Q:I have pain in my calves when I walk a short distance or up a few stairs. My practitioner says it’s artery clogging, which needs medications or surgery. Are there any natural treatments?

A:It seems as though your practitioner is talking about peripheral artery disease, or peripheral vascular disease (PVD), which is often treatable and sometimes reversible. It affects more than 8 million people in the United States, especially those over the age 60 and those who smoke, have diabetes, have high blood pressure, and are sedentary. Establishing a firm diagnosis will likely include some combination of laboratory tests, functional tests, and imaging.

If PVD is confirmed, you should know that your risk of stroke and heart attack will also be high, since it develops through the same process. Depending upon the severity of your condition, you may be able to use lifestyle approaches to relieve symptoms and reverse or slow the progress of the hardening of the inner lining of your arteries and the development of “scarring” of the arterial walls (plaque). But while lifestyle improvement is absolutely essential, it may be insufficient.

When the lining cells function properly, they produce nitric oxide (NO). NO is very potent in widening the capacity of arteries and improving circulation. Systemic inflammation, psychological stress, weight gain, high bad cholesterol, high blood pressure, diabetes, and smoking all promote malfunction of this normal process. Consequently, stress management, weight loss, smoking cessation, and active physical exercise may all contribute to your improvement or even help you avoid surgery. Please follow the recommendation for your treating physician. But get a second opinion, as treatment may necessitate surgical or balloon interventions to reestablish healthy circulation and avoid unnecessary loss of a limb.

Once diagnosed, stop smoking or using any tobacco product that you may now be using. If you have diabetes, high blood pressure, high cholesterol, or high triglycerides, get it (or them) under control by becoming actively involved in your own care. Take special care of your feet, which are at risk of gangrene. If you have diabetes, get your HbA1C, an indicator of blood sugar control, to the recommended level, since levels greater than 8.0 are associated with blood vessel complications in the eyes, heart, brain, and kidneys, as well as the legs.

Get active. A progressively more intense, daily walking schedule may reduce calf pains and increase the distance you can walk without pain. Consult your doctor about your heart disease risk, and get a recommendation for a safe starting point. If you smoke, stop! If you’re overweight, try to get lean and maintain a healthy weight. Check your blood pressure regularly and, if high, get it to safe levels. Eat more healthfully, and choose foods that help normalize nitric oxide levels and response in cells lining the arteries. Foods high in flavonoids, such as cocoa, walnuts, berries, and grapes, have been shown to help to some degree.

Prayerfully consider your situation and all options, and by God’s grace, do your best.

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.