My Legs Are Tired -- Causes and Cures

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Last updated April 15, 2017, originally published September 30, 2014
By Susan Callahan, Associate Editor and Featured Columnist   

If there is one complaint that almost all of us have had at
one point in our lives, it is that our legs “feel tired”.  Tired
legs affect almost everyone over the age of 30.  But are
there any medical condition that we should be concerned
about that cause tired legs? It turns out, that there are.

Have you ever heard of peripheral arterial disease, also
called “PAD”?  If you have, count yourself as lucky.  About
75% of Americans are not aware of this  disease, according
to the Centers for Disease Control.  And yet, PAD just may
be the most important disease you’ve never heard of.

Between 12% and 20% of people over the age of 65 in the
US have peripheral artery disease, according to the Centers
for Disease Control.

PAD may be the answer to the question "why do my legs
hurt so much at night"?

Peripheral arterial disease puts someone who has it at a
significantly higher risk of death from heart disease, stroke
and deep vein thrombosis.  Moreover , if you have diabetes,
PAD makes it more likely that you will one day need an
amputation of one of both of your legs.

PAD often leads to a number of problems with your legs.
PAD is behind many complaints about tired legs, cramped
legs or painful legs.

These complaints can indicate a serious medical concern
caused by PAD called “claudification”.  Claudification occurs
when not enough blood reaches your legs to meet the
demands you are making on them.  

Here is a common situation where claudification occurs.
You haven’t exercised in a while. One day, you decide to
start, so you begin to take long walks or maybe even jog a
bit. But soon after you start, you experience painful cramps
in your calves.  You try to massage them away to no avail.
The cramps are too painful for you to continue and you
have to stop.

What Causes Tired Legs?

With peripheral arterial disease, the arteries that supply
your legs are narrowed or blocked by the build-up of
plaque. As a result of the narrow or blocked arteries, not
enough blood reaches your legs from your heart.  You
poor circulation, cold feet, painful legs or tired

Peripheral arterial disease puts you at much greater risk of
death within the 5 years after you are diagnosed. One
study conducted in 2008 by researchers at the University of
Oklahoma Health Sciences Center found that the average
rate of mortality from PAD after 5 years is 63%.  

The 10-year prognosis with PAD is also pretty grim. A 1993
study from the University of Pittsburg, Graduate School of
Public Health, found that having PAD after age 50 severely
reduces the chances that you will be alive in 10 years.

Men older than age 50 with PAD have a 10-year survival
rate of 39%. Women over age 50 with PAD have a 10 year
survival rate of only 35%. You get the picture --- avoid
PAD at all costs and treat PAD seriously if you have it.

How Do You Know If You Have PAD?

One of the simple tests for PAD is called the “ankle-brachial
test”. Here, your doctor or nurse measures your blood
pressure at your ankles and compares that to your blood
pressure at your arms. In a healthy person, the two
numbers are about the same. In a person with PAD, the
blood pressure at the ankle is much lower than the arm
blood pressure.

Detecting peripheral artery disease using ankle blood
pressure measurements ---
feeling your ankles --- is
recommended practice and is commonly done by geriatric
doctors in certain European countries such as France but
less often done here in the United States.

In fact, one of the ways I judge whether my doctor is a
good is whether they test my ankles. If your doctor is not
testing your ankle blood pressure, ask them to do it.

Here are the common symptoms of PAD

  • Pain in your lower legs when you exercise. Because it
    comes only when you exercise, this condition is called
    “intermittent claudification”.

  • Trouble walking. You may find that one or both of
    your legs get tired when you walk. You may
    experience cramping in your legs, thighs, feet or in
    your buttocks. Importantly, the pain disappears when
    you rest.

  • Impotence, in men.  Erectile dysfunction often occurs
    when there is a blockage in arteries feeding the lower

  • Shiny, smooth skin on your legs.

  • Loss of hair from your legs.

  • Sores on your legs that don’t heal.

  • Skinny legs, legs that have lost muscle mass.

