: Mild disc desiccation is present with a left paracentral disc protrusion measuring 6 mm in AP dimension narrowing the left lateral recess and displacing the descending left L5 nerve (image 31 series 5). There is mild left neural foraminal narrowing due to encroachment by disc material.
L5-S1: Mild disc desiccation is present with fatty discogenic endplate signal change. A large right paracentral disc extrusion with caudal migration measuring 9 mm in AP dimension causes severe central canal and right lateral recess stenosis displacing the descending right S1 nerve (image 37 series 5). It is also close to the descending left S1 nerve. The left neural foramen is mildly narrowed due to encroachment by disc material.
Translation Attempt:

1. Mild disc dehydration (possibly normal, 30% of 35 year olds), with a herniation in the center protruding left. This herniation is also narrowing the spinal canal on the left side, shifting the left L5 nerve. There is mild pressure on the left side of the nerve due to disk material.
2. Mild disc dehydration is present with ???? (above my head, more research needed). A large herniation in the central protruding right, shifting towards the caudal (!). This herniation is causing severe narrowing of the spinal canal, shifting the right S1 nerve as well as the coming close to the left S1 nerve. There is mild pressure due to encroachment of the disc material.

Current symptoms: Before I started PT, I was having stabbing pains in my right hamstring. I could walk through it, but it caused quite a bit of pain. PT seemed to help, until they had me do an RDL & leg press and I ended up in urgent care. However, continuing the non painful exercises has helped me move to mild pain or tingling, except when I stand or walk. Very quickly that becomes pain and the sensation that my hips are unsteady. Sometimes (especially after extending right leg) horrible miserable sciatica. The cat scan showed significant facet anthropathy, which I think is what makes it hard to walk.
I actually have very limited lower back pain, just weird zapping sensations on occasion and the feeling like fat fingers twist in my back, but I understand that would be hard for them to put in the notes. AND I'm rocking some great antalgic gate from the herniation on the right side.
I took no NSAIDs the day of the MRI.
UPDATE 3/20
Finally saw the neurosurgeon, he said I could go with conservative treatment or surgery. I am going to try a shot first, see how things go.
Current diagnosis:
Lumbar foraminal stenosis
Disc protusion measuring 6mm at L4/L5
Disc protusion measuring 9mm at L5/S1
Lumber radiculopathy at S1
Bone spurring at S1
Lumber Degenerative Disc Disease
Lumber stenosis with neurogenic claudication
Facet Anthropathy
Bone spurring at L5/S1 level

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https://preview.redd.it/16pp5pt1guec1.png?width=1566&format=png&auto=webp&s=a808ae8a76db7a80f6be2377c6738f700c987984
https://preview.redd.it/hw6naty2guec1.png?width=1956&format=png&auto=webp&s=82d578af4de6a172cf100ed9edafeaad607c9583
I got this question wrong on Free 137. Why is the answer cilostazol and not aspirin? UWorld states not to initiate cilostazol until starting aspirin and lifestyle modifications

Male, 57, fit and active, lifetime non-smoker and vegetarian, keen runnecyclist all my life.
I'd been having some issues with cold hands and feet and my doctor referred me to a vascular surgeon to check for PAD. My ankle branchial indexes were normal, 1.1, and ultrasounds of my legs were normal. BUT an aorto-iliac scan showed a 50-75% stenosis of my left iliac artery.
The doctor asked me if I'd been experiencing any left leg pain when walking and when I said no, and that I was a keen runner and hadn't had any problems doing that either. He muttered something about it being unlikely to cause me any trouble and to come back if it did!
Initially I wasn't too worried about all this but after thinking about it it has sent me into a bit of a tailspin. I got my cholesterol checked and it was a little high so I've made some changes to my diet (goodbye butter and cheese) and it's in a good range now, ApoB 77 mg/dL. A CT coronary angiogram about a year before the arterial ultrasound showed a calcium score of 0.
I have a referral for a 2nd opinion from another vascular surgeon but since my case is deemed non-urgent my appointment with him is not for six months. In the meantime I have many questions...
The 50-75% stenosis figure sounds really high - wouldn't I be experiencing some claudication at higher intensities of exercise if it were true? Is it possible the ultrasound was wrong? Is it worth pressing for an angiogram to confirm the diagnosis? And is the cause most likely to be atherosclerotic or could it be a structural deformity that's been there forever?
I also wonder whether, despite not causing any pain, this level of stenosis is likely to be affecting my athletic performance? I've definitely noticed a bit of slowing down over the last few years but I've just attributed this to general aging instead of anything in particular. I guess the tendency with a diagnosis like this is to think it's responsible for every little change and I'm trying to resist doing that.
I'm also not altogether comfortable with the "wait and see" approach - it seems that if I wait until I experience claudication then the damage will be such that my treatment options will be limited to stenting/surgery. I want to maintain my current active lifestyle as long as possible into my later years so would prefer to prevent further damage. If that means starting statins etc sooner rather then later then so be it. Is there anything else I could be doing in the next six months to slow down any progression of this.
Thanks, in advance, to anyone who takes the time to read and reply to this.
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Hello. 20F, white, no smoking/drugs/ low bone density but within normal range, otherwise no significant clinical history.
For the past three years, I would say, I've pretty much always experienced pain with walking. It led me to being very sedentary. I wanted to change that, so for the past three months by now, I have been working on increasing fitness levels. Aiming for 10,000 steps a day, 150+ minutes of exercise.
Whenever I've exercised, or even just walked, honestly, I have always been in pain. It's usually dull enough that I can ignore it and push through, although it significantly worsens when increasing intensity. But short walks around the house, going to uni, they always cause pain. Always after a short distance, without fail. After an intense(ish. It's a brisk walk. I'm.. not super amazing) session it'll be next to unbearable, struggling to stand from the pain. But as soon as I return home and sit in bed, or get on the bus, or a chair anywhere, it goes away pretty much instantly. I'll be in a bunch of pain and then Poof. Gone. Like it was never there. It's similar to cramping, but I think also burning pain, especially on the longer (40+ minute) walks.
This happens on flat ground. I do try to take stairs where I can, and it definitely makes it worse though. Usually stairs make me feel like I've completely ran out of energy and need to hold onto the hand rail as it feels like they will give out. But as always, the pain goes away as soon as I stop.
Is this claudication? I'm not really sure, but it seems to be similar to what I've experienced. I have a doctor's appointment next month, but I also have a physio nearby and was considering going there anyway (for unrelated reasons.. my posture is horrendous), and I could bring it up to them. Do you think I should? Or is this just unfit-ness?
Thank you very much for reading. Apologies if formatting messes up, I'm on mobile.

