Vascular Diseases and Pain

Medically Reviewed by Jennifer Robinson, MD on September 19, 2023
5 min read

As your heart beats, it pumps blood through a network of blood vessels called the circulatory system. The vessels are flexible tubes that carry blood to every part of your body. Arteries carry blood away from your heart, while veins return it.

Vascular diseases include any condition that affects your circulatory system. This includes diseases of your arteries and veins. Vascular pain happens when the communication between blood vessels and nerves is interrupted or damaged because of vascular disease or injuries.

These vascular diseases may cause pain:

Raynaud's phenomenon consists of spasms of the small arteries of the fingers and sometimes the toes, brought on by exposure to cold or stress. Certain occupational exposures bring on Raynaud's. The episodes produce a temporary lack of blood supply to the area, causing the skin to appear white or bluish and feel cold or numb. In some cases, the symptoms of Raynaud's may be related to underlying diseases such as lupus, rheumatoid arthritis, and scleroderma.

Buerger's disease most commonly affects the small- and medium-sized arteries and veins. Although the cause is unknown, there is a strong association with tobacco use or exposure. The arteries of the arms and legs become narrowed or blocked, causing lack of blood supply (ischemia) to the fingers, hands, toes and feet. Pain occurs in the arms, hands and, more frequently, the legs and feet, even when at rest. With severe blockages, the tissue may die (gangrene), requiring amputation of the fingers and toes.

Superficial vein inflammation and symptoms of Raynaud's occur commonly in people with Buerger's disease.

Veins are flexible, hollow tubes with flaps inside called valves. When your muscles contract, the valves open and blood moves through the veins. When your muscles relax, the valves close, keeping blood flowing in one direction through the veins.

If the valves inside your veins become damaged, the valves may not close completely. This allows blood to flow in both directions. When your muscles relax, the valves inside the damaged vein(s) will not be able to hold the blood. This can cause pooling of blood or swelling in the veins. The veins bulge and appear as ropes under the skin. The blood begins to move more slowly through the veins, it may stick to the sides of the vessel walls and blood clots can form. The condition is called peripheral venous disease (PVD) and causes symptoms that include leg heaviness, pain, and skin changes.

Peripheral vascular disease (PVD) or peripheral arterial disease (PAD) is sometimes called “poor circulation.” It usually refers to the narrowing of arteries in the legs, causing less blood flow to the muscles. PAD can also affect the arms, stomach, and neck. It is caused by atherosclerosis of the arteries (cholesterol plaques causing hardening and narrowing of the artery) due to high cholesterol, diabetes, smoking, high blood pressure, inactivity, and obesity. The most common symptom of PAD of the legs is claudication, which is pain while walking that’s relieved with rest. You may also feel cramping or a tiredness in the leg or hip muscles while walking.

Another form of PAD involves the blood vessels leading to the kidneys. It can be caused by atherosclerosis, or it may be something you’re born with. The symptoms include uncontrolled high blood pressure, heart failure, and unusual kidney function.

Varicose veins are bulging, swollen, purple, ropy veins, seen just under your skin, caused by damaged valves within the veins. They are more common in women than men and often run in families. They can also be caused by pregnancy, being severely overweight, or by standing for long periods of time. The symptoms include:

  • Bulging, swollen, purple, ropy, veins seen under the skin
  • Spider veins -- small red or purple bursts on your knees, calves, or thighs, caused by swollen capillaries (small blood vessels)
  • Aching, stinging, or swelling of the legs at the end of the day

Blood clots in the veins are usually caused by:

  • Long bed rest or immobility
  • Damage to veins from injury or infection
  • Damage to the valves in the vein, causing pooling near the valve flaps
  • Pregnancy and hormones (such as estrogen or birth control pills)
  • Genetic disorders
  • Conditions causing slowed blood flow or thicker blood, such as congestive heart failure or certain tumors

There are many types of blood clots that can occur in the veins:

  • Deep vein thrombosis (DVT) is a blood clot in a deep vein.
  • Pulmonary embolism is a blood clot that breaks loose from a vein and travels to the lungs.
  • Chronic venous insufficiency isn't a blood clot, but a condition that occurs when damaged vein valves or a DVT causes long-term pooling of blood and swelling in the legs. If uncontrolled, fluid will leak into the surrounding tissues in the ankles and feet, and may eventually cause skin breakdown and ulceration.

An aneurysm is a bulge in the wall of a blood vessel. They can form in any blood vessel, but aneurysms are most common in the aorta (aortic aneurysm), which is the main blood vessel leaving the heart. The two types of aortic aneurysm are:

  • Thoracic aortic aneurysm (part of the aorta in the chest)
  • Abdominal aortic aneurysm

Small aneurysms generally pose no threat. But aneurysms increase your risk for:

  • Atherosclerotic plaque (fat, cholesterol, and calcium deposits) formation at the site of the aneurysm
  • The potential for a clot (thrombus) to form at the site and then dislodge
  • Increase in the aneurysm size, causing it to press on nerves or other organs, causing pain
  • Aneurysm rupture (Because the artery wall thins at this spot, it is fragile and may burst under stress. A sudden rupture of an aortic aneurysm may be life threatening.)

Symptoms may include:

  • Pain or heaviness in the area affected
  • Numbness, weakness, or a tingling in the affected area

Therapies to treat vascular pain can include medications, angioplasty, or bypass surgery. Angioplasty is a procedure to reduce or eliminate blockages in blood vessels. In bypass surgery, surgeons take a segment of a healthy blood vessel from another part of the body and make a detour around the blocked blood vessel.

Doctors who specialize in pain management can sometimes help if other treatments don't work. For some people, nerve blocks and other techniques can reduce pain and improve circulation.