  • Non-stop pain in your feet at night which goes away
    when you hang your foot out of the bed.

Sometimes, peripheral arterial disease has no symptoms at
all.  One of the reasons you may not have symptoms is that
you are too sedentary. Remember, pain in your calves only
mainly occurs when you exercise, climb stairs or put
demands on your legs in some way.  

Who Gets Tired Legs?

PAD affects 12 to 20% of people over the age of 60 in the
US, according to a 2013 report from the Centers for
Disease Control.

That would put the number of Americans affected at 8
million people.

In the UK, PAD affects between 4% and 12% of all people
between the ages of 50 and 70, according to the NHS.  

In Canada, estimates put the rate of PAD at 4% of all
Canadians over the age of 40, according to a 2009 study
led by Dr. Kenneth Harris of the University of Western
Ontario and Registered Nurse Marge Lovell of the London
Health Sciences Centre in Ontario, Canada.

And in Australia, the PAD affects between 10% and 15% of
all people over the age of 55, according to a 2004 study led
by Dr. Paul Norman of the University of Western Australia,
Fremantle Hospital.

Natural Remedies for Tired Legs

We have scoured research studies to ascertain natural
remedies for tired legs, especially where the tired legs are
caused by peripheral arterial disease:

Get Moving and Keep Moving.  Any form of exercise will
decrease your risk of dying from peripheral artery disease.
In the 2008 study led by Dr. Andrew Gardner from the
University of Oklahoma Health Sciences Center, researchers
studied 434 men and women with stable intermittent
claudification ---they experienced pain in their legs only
when they exercised. These patients included 299 who
were sedentary and 144 who were physically active.

At the end of 5 years, 108  of the patients had died.  But of
the 108 who had died, 88 of those were the ones in the
sedentary group. Only 22 of the physically active group had
died.   If you break it down by percentages,  the sedentary
ones made up over 80% of those who died, while the
physically active ones only made up less than 20% of those
who died.

The message is clear. Even if you have PAD, getting active
will increase your odds of living  longer.

How much exercise did the  “active” group do? Not much.
The researchers classified a patient as “active” if they did
less than an hour of regular physical activity each week.
That works out to just 8.5 minutes a day of activity.

Strengthen Your Hands, Calves and Knees to Combat
.  Here’s an interesting finding. A study in 2012 from
doctors at the Northwestern University Feinberg School of
Medicine found that PAD patients with stronger hand grips,
calf muscles and knee extensors lived longer.  

What explains this finding? Perhaps those PAD patients
who were in overall better physical shape to start with lived
longer. Or maybe, it means that if you build up your calf
muscles, hand grip and knee muscles you will somehow
slow or reverse some of the damage to your arteries from

More research is needed to answer this question. Bu , in
the meantime, it can’t hurt to strengthen your legs with
squats, your knees by doing balancing exercises such as Tai
Chi, and your hands by squeezing on a tennis ball. (Read
more about the
health benefits of squeezing a tennis ball-it
reduces high blood pressure.)

Get Thee to a Healthy Weight. I’m sure you saw this one
coming.  Studies have found that people who maintain
healthy body weights, even if they have PAD, experience
lower rates of death.  One study, for example, in 2012 also
from the Northwestern University Feinberg School of
Medicine discovered that PAD patients with more body fat
have  more fat in their calves relative to the calf muscle.
This deficit of muscle , it is speculated, is part of the reason
they were more likely to die from PAD.

Eat Flaxseeds. Studies with animals have suggested that
flax seeds could greatly benefit patients with PAD because
of its effectiveness in lowering blood pressure. People with
PAD often suffer from high blood pressure which leads to
and exacerbates the PAD.

One 2013 study from St Boniface Hospital Research Centre
in Manitoba, Canada found that patients who were fed
diets that contained 30 grams of flaxseed per day for 6
months saw their high blood pressure drop significantly.
Systolic blood pressure dropped 10 points on average and  
diastolic pressure dropped 7 points.

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