I've been treated for diabetes/HBP for over 20 years now. Have taken all the recommended OTC supplements for neuropathy to be had over the last 20 years ...ALA,LCARN,BENFO,B12 etc.etc.. Up to 2013 I was walking up to 5 miles 3 times a week,even with the pain of claudication;until I just couldn't walk without the danger of falling and breaking a hip due to balance/gait issues. Started a stationary bike since. Last year had 2 stents placed on each of my legs,by 3 different doctors in 2 different hospitals/clinics....I've actually gotten worse..I can barely walk 20 steps before my legs spread out as if I were riding a horse,and my gait changes and my legs feel heavier than ever and my shins feels like they are being pressed by a vice grip. Been walking with a cane for 5 years now...When at home have to be constantly grabbing walls/doors furniture as not to lose my balance or trip over my own feet. Didn't help that last year I had a big toe amputation because of gangrene. Yet;I wonder all the time if this could be more orthopedic than neurological. It only hurts when I stand up or when I walk. When I'm sitting or lying down...there is absolutely no pain. And is only in my legs..I've read about people who can no longer hold stuff with their hands. I barely leave my house other than work/groceries...I have to count the steps from my doorway to the parking lot/the trash bin just to make sure I can make it ...Can barely do the bike anymore..Just 5 minutes...stop for 10 or more...do 5 more minutes...The pain my shins/calves/ankles is unberarable..Of course this makes it useless to exercise...Progress is non-existent for whatever I exercise for. Hoping for a quick and sudden death to escape this hell on earth. I've lost all hope...It's quality not quantity of life. If I believed in God I would pray for a widow maker heart attack.
Thanks for listening....

Hi friends. I’m 24F and have struggled with my weight my entire life. Extensive family history of hypertension, obesity and ACS. Currently at my all time highest of 98kg at 5’3. Recently I have been under unprecedented stress and have gained additional weight rapidly over the last 6 months.
I have just developed terrible pain in my legs on exertion. I can’t even walk 200 metres before my legs feel like they have no oxygen. It’s debilitating.
Aside from diet, how can I lose weight without being able to do this type of cardio? Can anyone recommend some effective cardio I could start doing now?
I lift weights with a personal trainer twice a week.
Also, is anyone familiar with this struggle? I’m feeling so inadequate and weak. I truly want to be better but I’m so helpless since I can’t even walk for exercise.

I have been diabetic for around 10/11 years now and am aged 26. My hba1c is around 63, which is a little high.
I have been getting extremely bad pains which I can only describe as a lactic acid, in my legs. This usually comes after 0.5-0.8 miles of running and happens when I run slow or fast and even happens when I walk up hills or steep inclines.. and happens every single time. This happens if my blood sugar is normal or high, it makes no difference.
The pain usually starts around the top of my ankle/bottom of my shins (at the front) and quickly spreads to my calf until I can barely even stand up and to the point where I can’t walk properly. The pain is a bad pulsing pain for 3-5 minutes after I stop exercising (because of the pain) and then disappears until I begin to exercise again.
I have searched up different possibilities and Claudication best describes my symptoms, and is of course linked to diabetes.
However, I have spoken to a doctor and have had blood tests, as well as a full inspection of arteries from my stomach to my feet. In the opinion of 2 separate doctors, my arteries are not the issue and I do not have claudication.
I am posting here in hopes somebody else has had similar issues and can share their problems/solutions with me before I seek private consultancy to diagnose/help improve the issue… as doctors are refusing to believe the severity of the pain from the exercising.
Thanks in advance

