Poor circulation in feet

Something of great concern to many of my patients is poor circulation in feet. Certainly as we get older our circulation to the furthest part of our body can change and poor arterial circulation (the blood rich in oxygen coming from the heart) is more common. Diseases like diabetes and peripheral vascular disease can also affect circulation in the feet and smoking can reduce blood flow. The consequences of poor arterial circulation can be serious with pain, ulceration and even gangrene and amputation in some cases.

Assessing blood flow is an important part of any podiatrist’s work and Doppler is a great tool here. A Doppler machine is an ultrasound probe, Doppler ultrasound works by measuring sound waves that are reflected from moving objects, such as red blood cells. This is known as the Doppler effect. In the clinic I use a hand held doppler very similar

to the machine that is used to hear a baby’s heart beat when someone is pregnant. A water based gel is placed on points over the arteries of the feet which helps transmit the ultrasound waves which the machine amplifies so I can hear the flow of the blood.

This gives a very accurate picture of the blood flow and I can tell if the circulation is normal for the individual’s age or if it is poor or even if there is a blockage.

Although Doppler is important, it is only part of a vascular assessment, visual assessment and manual examination are also required. Questions about general health, activities and symptoms are also vital to create a complete picture of the vascular status of the feet and lower limb.

Diabetic patients should have a vascular assessment on an annual basis, and in my clinics this is included in routine care.

What happens if I do have poor circulation? Often patients simply require advice and reassurance, that may be specific advice on how to deal with symptoms or direct treatment for wounds, ulcers or more general advice on exercise and lifestyle. Occasionally it could involve onward referral for medication to help or even to a vascular surgeon for specialist intervention.

In my clinics vascular assessment is part of a routine appointment therefore no additional charge for this type of examination. I work in Javea, Calpe, Benissa, and Albir or why not come and visit the new clinic on the Moraira to Calpe coastal road.