Overhand Supine Row (aka inverted row) for a healing rotator cuff tear?
Fitness Goal(s): 1A) Gain-SO 1B) Muscle SO [Hypertrophy, Hyperplasia] 2A) Increase Muscle Density: Shoulders: Deltoid, Supraspinatus. 2B) Increase Muscle Density: Upper Arms: Triceps Brachii, Biceps, Brachioradialis. 2C) Increase Muscle Density: Forearm Flexors: (Anterior) Forearm Extensors: (Posterior) 2D) Increase Muscle Density: Back: Latissimus Dorsi. Teres Major. Trapezius (Upper, Middle, Lower). Levator Scapulae. Rhomboids. Infraspinatus. Teres Minor. Subscapularis. 3) Strength and Conditioning Focus Areas: mobility, stability, strength, endurance, power, speed, agility and performance. 4) Improve muscular endurance.
[Red] Beginning Date:Redacted; End Date: Redacted [Blue] Beginning Date:Redacted; End Date: Redacted [Green] Beginning Date:Redacted; End Date: Redacted
Fitness Access/Schedule: Complete cardio/HM facility. 60-90 min, 5xWK.
Overall Conditioning PFC Part B: (personal feedback chart) 1) Program Type Preference: Advanced. 2) Cardiovascular: N/A 3) Weight Training Experience: 5 years plus. 4) Muscular Endurance: Advanced. 5) Preferred Cardiovascular Machine/Activity: Sports 6) Muscular Strength: Average 7) Exercise Terminology: Advanced.
Overall Conditioning PFC Part B: (personal feedback chart) 1) Program Type Preference: Normal, not too advanced. 2) Cardiovascular: Average. 3) Weight Training Experience: Advanced. 4) Muscular Endurance: Average. 5) Preferred Cardiovascular Machine/Activity: Treadmill. 6) Muscular Strength: Average. 7) Exercise Terminology: Average. 8) Flexibility: Poor. 9) Core Development: Average.
Health Questionnaire. 1) [No] 1) Ischemia. 2) [No] 2) Smoke. 3) [Yes] 3) Drink (beer, six pack on weekends). 4) [No] 4) Edema. 5) [No] 5) Known heart murmur. 6) [No] 6) Intermittent claudication. 7) [No] 7) Palpitations or tachycardia. 8) [No] 8) Shortness of breath at rest or with mild exertion. 9) [No] 9) Dizziness or syncope at rest or with mild exertion. 10) [No] 10) Unusual fatigue or shortness of breath with usual activities. 11) [No] 11) Orthopnea/paroxysmal nocturnal dyspnea at rest or w/mild exertion. 12) [No] 12) Pain or discomfort (or anginal equivalent) in the chest, neck, jaw, arms.
Family History. 1) [No] 1) Heart attack or surgery prior to age 55. 2) [No] 2) Stroke prior to age 50. 3) [No] 3) Congenital heart disease or left ventricular hypertrophy. 4) [No] 4) Hypertension. 5) [No] 5) Leukemia or cancer prior to age 60. 6) [No] 6) High cholesterol. 7) [No] 7) Diabetes. 8) [No] 8) Asthma. 9) [No] 9) Osteoporosis. 10) [No] 10) Depression.
Medications. 1) [No] Diuretics 2) [No] Beta Blockers 3) [No] Vasodilators 4) [No] Alpha Blockers 5) [No] Calcium Channel Blockers 6) [No] NSAIDS 7) [No] Cholesterol 8) [No] Diabetes. Insulin 9) [No] Birth Control 10) [No] Other Drug
ORC [Other Relevant Condition(s)]: 1) Rotator Cuff. (No Clearance).
Overhand Supine Row Preparation: Lie supine under fixed horizontal bar. Grab bar with wide overhand grip raising torso off floor. You can rest heels on the floor or elevated on a bench.
Execution: Keeping body straight, pull body up to bar. Return until arms are extended, and shoulders are stretched forward. Repeat.
Comment: Fixed bar should be just high enough to allow arm to fully extend. To make it easier, resistance can be reduced by raising bar or sitting on hips. To make it harder place back of heels on elevated surface. This exercise is typically performed without added resistance although additional weight can be placed on belly or pelvis.
Primary: Trapezius - Transverse Part Trapezius - Ascending Part Latissimus Dorsi
Secondary: Teres Major Deltoid - Spinal Part Infraspinatus Teres Minor Brachialis Brachioradialis

Hello guys. I am seeing your posts learn a lot of things and have courage. Time to tell my story now.I am 26 years old always in shape did natural bodybuilding boxing and been in special forces always been active.The problem starting this summer as I was working as a Responsible of Doorman in a seasonal beach club every Friday-Saturday-Sunday for 4 months. So in this beach club they gave me a camp-bed το be sleeping in there for every Fr-Sat-Sun but I was already used to sleeping in the car, in the floor even inside tents (on the ground) on the army and never have a single problem with that. With time to time I was started to have lower back pain when I was waking up and driving for many hours on June but in the middle of every week I was going home, sleep in my bed working out and everything was fine until I had to sleep in the camp bed again. This thing went for 3+ months repeatedly. Suddenly on August I felt my lower back a bit worst, keep working and day by day without realizing I was having pain more than the half day. I had 3days to go back home to rest before went back to this job. First day I rested. Second day I was feeling a little better but I still had a little pain. Went to the gym for leg day taking it slow with good warmup and not much weights. I squat 20,40,60,80,100 I was feeling ok. Putted the belt on called a experienced spotter and went for last set on 120kg. After the first rep when trying to get up for second rep I just felt a "pop" in my right side of the back. I immediately stopped trying to keep the workout but left the gym after a little while. The day after My right side of lower back got swollen like Eve was gonna pop from Adam's rib. I had this for at least 3 weeks as I recall. It was embarrassing with swimsuit and made my even hard for me to walk and sit and get up. Then day by day on September stopped the work from the beach club and I started to have sciatica without being swollen anymore. Did some McKenzie exercises. As a trainer I had help a lot of people be paint free with these but not me. I keep working out with less weight. But I still problem of changing posture to sitting from standing the opposite causing me ONLY lower left leg pain. The only thing make a little better short term was walking a few minutes.
I went to and orthopedic doctor. Had an MRI herniation of L5S1 and he told me exactly that "Some people see chiros, some priests, some physios but neither McKenzie neither McDonalds can help you and you run out of time you need to remove the herniation with surgery.. But you can also take other opinions on these from doctors and physios"
So here I was. I found a job as doorman once or twice a week in my city (no driving pain and other beds pain). By that time still had the left leg pain only but when I was working standing still for 9 hours I was feeling way better and sometimes the next day almost pain free. They only thing was helping me short term to be pain-free was walking and standing for long time.
Also Everyone told me that I am very young for surgery the risk of surgery and that they are ways to heal. So I tried needling, chiropractic manipulation but nothing changed it .Then a bouncer sent me to a special physio kinesiology professional clinic said that they know the problem and I am gonna be pain free soon. They did my something like Deep Tussie Massage and Cupping Therapy. They guys just beat me up screaming from pain and then I paid them. Only that I was worst almost every week. And by that I mean that after every of last 4 sessions of painfully massage I started to have a difficult time standing at work causing lower back pain. I didn't had lower back pain for almost two months+. First in 4hours of standing then in 3 then in 2. Every weekend I was worst and worst causing unbearable lower back pain that I couldn't stand anymore. One time my expensive earing fall down and I was so in pain that I had not the courage to pick it up. These guys told me that my lower back was getting better but in my symptoms i was just getting started to get worse and worse.
Then I tried some decompression bed, high laser treatment and electrotherapy nerve treatment. All by a new special lower back clinic. Did 5 times. Saw not results at all.
So. I had a classic sciatica pain only when changing postures and sitting.(when i was standing and went to sit I had 5-10mins pain and the opposite) Walking and standing made me feel better. That turned into (sitting pain free as long as I want and increasing second by second as I am standing. I never quit that's why I am still working but every time I just want to die when doing it. even when I just go out with friend for 10minutes. Every time I am working I am taking ibuprofen and the leg pain starting to go away but then the lower back pain makes me wanna cripple. How's that possible?
The problem is I don't know if it is the same cause that causing the low back pain and why it is not go away with meds. It is something else? Also the doctors don't know anything. They just tell me that i have a simple big herniation. But why my symptoms changed? Why from sciatica now i have symptoms of stenosis or anything else? Why I am not at least feeling any better with all these treatments that I tried? Was something else behind and they tried to treat a wrong thing? Did Deep Tissue massage made me worst? And if why it did? Do now I have something else like stenosis or neurogenic claudication? Why doctors don't see that? Why a healthy guy that was all his life active can stand for 5minutes like a 90year old man? Does microdiscectomy going to help my case of is gonna treat just the herniation like other treatments did? Please does anyone had anything like this? Please help me. What to do. The doctors don't listen to me. I must find what is going on and then tell them to treat me for it They cannot I don't have any money left. Cant keep working like this. Cant even stand for 5minutes.
Sorry for this big thread but i am really really desperate. No doctor gonna sit and hear me tell him the whole story. Thank in advance

Hi AskDocs,
Last year I thought I could pick up vaping, enjoy the nicotine buzz, and be OK "because it's not smoke" - turns out I was wrong. With a BMI of 34.7 and no exercise routine, I honestly must have been crazy. In the past month I've been experiencing fatigue, pains, and aches. I've never had these before.
Any ideas what this might be? I would love to see a doctor, but I'm hesitant because I won't have insurance coverage until February.
I remember the week before Christmas I was feeling really fatigued. Went to Costco and grabbed a blood pressure monitoring device. I took some readings that indicated my blood pressure was really high - I'm told didn't take them correctly though. I hadn't been resting, and apparently my arm is too big for the cuff on the machine.
For most of December I was using a weaker e-juice type of nicotine vape, but on Dec 28, I thought I would try a stronger salt-nic version. It made me feel good, but at the end of the day, it felt like the veins/arteries in my arms and legs were hurting. I decided not to try that again and went back to the weaker version - the problem seemed to go away.
The last week of 2022 was really stressful for me. I was super busy all week preparing to leave my current job and start a new one in 2023. I was watching a dog for the week and I remember feeling more out of breath than usual after taking it for a walk. On New Year's Eve I was also out all night bar hopping, got drunk, and had a huge hangover.
I didn't feel good the first week of 2023. I was also getting these pains in my leg, it seemed to come from the veins in them, and I would need to keep my legs raised to stop it. The bottom of my calves look normal on the outside, but sometimes felt like they've been sliced with a knife. I decided something needed to be done. Diabetes runs in my family on my mother's side, and I had lots of rich food over the holidays, so I was worried maybe some of these problems I'm having might be a pre-diabetes thing. Jan 5th I went to a local CVS minute clinic to get a pre-diabetes screening test.
The earliest appointment I could make was 5:00 p.m., so I fasted all day, made it there on the adrenaline of rush hour, and got my A1C tested. Got 5.4 - normal. Blood pressure normal. I explained what had been going on with me, and the doctor who was there said it was probably the stress related to the holidays, job, etc. which triggered these things.
Then I explained the vein stuff. How my calves have been hurting. She asked me if I ever got cramps (occasionally I would in my toes). She asked if it occured while active or resting (I said both). She said it might be claudication.
She also told me to stop with the vaping, which I did. Haven't done it for over a week now.
It's 12 days later, vein aches/pain have gotten worse, and I'm scared.
It feels like my veins are hurting whenever I sit in a chair for an extended period of time. Basically, if my legs aren't up, or if I'm not lying down, then I can feel aching and throbbing after 15 minutes. Sitting up for a zoom call at work, or driving a car, both trigger this discomfort in my legs.
The pain isn't sharp like it was before, but it's achy and distressing. I also get it in my lower buttocks, more so on my left side. I can feel the aches and slight tingly sensation in my hands and forearms too. Makes it hard to sleep.
Getting up and walking around helps relieve the discomfort I get from sitting. I can't stop and stand too long in the same spot, otherwise the pain will come back. The walking motion seems to help keep the blood flowing.
I really wish I could go see a specialist, but I also need to pay my mortgage, so I need to wait until I get my insurance in February to see someone about this.
I'm not sure if it's relevant, but starting last summer and occurring every once in a while, I would feel a dull pain around my testicles. I was worried it might be a varicocele, but even today and like with this new vein pain problem, everything looks fine from the outside. This feeling is occurring a little bit more frequently now too.

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L-arginine (or arginine) is an amino acid that is known to be the "building blocks" of proteins. We get arginine from our diet, especially protein foods of animal origin, including beef and other types of red meat, poultry, fish, eggs and dairy products.
In addition to being naturally present in a "whole protein" that provides all the essential amino acids we need, it is also produced in a laboratory setting, so it can be used to create supplements that benefit heart health, athletic performance, mental performance, and more.
What is L-Arginine?
While not exactly an essential amino acid -- meaning the body cannot make its own, so must obtain it from an external source -- L-arginine is considered an essential amino acid because it's so important for many functions, but it's usually found in the form of A small amount exists, especially as someone gets older.
What is arginine good for? One of the reasons people take supplemental arginine is because of its ability to improve blood flow and circulation.
In the body, it is converted into nitric oxide, which opens blood vessels wider. This has multiple benefits, such as improved heart and brain health.
Another important aspect of L-arginine is that it stimulates the production of certain hormones, notably the beneficial human growth hormone and insulin, which help introduce glucose into cells for growth and energy output.
This is one of the reasons it is thought to improve physical performance, endurance and strength.
L-arginine differs from arginine vasopressin (AVP), an antidiuretic hormone in humans and most mammals that promotes water reabsorption and increases blood pressure.
Research shows that the benefits of L-arginine include:
fight inflammation
Reduce the risk of hardening of the arteries and heart attack
repair blood vessels
Fights Congestive Heart Failure and Coronary Artery Disease
Help lower high blood pressure
Improve athletic performance and high-intensity exercise endurance
boost immune function
Reduce muscle pain (especially in the legs caused by blocked arteries)
Improve kidney function
Improve mental ability
fight dementia
Corrects impotence, erectile dysfunction and male infertility
Prevent the common cold
To gain a deeper understanding of L-arginine's function, it helps to understand how nitric oxide (NO) works in the body.
Nitric oxide is a natural reactive gas produced by both plants and animals. It is produced using L-arginine and nitric oxide synthase (which makes L-arginine its precursor) and is actually a by-product formed from many different chemical reactions.
Endothelial cells (the cells inside all blood vessels) need L-arginine to form enough nitric oxide to keep blood flowing freely.
Nitric oxide improves circulation by dilating blood vessels, so when people don't have enough blood in their arteries, they have a higher risk of heart disease.
NO keeps your blood pressure levels within the normal range by signaling the muscles in your blood vessels to relax, dilate, and let blood pass, while also preventing the formation of blood clots and plaque.
Research shows that as he or she ages, his or her ability to produce enough NO in the lining of the arteries decreases. Fortunately, getting more L-arginine through arginine supplementation or dietary arginine can help boost nitric oxide capacity and correct impaired endothelial function.
However, the benefits of L-arginine go beyond producing NO to aid circulation. As you'll see, it plays an important role in nerve signaling, cell replication, and fighting oxidative stress that leads to disease and signs of aging.
Benefits of L-Arginine

1. Improves Heart Health

Studies have shown that L-arginine helps reduce inflammation and improve the health of the cardiovascular system, which is why oral L-arginine supplements are some of the most popular types recommended by cardiologists.
For people with high risk factors for coronary heart disease, these supplements can be an effective way to prevent heart attack or stroke.
Some of the ways L-arginine improves cardiovascular health include:
May help prevent high blood pressure (although overall results are mixed)
Improve blood flow in people with blocked arteries (coronary artery disease)
Lower cholesterol and triglyceride levels
Help relieve congestive heart failure
Improve stamina
Reduce symptoms associated with interruption of blood flow from the heart to the extremities (called lameness)
Lower fasting blood sugar
It is also commonly used to treat chest pain (angina) because nitric oxide works to prevent blood clots (thrombosis) from cutting off the blood supply. Some studies suggest that supplementing with two to three grams of L-arginine daily can resolve nitrate intolerance in most people with angina.
Finally, arginine can safely improve exercise performance in people with low endurance, circulation problems, and a history of heart disease.

1. Reduces inflammation and fights the effects of aging

Aside from heart health, one of the main benefits of L-arginine is fighting disease-causing inflammation and boosting immune function.
Due to its action on an enzyme called superoxide dismutase (SOD) as well as other antioxidant mechanisms, it has been found to have substantial free radical scavenging abilities. Often used in combination with antioxidants like vitamin C and omega-3 fish oil supplements, it helps slow the aging process and prevent many chronic diseases.
L-Arginine also positively affects central nervous system and immune system function, as in the brain, NO acts as a neurotransmitter and protector against external threats.
It helps detoxify the body and can even reduce ammonia levels in the blood, which is why it is sometimes used to treat people with metabolic problems and damaged urinary tracts, where ammonia is excreted from the body. Ammonia (ammonium hydroxide) is a product of the body's breakdown of proteins and is one of the causes of tissue necrosis that leads to cell destruction and inflammation.

1. Improves Athletic Performance, Strength, and Recovery

L-arginine is known to be effective at improving blood flow, which means it helps bring nutrients and oxygen to muscle and joint tissue. This means that with the help of L-arginine, you can enjoy more of the benefits of exercise, possibly at a higher intensity and with less pain.
It can increase heat and circulation in damaged joints or cold hands and feet, especially in people with complications from other health conditions, such as poor blood flow, arthritis, or diabetes.
Some studies show that it improves walking distance and reduces muscle soreness, including in people with intermittent claudication (narrowing of blood vessels in the legs and feet caused by fat deposits).
It is used by the body to increase the production of human growth hormone, prolactin and several amino acids - including creatine, L-proline and L-glutamic acid.
Studies have shown that arginine can improve glucose tolerance and sensitivity to insulin, just like exercise, by allowing more glucose to enter cells.
L-arginine's role in metabolic health is important for building strong muscle tissue, fighting inflammation that causes bone and joint pain, repairing damage, and general nervous system function.
It has also been shown to help increase fatigue time in athletes and increase tolerance for high-intensity exercise.
There is also evidence that it may aid in bodybuilding, athletic performance and increase muscle mass. Some research suggests that supplementation can increase plasma insulin and help build stronger muscles, even when you're resting because of its effects on your body's capillaries. These hormonal changes affect your metabolism in a positive way by helping to repair, build and maintain the youthful foundation of your musculoskeletal system.
Some studies have found that taking 5 to 9 grams of L-arginine supplements daily can significantly increase growth hormone levels.
In most cases, arginine increases resting HGH levels by at least 100% (by contrast, regular exercise increases HGH levels by 300% to 500%). Even more powerful is the combination of L-arginine plus exercise.

1. Improve immunity, help prevent infection and speed up healing

Low circulating L-arginine has been found in some patients with disease, trauma and cancer. It is thought that certain immune system suppressor cells, known as MSCs, may cause arginine deficiency or low levels of circulating in the blood.
This is problematic because the immune system's protective lymphocytes and T cells rely on arginine to protect the body.
L-arginine, used with omega-3 fish oil and other supplements, can reduce the risk of infection (especially respiratory infections or lung problems), improve wound healing, and reduce recovery time after cancer, disease, or surgery.
It is sometimes added to topical ointments used to treat wounds for the following reasons: it helps keep blood flowing more freely, fights pain and swelling, forms L-proline, which is important for collagen synthesis in the skin, and increase antioxidant activity.
It's also used to improve protein function, help heal burns, and may even help fight tooth decay and tooth decay. Although more research is still needed, because of its immune-boosting properties, L-arginine is commonly used in people cured of chemotherapy or surgery, viruses and infections, including HIV.

1. Helps Treat Erectile Dysfunction and Infertility

What is the role of L-arginine in sex? Numerous studies have shown that in addition to enhancing blood circulation, L-arginine is also involved in the proper cellular replication process.
This means that the benefits of arginine for men include improved sperm production and motility.
Men who deal with cardiovascular problems related to low levels of nitric oxide in the blood are more likely to experience erectile dysfunction and fertility problems because erection requires smooth muscle relaxation triggered by nitric oxide. While not effective for every man, studies have shown that a high percentage of male infertility cases (up to 92% according to some studies) can be treated with L-arginine supplementation in combination with other dilators, antioxidants or anti-inflammatory drugs combination therapy.
Some studies have shown that high stress levels can reduce the presence of L-arginine in the sperm production pathway, so stressed men in particular may benefit from supplements.
The combination of L-arginine, L-glutamic acid, and yohimbine hydrochloride is commonly used to treat ED and appears to be more effective than L-arginine alone. In fact, many of the most commonly prescribed ED medications work similarly to L-arginine by increasing nitric oxide production.
The standard arginine dose for the ED is about 3 to 6 grams per day (divided into two doses).
Even women can get better reproductive help from L-arginine - doctors sometimes prescribe topical creams containing this amino acid to help heal sexual problems and naturally treat infertility in both sexes because it Can improve the circulation of genital tissues.
In addition, there is some research showing that simultaneous treatment with N-acetylcysteine (NAC) and L-arginine can help naturally balance hormones and restore normal sexual function in women with PCOS and estrogen imbalances .
Other studies have shown that L-arginine when used with herbs such as chaste berries, green tea extract, and antioxidant supplements can improve pregnancy rates in women who have difficulty conceiving.
Risks, Side Effects and Interactions
While it's generally safe, there are some potential L-arginine side effects to be aware of, considering it's a natural amino acid. If you have a history of heart disease, low blood pressure, diabetes, kidney problems, or an active virus (such as herpes or shingles), it is not recommended to consult your doctor before taking supplements.
There is some research suggesting that taking arginine supplements after a heart attack can be dangerous. Because this supplement has the potential to cause complications in people with a history of heart disease, avoid taking arginine supplements if this applies to you.
Is L-arginine safe to take daily? It is harmless to consume it from natural food sources, but high daily doses may complicate your condition, especially if you are taking other medications or a range of supplements.
Discuss with your doctor what dose might be most beneficial to you and whether you should be concerned about adverse effects based on your current situation.
If you are generally healthy and take a dose of about 1 gram per day, you may still experience short-term side effects such as abdominal pain, bloating, diarrhea, gout, worsening allergies or asthma, and low blood pressure.
This supplement also has the potential to cause allergic reactions or increase swelling of the lungs and airways, so people with allergies or asthma should use L-arginine with caution.
Lastly, L-arginine appears to be safe for pregnant women and even children, although there isn't much research into the effects in these populations, so it's best to stick to a low dose or seek medical attention.
top food
Everyone produces some L-arginine on their own, but how much depends on factors such as your age, inflammation levels, heart and arterial condition, gender, diet quality, and genetics.
Some reasons some people may not be producing optimal levels of L-arginine include:
Eat a vegetarian/vegan diet low in complete protein sources
Difficulty in protein metabolism due to indigestion
High levels of oxidative stress caused by free radicals (due to diet, stress or pollution)
smokes
genetic factors
Which foods are high in arginine? Essentially, any food high in protein will provide some L-arginine, but denser protein sources are best.
To help your body make and use more L-arginine and nitric oxide naturally, focus on a diet based on whole, real foods—especially "clean" protein sources that provide full Orientation of amino acids.
Complete proteins are the most beneficial because they provide not only L-arginine, but all the other acids needed to aid muscle tissue growth and proper neurotransmitter function.
Wild fish such as nutrient-dense salmon are an especially good choice because, in addition to L-arginine, it provides anti-inflammatory omega-3 fatty acids that further help maintain cardiovascular health.
If you are a plant-based dieter or have symptoms of lactose intolerance, other ways to get more L-arginine in addition to animal protein include eating nuts, seeds, coconut products, sea vegetables, or whole grains and legumes in moderation .
Some of the top arginine-rich foods include:
cage free eggs
Dairy products, such as fermented yogurt, kefir, and raw cheese (choose organic and raw dairy when possible)
Grass-fed beef or meat and pasture-raised poultry (including turkey and chicken)
Liver and organ meats (such as chicken liver pate)
wild caught fish
sesame seeds
pumpkin seeds
sunflower seeds
Seaweed and Sea Vegetables
Spirulina
Brazil Nuts
Walnut
almond
coconut meat
Supplementary dose
While it's always best to get your nutrition from natural food sources whenever possible, L-arginine is also sold as an over-the-counter and prescription drug, including capsule/pill form and L-arginine powder.
This amino acid is considered "semi-essential" because many people get enough of it from their diet alone.
Doctors sometimes prescribe high doses of L-arginine and other supplements for a variety of ailments, including heart disease, migraines and infections, and even for the side effects of diabetes, HIV or cancer.
Other supplements often used with arginine include citrulline, ornithine, and arginase. Arginase converts L-arginine into L-ornithine and urea, and agmatine is a chemical that is naturally produced from arginine.
The recommended dosage of an L-arginine supplement depends largely on the condition it is used to treat.
For example, to help with heart disease or erectile dysfunction, 3 to 6 grams per day can be taken (in two doses), while to improve athletic performance, doses of up to 9 grams per day are not uncommon.
For generally healthy adults looking to prevent inflammation and benefit from improved circulation, the usual recommended dose is about one gram (1,000 mg) per day.
Higher doses obviously come with more risk of side effects—plus, some studies suggest that more isn't always better when it comes to L-arginine's function within blood vessel walls.
final thoughts
L-arginine is an amino acid that we get from our diets, especially animal sources of protein foods, including beef and other types of red meat, poultry, fish, eggs, and dairy.
Studies have shown that arginine benefits heart health, reduces inflammation, combats the effects of aging, improves exercise performance, boosts immunity, helps prevent infections, speeds healing, and helps treat erectile dysfunction and infertility.
Everyone produces some L-arginine on their own, but how much depends on factors such as your age, inflammation levels, heart and arterial condition, gender, diet quality, and genetics. Some reasons some people may not be able to produce optimal levels of L-arginine include eating a vegetarian/vegan diet, inadequate sources of complete protein, poor digestive health that leads to difficulties in protein metabolism, high levels of oxidative stress caused by free radicals stress (due to diet, stress or pollution), smoking and genetics.
To help your body make and use more L-arginine and nitric oxide naturally, focus on a diet based on whole, real foods—especially "clean" protein sources that provide full Orientation of amino acids.
https://www.arshinefood.com/detail/Industry%20Information/What%20is%20L-Arginine.html

Hello! I’m currently experiencing some weird symptoms (praying it doesn’t stay).. I’m not sure if it’s due to physical activity in general or repeated head movement (up and down, left and right), but I’ve been having the feeling of having ran a marathon (like the want to take more breath, feeling winded and this slight fatigue disoriented sensation in your head - when you are tired after vigorous exercise) when I clean the house (so lots of bending over, etc), walking to the mall (lots of turning round corners, slight incline, small stairs)... It goes away if I pause for short moments but then come back when I move again..
Has anyone experienced this before? Just wanted to ask so that I have an idea of what could be the problem.. Could cervical issue cause such symptoms? Or could neurogenic claudication affect?
p.s I don’t have POTS Ö

22M
Height: 175 cm/ 5'9"
Weight (last time I checked): 80kg, slightly overweight
Current Location: England
Hello,
For the longest time, I have struggled with foot and leg pains after a short duration of walking. I haven’t exercised for a few years now and I’m very out of shape. However; from my understanding it’s quite rare to have issues with claudication at such a young age. Here’s the kicker tho, I have been diagnosed with hypertension. I even did a 24hr blood pressure monitor to prove it.
I was diagnosed with hypertension during my in patient stay when I was also diagnosed for Rhabdomyolysis after lifting too hard at the gym at the start of the 2022 year. While I was diagnosed by an internal medicine doctor, my primary care doctor told me I DIDN’T have hypertension when reviewing my 24 hour monitor results.
I feel this is because I had already started blood pressure medication prior to doing the monitor so it affected results. I also suffer from severe anxiety which could be the true cause of my constant blood pressure problems but understandably it’s hard to confirm. I get nervous from absolutely everything no matter how minor especially when I’m driving.
Sorry for the long post but I just wanted to be as transparent as possible. Is there a possibility that I could be suffering from atherosclerosis at such a young age if I already suffer from hypertension?
Thank you.

I had L3-4, L4-5 stenosis and had decompressive Laminectomy on L3-4, L4-5. This is what the Dr said in medical report: Decompression performed by first resecting midline spinous process and lamina of L4 and portion of L3 and the superior portion of L5. Significant stenosis at L3-4. Able to decompress L4 nerve root all the way to the foramen. L5 nerve roots were decompressed bilaterally.
The pain that used to be there is gone but not all. My feet still feels strangely stiff and some weakness in knee and heel area of foot.. Walking is no problem but if I use a SI Joint belt it helps a lot. Could it be leg claudication after laminectomy which readings suggest but not sure. Another post X-Rays shows everything is fine as the surgeon says. Ideas what is going on? I do not want to go for another surgery which I think is probably fusion but the doctor said it is not necessary. I also read doing lunges or certain forms of exercise might do worst than improve. Ideas (spinal decompression or what can help)

When You Have a General Ache, Overuse is generally the source of muscle discomfort that affects only a limited region of your body, such as aching arms from lifting boxes all day. Usually whenever someone feels a pain or discomfort they want Immediate Pain Relief. Overuse of muscles might also lead to a small injury, such as a bruised shoulder after a tumble. When you have a generalised soreness, it is more likely to be the result of an infection, disease, or medication you've taken. If you feel discomfort in your arms, legs, or both, your muscles may be receiving insufficient blood, a condition known as claudication. At first, you may only experience it while you exercise, but over time, you may notice it whether you sit or stroll. This is commonly caused by a condition known as arteriosclerosis, which occurs when there is a blockage in the arteries.
This occurs when your thyroid gland fails to produce enough of certain important hormones. It can cause muscular and joint pain, swelling, and discomfort. It can cause fatigue, cognitive difficulties, thinning hair, dry skin, elevated cholesterol, slower heart rate, and other problems. If you have it, your doctor can do a simple blood test to determine if you have it, and if so, medications can help replenish the missing hormones. When a flu virus strikes, it causes fever and congestion, as well as muscular aches, particularly in the back, legs, and arms. It normally goes away on its own within a week or so, but if it doesn't, see your doctor or Use Tanyx , the best knee pain relief device. Certain drugs and therapies have the potential to induce transient or persistent discomfort. Some medications promote inflammation surrounding muscle cells (myositis) or activate pain receptors in the muscles. That is why we propose Tanyx, the quickest pain relief gadget that works in just 20 minutes. It is one of the most cost-effective Immediate Pain Relief devices. T.E.N.S Therapy includes physically stimulating the pain location in order to change the pain signals that are sent to the brain, resulting in a Pain Relief Experience. Tanyx has received approval from the US FDA, CE, ANVISA Brazil, and UL. Tanyx has also undertaken several clinical investigations that have been published in the world's premier medical journals. Buy Tanyx today and say goodbye to all muscle or joint pain issues.

Early period: Puppies do not like sports and become lazy. The owner who observes carefully will find that animals sometimes make rabbit jumps;
Mid-term: Symptoms such as hyperextension of the ankle, rupture of the cruciate ligament of the knee joint, and painful claudication of the forelimb. Once degenerative arthritis occurs, painful symptoms will begin to appear
Later period: Symptoms of shifting the body's center of gravity to the forelimbs occur. At this time, the sick dog will have the head and neck stretched or bowed during exercise, and the forelimbs will be used for weight-bearing. When the animal moves, the swing amplitude of the hind limbs, especially the thighs, decreases, and the distance between the feet is shortened. After the animal moves, obvious symptoms of pain will appear.
Do you have any better suggestions for relieving symptoms?

Spinal stenosis is defined as a narrowing of the spinal space and/or compression of the spinal cord and nerve roots as they exit each vertebra. A common cause is changes in your spine as you age. Back and/or neck pain, as well as numbness, tingling, and weakness in the arms and legs, are symptoms.
What is spinal stenosis?
Spinal stenosis refers to the narrowing of one or more sections of your spine. The amount of space available to your spinal cord and nerves spreading off it is reduced. As a result of the narrowed space, the spinal cord or nerves may become inflamed or pinched, causing back pain and claudication pain known as neurogenic claudication.
Spinal stenosis usually develops over a long period of time, especially beyond the age of 50. The most prevalent cause is osteoarthritis, or “wear and tear” changes in the spine that occur naturally as people age. As a result, if certain changes are detected on X-rays or other imaging tests done for a different reason, you may not experience any symptoms for a long time.
To get proper treatments for spinal stenosis visit Pentagon Hospital, which has the best brain and spine Surgeon in Aurangabad.
What parts of the body does spinal stenosis affect?
Spinal stenosis can affect any section of the spine, however it most commonly affects two:

• Neck (cervical spinal stenosis)
• Lower back (lumbar canal stenosis)

Who has spinal stenosis affected?
Although anybody can get spinal stenosis, it is most common in men and women over the age of 50. Younger people who were born with a narrow spinal canal can develop spinal stenosis. A range of illnesses that affect the spine, such as scoliosis or a spinal injury, can induce spinal stenosis.
Spinal stenosis can be caused by a variety of factors.
Spinal stenosis can occur for a variety of reasons. They all have one thing in common: they change the structure of your spine, narrowing the space around your spinal cord and the nerve roots that exit through it. Symptoms such as low back pain and sciatica are caused by compression or pinching of the spinal cord or nerve roots.
The causes are:

• Bulging disks/herniated discs: the vertebral disc is a flat, circular cushioning pad that rests between each vertebra and acts as a stress absorber along the spine. Due to age-related drying out and flattening of vertebral discs, as well as cracking in the exterior border of the discs, the gel-like centre of these discs breaks through a weak or damaged outer layer. The bulging disc then compresses the nerves near the disc.

Herniated discs and bone spurs usually induce spinal stenosis by narrowing the spinal and neural foramina.

• Ligaments have thickened, which means the fibre bands that hold the spine together have thickened. As a result of arthritis, ligaments might expand and bulge into the spinal canal space (and can cause lateral recess syndrome)
• Spinal stenosis is frequently caused by both disc prolapse and ligament and facet enlargement.
• Damage to the spine can cause inflammation, which might narrow the canal space or put pressure on the nerves.
• Bone overgrowth/ arthritic spurs: Osteoarthritis is a “wear and tear” condition in which cartilage in your joints, including your spine, breaks down. Cartilage is the protective layer that covers joints. When cartilage is lost, the bones begin to rub against one another. Your body responds by making more bone tissue. Bone spurs, also known as bone overgrowth, are very frequent.

Vertebral bone spurs extend into the spinal canal, constricting space and squeezing nerves.
Spinal stenosis symptoms include:
1. Lower back (lumbar) spinal stenosis:

• Lower back pain is a very prevalent condition. Pain can range from a minor ache or discomfort to a burning or electrifying sensation. Pain is natural and will come and go.
• Sciatica is a type of pain that begins in the buttocks and travels down the leg, possibly into the foot.
• Leg cramps in one or both legs owing to a heavy sensation in the legs after walking for a short period of time in the beginning, later phases even a few steps might cause leg pain ( neurogenic claudication)
• Numbness or tingling in the buttocks, leg, or foot (sometimes known as "pins and needles") is a common symptom.

2. Neck (cervical) spinal stenosis:

• Neck pain
• Numbness or tingling in the arm, hand, leg, or foot. (Symptoms can appear anywhere below the location of nerve compression)
• Weakness or clumsiness in an arm, hand, leg, or foot.
• Instability of the body's balance.
• Hand dysfunction, such as difficulties writing or buttoning clothing.
• Control issues with the bladder or bowels (in severe cases)

3. Abdomen (thoracic) spinal stenosis:

• There is pain, numbness, tingling, or weakness at or below the level of the abdomen.
• There are issues with equilibrium.

Diagnosis
Neuroimaging – MRI to see the degree of canal stenosis and disc herniation; X-rays to see the slide vertebrae and spondylolysis
Treatment
If your spine is showing, Medically, mild to severe canal stenosis and isometric spinal exercises will often suffice.
Surgery to relieve the compression is recommended in severe situations.
Our expert Brain and Spine Surgeon in Aurangabad provides consultation and treatment to all neuro problems.

22M Do I have Intermittent Claudication/PAD
I recently moved countries to further my studies and have noticed cramping on the side (anterior) of both my lower legs when walking long distances or uphill. The pain gets worse with more exertion and stops when I rest, which a symptom of claudication. I also had this pain back at home but only after strenuous exercise. I do not smoke, casually drink and am not overweight. I have increased my physical activity significantly since moving here (a lot of walking) as I was pretty much just resting at home for the past 2 years due to lockdowns.
As I am alone in a foreign country, it is quite worrying to read about the consequences of PAD so I would really appreciate any insight.

Hematocrit peaked at 47.5 this year. (Normal high range is 44)
Currently Ferritin is 9. (Normal range 16-165)
37f. Af Am. 5’9. 140lbs.
Problems.
Persistent headache. Severe abdominal pain. Raynauds without spasm - hands stay cold. Severe chest pain. Abnormal EKG (compared to previous) w/t wave inversions. Intermittent claudication with 0.7 ABI post exercise. Paresthesias. Sudden high blood pressure since my hematocrit went out of range. Fatigue. Night sweats. Sudden high blood pressure when hematocrit went up to 46. 12 yrs ago, retinal detachment left and tears/holes both eyes retina surgeon can be signs of microvasculahematology issues.
Meds.
Continuous BCP 12 years bc of heavy bleeding. Amlodopine off label for poor circulation in legs/hands.
Saw a hematologist and they declined to test for JAK2 mutation for polycythemia Vera because hematocrit wasn’t that high and EPO was low normal 3.2.
Unlikely sleep apnea. Live at 100ft above sea level. Don’t smoke. Changed houses since hematocrit started climbing years ago, so carbon monoxide unlikely. Drink a gallon of water daily. 3 cardiologists say I do not have a heart or cardiopulmonary problem. Entire body has been imaged neck down for large vessel blockages. Neurologist did EMG and entire spine has been imaged for paresthesias. All normal.
Should I continue the endless investigations? I have GI, rheumatology appts scheduled.
See hematology ASAP?
Take an iron supplement and see if I feel better?